Aphthous ulcers are common but benign lesions of the mouth.


Synonyms: canker sore, aphthae, recurrent aphthous stomatitis


Clinical features:

(1) The patient has recurrent episodes of painful ulcers confined to the mouth.

(2) The onset is typically during childhood and episodes may last into middle age.

(3) Often there is a family history in a parent or sibling.

(4) The patient may have one or more shallow ulcers that are typically round or oval with an inflammatory (erythematous) halo.

(5) The ulcers tend to last from 10 to 14 days.

(6) Other causes of oral ulcerations should be excluded and the ulcers should not be part of a systemic disorder.


Common locations in the mouth:

(1) tongue

(2) buccal mucosa

(3) labial mucosa

(4) floor of the mouth


Differential diagnosis:

(1) Behcet's disease

(2) celiac disease (gluten sensitive enteropathy)

(3) idiopathic inflammatory bowel disease

(4) immunodeficiency disorder, including HIV disease

(5) herpesvirus infection

(6) Reiter's syndrome

(7) Sweet's syndrome

(8) erythema multiforme

(9) neutropenia (associated with leukemia, chemotherapy-induced, cyclic, etc.)

(10) drug-related

(11) dental biting trauma

(12) SLE


The term "aphthous-like ulcer" may be used if an oral ulcer has some but not all of the typical features of the aphthous ulcer.


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