Aphthous Ulcers - Causes, Symptoms & Treatment

Aphthous ulcers are a common and painful problem. Aphthous ulcers can be classified into three different types: minor, major and herpetiform. Minor aphthae are generally located on labial or buccal mucosa, the soft palate and the floor of the mouth. Major aphthae are larger and involve deeper ulceration. Aphtha means ulcer it has been used for many years to describe areas of ulceration on mucous membranes. Major aphthae may also be more likely to scar with healing. Herpetiform aphthae frequently are more numerous and vesicular in morphology. Patients with benign aphthous ulcers should have no other findings such as fever, adenopathy, gastrointestinal symptoms or other skin or mucous-membrane symptoms.

Aphthous stomatitis is a condition which is characterized by recurrent discrete areas of ulcerationIt is starts in childhood or adolescence as recurrent small, round, or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or gray floors. Some lesions have also had mast-cell activation and degranulation. The primary disorder appears to be the result of activation of the cell-mediated immune system. Early lesions show a cluster of macrophages and lymphocytes (predominantly cytotoxic and natural-killer T cells) at the pre-ulcerative base, followed by formation of an ulcer with a neutrophilic base and an erythematous lymphocytic ring.

Causes of Aphthous Ulcers

Common causes of Aphthous Ulcers

• Hematinic ( iron, folic acid and vitamin B-12) deficiencies.
• Hypersensitivity reactions
• Trauma.
• Genetic predisposition(human leukocyte antigen).
• Aphthouslike ulceration .
• Psychological illness and sex hormone levels.

Symptoms of Aphthous Ulcers

Common Symptoms of Aphthous Ulcers

• Fever..
• Genital or conjunctival lesions..
• Headache.
• Cough.
• Nausea.
• Vomiting.
• Abdominal pain.
• Diarrhea.
• Sore throat.
• Swollen or painful lymphadenopathy.
• Rash.

Treatment of Aphthous Ulcers

Common Treatment of Aphthous Ulcers

• Early data indicate treatment at onset may reduce symptoms or eliminate ulcer development. Initial studies of the use of 5% amlexanox paste at the onset of burning or pricking mucosal sensation 1-2 days before the ulcer appears can reduce the pain and severity.
• Thalidomide has been effective in unresponsive aphthous stomatitis and in Behçet syndrome.
• Local injectable anesthetics may be needed in patients with more severe pain. Injectable anesthetics are effective, but relief is brief.
• High-potency corticosteroid gels, creams, or ointments (with or without adhesive bases) have proven successful in promoting healing and shortening the clinical course of RAU.

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