Recurrent aphthous/ aphthous like stomatitis

Question 1

what is Bechets disease

Answer 1

at least 3 episodes of apthous ulceration in past 12 months and at least 2 of the following:
- recurrent genital ulceration
- eye involvement
- skin lesions
- positive pathergy test

Question 2

what is pathergy

Answer 2

a skin condition in which a minor trauma such as a bump or bruise leads to the development of skin lesions or ulcers that may be resistant to healing

Question 3

what is erythema nodosum

Answer 3

a condition that causes painful patches of skin that look red or darker than the surrounding skin.

Question 4

management of recurrent aphthous stomatitis if asymptomatic

Answer 4

no tx required

Question 5

management of recurrent aphthous stomatitis if symptoms

Answer 5

match tx to symptom severity

Question 6

manangement options for recurrent aphthous stomatitis

Answer 6

SLS free toothpaste
topical analgesic
topical steroid
diet modification - consider benzoate and cinnamon avoidance

Question 7

topical analgesics

Answer 7

• benzydamine mouthwash 0.15% or oromucosal spray 0.15%
• Lidocaine ointment 5%
• Lidocaine spray 10%

Question 8

antimicrobial mouthwashes

Answer 8

-chlorhexidine gluconate mouthwash
-dispersible doxycycline tablet, as mouthwash

Question 9

topical steroids

Answer 9

• betamethasone soluble tablets 500 micrograms (as a mouthwash)
• Clenil modulie 50 micrograms per metered inhalation (beclometasone
  diproprionate)
• hydrocortisone oromucosal tablets

Question 10

triple mouthwash given in secondary care components

Answer 10

Betamethasone 500microg soluble tablet, doxycycline 100mg dispersible tablet, nystatin suspension
1ml in 10 to 15ml water

Question 11

systemic medication given in secondary care for management of recurrent apthous stomatitis

Answer 11

• short course of prednisolone
• colchicine
• disease-modifying antirheumatic drugs (DMARDs) e.g. azathioprine, mycophenolate mof