Recurrent Aphthous Ulcers Flashcards
what are aphthous ulcers
immunologically generated recurring oral ulcers
what are the types of recurrent aphthous stomatitis
minor, major, herpetiform, oro-genital ulcer syndromes (behcets)
on examination, what will aphthous ulcers look like
yellow/grey base with erythematous margin
what does a minor aphthous ulcer look like
less than 10mm diameter
non-keratinised mucosa
heal without scarring
last for 2 weeks
what does major aphthous ulcers look like
lasts for months
affect any part of mucosa
may scar when healing
larger than 10mm
what type of ulcers respond well to topical steroids
minor aphthous ulcers
what type of ulcers require intralesional steroids
major aphthous ulcers
what do herpetiform ulcers look like
multiple small ulcers on non-keratinised mucosa which can coalesce into larger areas of ulceration
heal within 2 weeks
what is the diagnosis for behcets disease
three episodes of mouth ulcers in a year
at least 2 of genital sores/eye inflammation/skin ulcers/pathergy
what causes behcets disease
inflammation of blood vessels (vasculitis)
what is the management of behcets disease
treat local ulcers
systemic immunomodulation where multisystem
what are the predisposing factors for recurrent aphthous stomatitis
genetic predisposition
systemic diseases
stress
mechanical injuries
hormonal level fluctuations
microelement deficiencies
viral and bacterial infections
what is the immunology of aphthous ulcers
damage to basal cells at basement membrane so they cannot produce epithelial replacement cells so as existing cells are lost the ulceration appears as there are no new cells to replace them
when does the damage occur with aphthous ulcers
before the ulcer appears (3-4 days after immunological process started)
when is treatment most effective with aphthous ulcers
in prodromal period
