APHTHOUS ULCER

Question 1

1. etiology
2. manifests after ___
3. Frequency of occurrence
4. May be secondary to ___
5. When in doubt?

Answer 1

“canker sores”

(1) Common and easy to recognize.
(2) Unknown etiology. Immune response thought to be associated with herpesvirus 6, but not viral or communicable.
(3) Manifests after malnutrition, disease, trauma, or stress.
(4) May re-occur several times a year, with some patients being more susceptible.
(5) Large or persistent areas may be secondary to erythema multiforme or drug allergies, acute herpes simplex, pemphigus, pemphigoid, epidermolysis bullosa acquisita, bullous lichen planus, Behcet disease, infamatory bowel disease, or squamous cell carcinoma.
(6) When in doubt, biopsy.

Question 2

Diagnosis of aphthous ulcer

Answer 2

(1) May have prodrome of burning or itching.
(2) ¼ to 6mm round ulcerations with yellow-gray fibrinoid centers surrounded by red halos.
(3) Found on non-keratinized tissue.
(4) Higher concentration under appliances.
(5) Painful, especially when aggravated by physical contact or spicy food.

Question 3

treatment of aphthous ulcer

Answer 3

(1) Self healing, 10-14 days.
(2) Treatment is nonspecific, and aimed at treating symptoms.
(3) Topical corticosteroids in an adhesive base do appear to provide symptomatic relief:
(a) triamcinolone acetonide, 0.1%
(b) fluocinonide ointment, 0.05%
(4) Thalidomide has been used selectively in recurrent aphthous ulcerations in HIV-positive patients.

Question 4

disposition of aphthous ulcers

Answer 4

retain on board