Aphthous stomatitis - Revision history

Danbot: Expand: herpes distinction (keratinized vs non-keratinized), types, pain management, magic mouthwash

2026-03-21T01:49:06Z

Expand: herpes distinction (keratinized vs non-keratinized), types, pain management, magic mouthwash

← Revisión anterior		Revisión del 01:49 21 mar 2026
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	==Background==		==Background==
	*~~Affects~~ 20% of the ~~normal~~ population		*Common oral ulcers (''canker sores'') affecting ~20% of the population
	*~~Unclear~~ etiology~~. Common triggers~~: stress, hormonal changes, ~~smoking~~, certain ~~food such as~~ coffee, ~~chocolate.~~		*Recurrent episodes; etiology unclear
	*~~Resolve spontaneously~~ in 10-~~14d~~		*Triggers: stress, hormonal changes, local trauma, certain foods (citrus, chocolate, coffee), nutritional deficiencies (B12, folate, iron)
			*Self-limited; resolve in 10-14 days without scarring (minor type)

	==Clinical Features==		==Clinical Features==
	[[File:Aphthous stomatitis.jpg\|thumbnail\|~~Apthous~~ ulcer of lip]]		[[File:Aphthous stomatitis.jpg\|thumbnail\|Aphthous ulcer of lip]]
	*~~Involves the~~ nonkeratinized ~~epithelium~~ (~~especially~~ labial ~~and~~ buccal mucosa)		*Well-circumscribed, painful ulcers on '''nonkeratinized''' mucosa (labial, buccal mucosa, floor of mouth, ventral tongue)
	*~~Begins as~~ erythematous ~~macule that ulcerates and forms a central fibropurulent eschar~~		*Central yellow-white fibrinous base with erythematous halo
	*~~Lesions measure~~ from 2-~~3mm to several~~ cm in ~~diameter~~		*'''Key distinction from herpes:''' Aphthous ulcers are on non-keratinized mucosa and do NOT involve attached gingiva or hard palate (herpes involves keratinized mucosa)
			*Types:
			**Minor (<1 cm, most common, heals in 10-14 days)
			**Major (>1 cm, deeper, may take weeks to heal, can scar)
			**Herpetiform (clusters of tiny ulcers, mimics herpes but on non-keratinized mucosa)

	==Differential Diagnosis==		==Differential Diagnosis==
	{{DDX oral rashes and lesions}}		{{DDX oral rashes and lesions}}
			*'''Consider systemic disease if:''' Recurrent severe episodes, genital ulcers ([[Behcet's disease]]), GI symptoms (Crohn's), or systemic symptoms

	==Evaluation==		==Evaluation==
	*Clinical diagnosis		*Clinical diagnosis
			*Consider labs (CBC, iron, B12, folate) for recurrent or severe cases
			*Biopsy if lesion does not respond to treatment or concern for malignancy

	==Management~~<ref>Tilliss TS~~, ~~Mcdowell JD. Differential diagnosis: is it herpes~~ or ~~aphthous?. J Contemp Dent Pract. 2002;3~~(1)~~:1-15.</ref>==~~		==Management==
	*~~[[Topical corticosteroids]]~~		*'''Pain control:''' Viscous lidocaine 2%, benzocaine gel, or ''magic mouthwash'' (equal parts viscous lidocaine, diphenhydramine, and antacid)
	**[[Betamethasone]] syrup '''OR'''		*'''Topical corticosteroids:'''
	**[[Dexamethasone]] 0.01% elixir as mouth rinse ~~'''OR'''~~		**[[Dexamethasone]] 0.01% elixir as mouth rinse
	**Fluocinonide 0.05% gel applied ~~topically~~ to isolated lesions		**Fluocinonide 0.05% gel applied to isolated lesions
	*~~Biopsy to evaluate for malignancy or immune-mediated disease is recommended if lesion does not respond appropriately to steroids~~		**[[Betamethasone]] syrup
			*Avoid irritating foods (acidic, spicy)

	==Disposition==		==Disposition==
	Discharge		*Discharge with symptomatic treatment
			*Refer to oral medicine or ENT if recurrent severe episodes or non-healing ulcers

	==See Also==		==See Also==
	[[~~Rash~~]]		*[[Herpes simplex virus]]
			*[[Hand foot and mouth disease]]
			*[[Behcet's disease]]

	==References==		==References==
	<references/>		<references/>


	[[Category:ENT]]		[[Category:ENT]]
	[[Category:Dermatology]]		[[Category:Dermatology]]

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

2019-09-27T18:13:30Z

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

← Revisión anterior		Revisión del 18:13 27 sep 2019
Línea 17:		Línea 17:

	==Management<ref>Tilliss TS, Mcdowell JD. Differential diagnosis: is it herpes or aphthous?. J Contemp Dent Pract. 2002;3(1):1-15.</ref>==		==Management<ref>Tilliss TS, Mcdowell JD. Differential diagnosis: is it herpes or aphthous?. J Contemp Dent Pract. 2002;3(1):1-15.</ref>==
	*Topical corticosteroids		*[[Topical corticosteroids]]
	**Betamethasone syrup '''OR'''		**[[Betamethasone]] syrup '''OR'''
	**[[Dexamethasone]] 0.01% elixir as mouth rinse '''OR'''		**[[Dexamethasone]] 0.01% elixir as mouth rinse '''OR'''
	**Fluocinonide 0.05% gel applied topically to isolated lesions		**Fluocinonide 0.05% gel applied topically to isolated lesions

Kearny89: /* Management */

2019-06-04T17:36:09Z

Management

← Revisión anterior		Revisión del 17:36 4 jun 2019
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	*Clinical diagnosis		*Clinical diagnosis

	==Management==		==Management<ref>Tilliss TS, Mcdowell JD. Differential diagnosis: is it herpes or aphthous?. J Contemp Dent Pract. 2002;3(1):1-15.</ref>==
	*Topical corticosteroids		*Topical corticosteroids
	**Betamethasone syrup '''OR'''		**Betamethasone syrup '''OR'''

Kearny89: /* Management */

2019-06-04T17:34:28Z

Management

← Revisión anterior		Revisión del 17:34 4 jun 2019
Línea 21:		Línea 21:
	**[[Dexamethasone]] 0.01% elixir as mouth rinse '''OR'''		**[[Dexamethasone]] 0.01% elixir as mouth rinse '''OR'''
	**Fluocinonide 0.05% gel applied topically to isolated lesions		**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==		==Disposition==

Spenceemmett: /* Disposition */

2018-11-21T02:54:23Z

Disposition

← Revisión anterior		Revisión del 02:54 21 nov 2018
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	==Disposition==		==Disposition==
			Discharge

	==See Also==		==See Also==

Iwm5010: /* Evaluation */

2017-11-27T19:52:02Z

Evaluation

← Revisión anterior		Revisión del 19:52 27 nov 2017
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	==Evaluation==		==Evaluation==
			*Clinical diagnosis

	==Management==		==Management==

Iwm5010: /* Background */

2017-11-27T19:50:53Z

Background

← Revisión anterior		Revisión del 19:50 27 nov 2017
Línea 1:		Línea 1:
	==Background==		==Background==
	*Affects 20% of the normal population		*Affects 20% of the normal population
	*Unclear etiology		*Unclear etiology. Common triggers: stress, hormonal changes, smoking, certain food such as coffee, chocolate.
	*Resolve spontaneously in 10-14d		*Resolve spontaneously in 10-14d

Mholtz: Text replacement - "OR" to "'''OR'''"

2017-05-30T22:57:37Z

Text replacement - "OR" to "'''OR'''"

← Revisión anterior		Revisión del 22:57 30 may 2017
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	==Management==		==Management==
	*Topical corticosteroids		*Topical corticosteroids
	**Betamethasone syrup OR		**Betamethasone syrup '''OR'''
	**[[Dexamethasone]] 0.01% elixir as mouth rinse OR		**[[Dexamethasone]] 0.01% elixir as mouth rinse '''OR'''
	**Fluocinonide 0.05% gel applied topically to isolated lesions		**Fluocinonide 0.05% gel applied topically to isolated lesions

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-24T11:19:06Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 11:19 24 jul 2016
Línea 13:		Línea 13:
	{{DDX oral rashes and lesions}}		{{DDX oral rashes and lesions}}

	==~~Diagnosis~~==		==Evaluation==

	==Management==		==Management==

Neil.m.young: Text replacement - "==Treatment==" to "==Management=="

2016-07-08T06:50:26Z

Text replacement - "==Treatment==" to "==Management=="

← Revisión anterior		Revisión del 06:50 8 jul 2016
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	==Diagnosis==		==Diagnosis==

	==~~Treatment~~==		==Management==
	*Topical corticosteroids		*Topical corticosteroids
	**Betamethasone syrup OR		**Betamethasone syrup OR