Apthous Ulcers

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Definition

-  Ulcer of tongue or oral mucosa

 

Features

-  Oral ulcer

-  May occur in crops

-  Usually effects non-attached mucosa

-  Decreased severity & frequency w age

-  Recurrent in 5-25% population

-  Minor

-  2-4mm

-  Heal 7-10/7 wo scar

-  Major

-  >10mm

-  Heal up to 6/52 +/- scar

-  Herpetiform

-  Recurrent non-vesicular crops

-  1-1mm --> coalesce

-  Heal 1-2/52

-  Not caused by HSV

 

 

Causes

-  Smoking cessation

-  Idopathic

-  Vitamin deficiencies: Fe, Folate, B12

-  Bechets syndrome

-  AID: AIDS, DM, IBD, SLE, Lichen Planus

-  Trauma: biting, brushing

-  Poor oral hygiene

-  Stress, menstrual period

 

DDx other causes of Oral ulcers

-  Ca: if not healing in 3/52

-  Infection

 

Mx

-  Rinse mouth w warm salty water

-  Keep mouth clean

-  Paracetamol

-  Topical anaesthetics

-  Lignocaine 3/24+/- (symptomatic)

-  Bonjela (salicylate)

-   OTC

-   Not for <6yrs old (Reyes syndrome)

-  Topical corticosteroids

-  Triamcondone 0.1% topical paste TDS after meals

-  Betamethasone 0.05% topical ointment TDS after meals