Aphthous stomatitis

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Background

  • Affects 20% of the normal population
  • Unclear etiology. Common triggers: stress, hormonal changes, smoking, certain food such as coffee, chocolate.
  • Resolve spontaneously in 10-14d

Clinical Features

Apthous ulcer of lip
  • Involves the nonkeratinized epithelium (especially labial and buccal mucosa)
  • Begins as erythematous macule that ulcerates and forms a central fibropurulent eschar
  • Lesions measure from 2-3mm to several cm in diameter

Differential Diagnosis

Oral rashes and lesions

Evaluation

  • Clinical diagnosis

Management[1]

  • Topical corticosteroids
    • Betamethasone syrup OR
    • Dexamethasone 0.01% elixir as mouth rinse OR
    • Fluocinonide 0.05% gel applied topically to isolated lesions
  • Biopsy to evaluate for malignancy or immune-mediated disease is recommended if lesion does not respond appropriately to steroids

Disposition

Discharge

See Also

Rash

References

  1. Tilliss TS, Mcdowell JD. Differential diagnosis: is it herpes or aphthous?. J Contemp Dent Pract. 2002;3(1):1-15.