Recurrent Aphthous Stomatitis Flashcards
what are aphthous ulcers
immunologically generated recurring oral ulcers
what are the types of aphthous ulcers
minor
major
herpetiform
behcets syndrome
what are features of minor aphthous ulcers
less than 10mm in diameter
last up to 2 weeks
only affect non-keratinised mucosa
heal without scarring
what type of mucosa do aphthous ulcers affect
non-keratinised
what do minor aphthous ulcers usually respond well to
topical steroids
what are features of major aphthous ulcers
last for months
affect any part of oral mucosa
scar when healing
poor response to topical steroids
larger than 10mm
what type of mucosa do major aphthous ulcers affect
non-keratinised and keratinised
what are herpetiform aphthae
multiple small ulcers on non-keratinised mucosa that heal within 2 weeks
are herpetiform aphthae related to herpes viruses
no - HSV involve keratinised epithelium (herpetiform aphthae is just non-keratinised)
what is behcets disease
three episodes of mouth ulcers in a year and at least two from genital sores, eye inflammation, skin ulcers
what type of disease is behcets disease
vasculitis - inflammation of blood vessels
how is behcets disease treated
locally treat oral disease or RAS
systemic immunomodulation where multisystem involvement
what are some examples of predisposing factors for RAS
genetic predisposition
stress
systemic disease
hormonal level fluctuations
when does damage occur in aphthous ulcers
damage happens before the ulcer appears
when is treatment most effective in aphthous ulcers
prodrome period
what investigations would be used to screen for aphthous ulcers
blood tests (haematinics/ coeliac)
allergy tests
what is treatment for aphthous ulcers
correct blood deficiencies
refer for investigation of coeliac
avoid dietary triggers
what drugs are allowed to be prescribed to treat aphthous ulcers
non-steroidal topical therapy for inconvenient lesions
steroidal topical therapy for disabling lesions
what age group might tend to have a spike in getting aphthous ulcers
children between periods of rapid growth
when should you refer aphthous ulcers to oral medicine
after arranging blood tests with GP
after topical treatment
children under 12
and seen no good result