Recurrent Aphthous Ulcers Flashcards
What are aphthous ulcers?
- immunologically generated RECURRING oral ulcers
- follow a set pattern depending upon the ulcer type
- genetically driven with environmental modification
What can cause aphthous ulcers?
Multifactorial environmental triggers and variable expression
How do recurrent aphthous stomatitis ulcers typically present on examination?
yellow/grey base with erythematous margin
How can minor aphthous ulcers be classified?
- less than 10mm diameter
- last up to 2 weeks
- only affect NON-keratinised mucosa
- heal without scarring
- usually good response to topical steroid
What is the commonest type of recurrent oral ulceration?
minor aphthous ulcers
What are the characteristics of major aphthous ulcers?
- can last for months
- can affect ANY part of the oral mucosa (keratinised or non-keratinised)
- may scar when healing
- poorly responsible to topical steroids
- usually larger than 10mm
What are herpetiform aphthous ulcers?
rarest form of aphthous ulcers
- multiple small ulcers on non-keratinised mucosa
- heal within 2 weeks
- can coalesce into larger areas of ulceration
How is Behçet’s Disease diagnosed?
Patient must have had three episodes of mouth ulcers in a year as well as two of the following:
- genital sores
- eye inflammation
- skin ulcers
- pathergy
How is Behçet’s Disease managed?
- treat local oral disease
- systemic immunomodulation where multi system involvement
what immune modulating drugs are used in those with Behçet’s Disease?
- Colchicine
- Azathroprine
- Infliximab
What are some predisposing factors to development of Recurrent Aphthous Stomatitis?
- genetic predisposition
- systemic diseases
- stress
- mechanical injuries
- hormone level fluctuations
- microelement deficiencies
- viral & bacterial infections
What investigations should be done when a patient presents with Aphthous Ulcers?
- Blood tests = haematinic deficiencies & coeliac disease
- Allergy tests = food additives
How are recurrent aphthae treated & managed?
- correct blood deficiencies
- refer for investigation if coeliac positive
- avoid dietary triggers
- non-steroid treatment for infrequent ulcers
- steroid based treatment for more disabling, frequent ulcers
