An aphthous ulcer is an ulcer that forms on the mucous membranes. They are also called as aphthae, aphthosis or cankersores. Aphthous ulcers generally present as recurrent oval or round ulcers inside the oral cavity. Local trauma, genetic factors, nutritional deficiencies,viral and bacterial infections, and immune or endocrine disturbances have all been implicated as etiological factors of frequent oral ulcerations.Etiology:The following factors have been implicated in the development of aphthous ulcers.· Emotional stress·
Mechanical trauma·
Nutritional deficiencies like deficiency of vitamin B12, iron and folic acid. ·
Viral infections
Clinical Features:
Minoraphthous ulcers:They present as round, oval, greyish whitelesions. They are generally 1 to 5 in number and measure less than 10 cm in diameter. These lesions generally resolve in 4 to 10 days without any scarring.
Majoraphthous ulcers:They present as round, oval greyish whitelesions. They are generally 1 to 10 in number and measure greater than 10 cm in diameter.
Herpetiformaphthous ulcers:They present as small deep ulcers and are generally numerous in number. They are acutely painful and generally resolve with scarring.
Treatment:Chlorhexidine mouthwash can be beneficial in the treatment. Topical antibiotics in the form of doxycycline or minocycline mouth wash can be used. Local lignocaine can be used to provide analgesia. This leads to considerable relief for the patient. Topical steroids like triamcinolone are also commonly used in the management. Systemic therapies in the form of oralsteroids are used in severe cases. Steroid sparing agents like colchicines orazathiprine are also shown to have benefit. Recently thalidomide has been suggested as an important immunomodulator in the management of aphthous ulcers. However it’s use has been restricted due to its side effect profile.