Aphthous Ulcers (Canker Sores)
Evaluation
General—common, painful lesions are present on the labial mucosa or mucous membranes of the oral cavity.
Description—usually red, sometimes have a white coating; not contagious.
Clinical—if benign, the patient should NOT have fever, adenopathy, gastrointestinal (GI) symptoms, or skin manifestations.
Etiology—unclear; consequently treatments focus on symptoms rather than a specific cause.
Epidemiology—they are more common in young adults (teens-20s).
Classification
Minor aphthae—can be singular or multiple, <A onclick="get_content(event,'AB1-M12'); return false;" onmouseover="window.status=this.title; return true;" onmouseout="window.status=''; return true;" title="<1 cm in diameter, and shallow
Major aphthae—diameter is ” class=LK href=”javascript:void(0)” target=right xpath=”/CT{06b9ee1beed59419a81e5e1e1a4f60b0cc8cd1057525de73425b2b43f4df7f1ba9d8a14f7f3e720cd1aa9bce2b39adf7}/ID(AB1-M10)”>>1 cm and ulceration is deeper; more likely to scar
Herpetiform aphthae—very numerous and vesicular in nature
Differential diagnosis (with diagnostic discriminators noted)
Infectious
Viral
Herpes simplex virus (HSV)—vesicular; Tzank stain reveals inclusion-bearing giant cells
Cytomegalovirus (CMV)—biopsy reveals multinucleated giant cells
Varicella (chicken pox/zoster)
Coxsackie virus—may also have hand and foot lesions
Treponemal
Example: syphilis—rapid plasma reagin (RPR) positive
Psychiatric correlate—neurosyphilis most frequently presents with personality changeRelated posts:
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