Presentation
This paper describes 2 patients with periodic syndromes presenting with ALU and reviews the present understanding of the syndromes. [ncbi.nlm.nih.gov]
Here a case report is presented that describes the diagnostic process that was followed for a patient presenting with atypical oral ulceration. [dentistrytoday.com]
Jaw & Teeth
- Aphthous Stomatitis
Recurrent oral ulceration that clinically resembles recurrent aphthous stomatitis but presents atypically, including commencement after adolescence, with fever, with a strong family history, or failing to resolve with age, has been termed aphthous-like [ncbi.nlm.nih.gov]
In case 8, aphthous stomatitis reappeared 2 months after administration of irsogladine 2 mg/ day. The dose of irsogladine in this patient was then increased to 4 mg/day, after which aphthous stomatitis resolved. [link.springer.com]
Recurrent Aphthous Stomatitis (recurrent mouth ulcers) What is Recurrent Aphthous Stomatitis (RAS)? RAS consists of recurrent bouts of one or more painful, rounded or ovoid ulcers. Most aphthous ulcers last for 10-14 days. [moderndentistry.com.au]
Aphthous stomatitis Other names Recurrent aphthous stomatitis, recurring oral aphthae, recurrent aphthous ulceration Canker sore on the lower lip Specialty Oral medicine, dermatology Frequency ~20% of people to some degree [1] Aphthous stomatitis is a [en.wikipedia.org]
The treatment of recurrent aphthous stomatitis (RAS) still remains unclear and is based mainly on experimental data. [clinicaltrials.gov]
- Oral Mucosal Disorder
2015/2/1/25/166117 Introduction Recurrent aphthous stomatitis (RAS) is defined as recurrent episodes of oral aphthous ulceration where the ulcers heal spontaneously with subsequent recurrence. [1] RAS is one of the most common oral mucosal disorders affecting [jiadsr.org]
Conclusion RAS is a common oral mucosal disorder with uncertain etiopathogenesis. The diagnosis of this condition is made on clinical grounds alone. Several factors such as trauma, diet and stress are known to trigger the disease. [biomedpharmajournal.org]
- Sore Mouth
(sore) K12.0 Periadenitis mucosa necrotica recurrens K12.0 Sore mouth K13.79 ICD-10-CM Diagnosis Code K13.79 Other lesions of oral mucosa 2016 2017 2018 2019 Billable/Specific Code Applicable To Focal oral mucinosis canker K12.0 Stomatitis (denture) [icd10data.com]
- Tongue Ulcer
Figure 1 Large ulcer on dorsum of tongue Case 2 A 64-year-old Caucasian male referred for an urgent appointment with regard to a suspicious oral ulcer. An ulcer had been present on the tongue for one month. [nature.com]
Workup
All other infectious workup remained negative, including cultures of the acneiform skin lesions and HSV polymerase chain reaction of the serum, cerebrospinal fluid and vulvar lesions. [shmabstracts.com]
Serum
- Macrocytosis
Hemoglobin, hematocrit and mean corpuscular hemoglobin concentrations were in the normal range in both groups and none had anemia or macrocytosis. [ncbi.nlm.nih.gov]
HLA Type
- HLA-DR4
On the other hand, HLA DR4 was present in 16 of 30 (53%) patients with ROU whereas the same allele was present in 16% of BS patients and 22% of the healthy controls. These findings suggest that ROU and BS are not in the same disease spectrum. [ncbi.nlm.nih.gov]
- HLA-B5
Abstract Among 50 patients with recurrent oral ulceration (ROU) the prevalence of HLA B5 was not increased as was the case among 50 patients with Behçet's Syndrome (BS) compared to 52 healthy controls. [ncbi.nlm.nih.gov]
Treatment
Though a small, consistent improvement occurred with placebo, there was a significant reduction in mean pair scores and numbers of new ulcers recorded daily during the active-treatment periods, the effect lasting for at least four weeks after treatment [ncbi.nlm.nih.gov]
Authors' conclusions: No single treatment was found to be effective and therefore the results remain inconclusive in regard to the best systemic intervention for RAS. [cochrane.org]
Treatment The aim of treatment is to prevent long-term damage. The most severe manifestation present usually determines the choice of treatment. [gponline.com]
Prognosis
We assessed the prognosis of ROU by performing prospective evaluations of 67 patients who had only a history of ROU and were registered at the Behçet's Disease Specialty Clinic at Severance Hospital of Yonsei University, Seoul, Korea. [ncbi.nlm.nih.gov]
Prognosis Most canker sores clear up without treatment and do not leave scars, although they usually return. [colgateprofessional.com]
[…] the first time Your sores are larger than 1centimeter (almost one-half inch) across You get more sores now than you used to You get sores more often than you used to You have other symptoms with your sores, such as: Rashes Joint pain Fever Diarrhea Prognosis [colgate.com]
The prognosis is worse in those with RAS beginning under the age of five [ 12 ]. Case (Part 2) After a motivational interview with the patient we advise the patients to exercise some life style modifications described elsewhere [ 13 ]. [omicsonline.org]
[…] numerous treatments of unproven effectiveness, ranging from herbal remedies to otherwise alternative treatments, including aloe vera, myrtus communis, Rosa damascena, potassium alum, zinc sulfate, nicotine, polio virus vaccine and prostaglandin E2. [2] Prognosis [en.wikipedia.org]
Etiology
Abstract Recurrent oral ulceration (ROU) is a common oral mucosal condition of unknown etiology. However, there is evidence to suggest that vasculitis may play a role. [ncbi.nlm.nih.gov]
This review examines the existing topical and systemic treatments for RAS and explores its etiology in depth. [nursingcenter.com]
This case demonstrates that not all lesions detected in the oral cavity (oral mucosa) have a clearly defined etiology. [dentistrytoday.com]
The etiology of RAS is still unknown; the condition may in fact manifest from a group of disorders of quite different etiologies rather than from a single entity. [3] Despite many studies trying to identify a causal microorganism, RAS does not appear [emedicine.medscape.com]
HEMATOLOGIC/ONCOLOGIC DISEASES Hematologic etiologies should be considered when evaluating recurrent or slow-healing mouth ulcers. [aafp.org]
Epidemiology
Neuro-Behcet's disease: epidemiology, clinical characteristics, and management. Lancet Neurol 2009; 8(2): 192-204. 2. Criteria for diagnosis of Behcet's disease. International Study Group for Behcet's Disease. Lancet 1990; 335(8697): 1078. 3. [gponline.com]
An epidemiological study of factors associated with recurrent aphthae in women. J Oral Med 1984;39:212-7. [ PUBMED ] [Table 1] [jiadsr.org]
Epidemiology [ 1, 2 ] Oral ulceration is a common condition. It has an estimated 4% point prevalence in the USA, and 25% of the global population are thought to be affected by aphthous ulcers, one of the most common causes of oral ulceration. [patient.info]
Enterovirus infections: their epidemiology and pathogenesis. Clin Pediatrics (Philadelphia). 1966;5:659-664. 15. Estrin HM, Hughes RW Jr. Oral manifestations in Crohn’s disease: report of a case. Am J Gastroenterol. 1985;80:352-354. 16. [dentistrytoday.com]
There are growing epidemiologic evidences for the effects of tobacco use and tobacco cessation therapy on a variety of oral diseases and conditions. [omicsonline.org]
Pathophysiology
Despite the fact that clinical, pathologic and therapeutic feature of the disease has been comprehensively studied, the pathophysiology of aphthous ulcers remains incompletely understood. [clinicaltrials.gov]
• Pathophysiology is thought to involve cell mediated immunity with destruction of epithelial cells and also deposition of immune complexes and complement activation causing a vasculitis. [brainscape.com]
Pathophysiology The pathophysiology of aphthous ulcers is poorly understood. Histologically, aphthae contain a mononuclear infiltrate with a fibrin coating. 3 Patients with recurrent aphthae may have alteration of local cell–mediated immunity. [aafp.org]
• Herpetiform ulcers, the uncommon RAS, are Pathophysiology: Despite the high prevalence of RAS, evidence is uncertain regarding the etiology. [uspharmacist.com]
Prevention
Prevention There is no way to prevent canker sores. Treatment Treatment focuses on relieving symptoms. Rinsing with a warm-water solution and eating bland foods can minimize discomfort. [colgateprofessional.com]
Preventative therapies : In cases where recurrences are frequent, preventative strategies should be considered that are proportionate to the severity and frequency of recurrences. However, evidence of efficacy is limited. [ep.bmj.com]
Prevention of canker sores Prevention of cancer sores involves: – Maintenance of dental hygiene. [news-medical.net]
[…] brushing and flossing, may help to prevent mouth ulcers. [medicalnewstoday.com]
Use a soft brush to help prevent irritation to delicate mouth tissues, and avoid toothpastes and mouth rinses that contain sodium lauryl sulfate. Protect your mouth. [mayoclinic.org]