Aphthous stomatitis

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

References

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

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