dental disorders
Recurrent Aphthous Stomatitis
Symptoms and Signs of Recurrent Aphthous Stomatitis
Symptoms and signs usually begin in childhood (most patients are<30 years) and decrease in frequency and severity with aging. Symptoms may involve as few as one ulcer 2 to 4 times a year or almost continuous disease, with new ulcers forming as old ones heal. A prodrome of pain or burning for 1 to 2 days precedes ulcers, but there are no antecedent vesicles or bullae. Severe pain, disproportionate to the size of the lesion, can last from 4 to 7 days. Aphthous ulcers are well-demarcated, shallow, ovoid, or round and have a necrotic center with a yellow-gray pseudomembrane, a red halo, and slightly raised red margins. (canker sores) account for 85% of cases ( Symptoms and signs reference ). They occur on the floor of the mouth, lateral and ventral tongue, buccal mucosa, and pharynx; are Major aphthousulcers (Sutton disease, periadenitis mucosa necrotica recurrens) constitute 10% of cases. Appearing after puberty, the prodrome is more intense and the ulcers are deeper, larger (>1 cm), and longer lasting (weeks to months) than minor aphthae. They appear on the lips, soft palate, and throat. Fever, dysphagia, malaise, and scarring may occur. Herpetiform aphthous ulcers(morphologically resembling but unrelated to herpesvirus) account for 5% of cases. They begin as multiple (up to 100) 1- to 3-mm crops of small, painful clusters of ulcers on an erythematous base. They coalesce to form larger ulcers that last 2 weeks. They tend to occur in women and at a later age of onset than do other forms of recurrent aphthous stomatitis. 1.Akintoye SO, Greenberg MS: Recurrent aphthous stomatitis.Dent Clin North Am58(2):281-297, 2014. doi: 10.1016/j.cden.2013.12.002 