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A digital manual for the early diagnosis of oral neoplasia

Aphthous stomatitis  Search in Medline for Aphthous stomatitis

Aphthous stomatitis is a common benign condition of the oral cavity characterized by recurring painful solitary or multiple shallow ulcers covered by a yellowish or white pseudomembrane surrounded by an erythematous halo. Although various host and environmental factors have been implicated, the precise pathogenesis is not clear. Factors like stress, fatigue, food allergy and vitamin deficiency often precipitate this condition. The disease is classified into three clinical forms: minor, major and herpetiform. Minor aphthous ulcer is the most common form, which can be a single or multiple ulcers measuring less than 1 cm. These lesions usually heal in 10–14 days without any scarring. Major aphthous ulcer has the same clinical appearance as the minor, but is bigger than 1cm. They are extremely painful, usually take more than one month to heal, and cause scarring. The herpetiform variant appears as clusters of numerous small ulcers; this is the most severe form. They heal without scarring. The diagnosis is based on clinical findings. Most patients with aphthous ulcer do not require any treatment, but if the pain is severe, topical steroids can be tried.



Figure 1: Recurrent apthous stomatitis (yellow arrows) on the left lateral margin of the tongue. Note the extensive white coating due to fungal infection on the dorsum of the tongue (red arrow).
Figure 2: Recurrent apthous stomatitis. Note the shallow ulcer on the left buccal mucosa with surrounding erythematous mucosa.
Figure 3: Recurrent apthous stomatitis. Note the ulcer on the right lateral margin of tongue.
Figure 4: Recurrent apthous stomatitis. Note the multiple, oval ulcers on the left buccal mucosa in this 35–year-old male.
Figure 5: Major aphtous ulcer (arrow). Note the 1.5x1.5 cm ulcer that has been on the lower lip of this 28–year-old man for one month.
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