RAS key points Flashcards

1
Q

definition

A

recurrent episodes of oral ulceration in an otherwise healthy individual

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2
Q

onset

A

often childhood/adolescence, natural history to improve with age

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3
Q

prevalence

A

5-25%

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4
Q

predisposing factors

A
genetic predisposition
drugs - NSAIDs, nicorandil
nutritional deficiencies
stress
smoking cessation
chemicals - SLS
food allergies
trauma
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5
Q

clinical appearance

A

round/ovoid
yellow/whitish floor (fibrin)
erythematous halo on non-keratinised mucosa

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6
Q

prodrome S+S

A

itching
burning
stinging
erythema

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7
Q

minor

A
<10mm
<10 lesions
round/oval
shallow
no scar
10-14 days duration
75-90% RAS
non-keratinised
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8
Q

major

A
>10mm
1-5lesions
deep, can scar
>14 days duration
10-15% RAS
keratinised/non-keratinised
oval/irregular
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9
Q

herpetiform

A
<5mm (pinpoint)
multiple >10
shallow, no scar
10-14 days duration
5-10% RAS
NK mucosa
round/oval, often coalesce
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10
Q

systemic diseases that can cause ROU

A
Behcet syndrome
Reactive arthritis (reiter's syndrome)
MAGIC syndrome
cyclic neutropenia
PFAPA syndrome
aphthous like ulcerations of HIV
haematinic deficiencies
coeliac disease
IBD (UC, Crohns)
SLE
H pylori
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11
Q

how is diagnosis made?

A

clinical - no biopsy required

but can mimic lots of conditions so need thorough work up

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12
Q

causes of ulceration (not just RAS)

A
trauma
ROU
 - non-aphthous - LP, viral, vesiculobullous
 - RAS
 - Behcet
 - Reiter syndrome
carcinoma
infections
GI 
drugs
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13
Q

overall management

A

identify and correct predisposing factors
identify possible systemic disease
medical management

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14
Q

tx

A
mouthwashes
 - CHX, benzydamine
topical steroids
 - hydrocortisone, triamcinolone, fluocinolone, beclomethasone, betamethasone
systemic medication
 - prednisolone
 - azathioprine
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15
Q

potential problems

A

infection

dehydration

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