Aphthous ulcer

What is a foot and mouth disease? ulcer?

An aphthous ulcer is an ulcer that forms on the mucous membranes Also called canker sores, aphthosis, aphthous stomatitis and thrush.

An aphthous ulcer is typically a recurrent round or oval sore or ulcer inside the mouth in an area where the skin is not firmly attached to the underlying bone, such as on the inside of the lips and cheeks or under the tongue. Aphthous ulcers It can also affect the genitals in men and women.

Recurrent aphthous ulcers are mostly a minor discomfort, but they are associated with significant health problems in some people.

Who is at risk for foot and mouth disease?

Anyone can get an aphthous ulcer; 20% of the population has one or more, at least occasionally. They usually appear for the first time in childhood or adolescence, and more commonly affect women than men.

Interestingly, smoking can protect against canker sores, although smoking worsens many oral and skin conditions.

Genitalia not sexually acquired ulceration

Sexually not acquired genital ulceration (NSGU) refers to an aphthous ulcer at the genital sites. A genital aphthous ulcer is also called a Lipschutz ulcer.

• A genital aphthous ulcer is more common in women than in men.
• It can be accompanied by considerable pain and swelling.
• Reactive genital ulcer follows a infection.

NSGU simple oral aphtosis is more likely to be associated with systemic disease, such as:

• Behcet syndrome
• Gluten sensitive enteropathy (celiac disease)
• Inflammatory gastrointestinal disease

• Human immunodeficiency virus (HIV) infection.

See images of vulvar ulcers ...

What causes an aphthous ulcer?

The exact reason why aphthous ulcer develops is not yet clearly defined. About 40% of people who have aphthous ulcers have a family history of aphthous ulcer. Current thinking is that the immune system is altered by some external factor and reacts abnormally against a protein in mucous membrane tissue.

Factors that appear to trigger ulcer outbreaks include:

• Emotional stress and lack of sleep.

• Mechanic traumaeg self-inflicted bite
• Nutritional deficiency, particularly of vitamin B, iron and folic acid.
• Certain foods, including chocolate.
• Certain toothpastes; this may be related to sodium laureth sulfate (the foaming component of toothpaste)
• Menstruation
• Certain medications, including nicorandil, given for angina pectoris
• Viral infections.

Which is the differential diagnosis aphthous ulcer?

Other causes of mouth ulcer should be considered, including:

• Herpes Simplex

• Herpangina
• Erythema multiform

• Fixed drug eruption.

What are the signs and symptoms of an aphthous ulcer?

Recurrent aphthous ulcer usually begins as a raised, yellowish, round spot surrounded by a red halo. This then breaks down into a perforated ulcer, which is covered with a freely attached white, yellow, or grayish membrane. The surrounding tissue is healthy and unaffected. The ulcer can be painful, especially if it is irritated by movement or when eating certain types of food, such as citrus.

People can experience a single ulcer or multiple ulcers. Multiple ulcers tend to spread widely through a person's mouth.

Aphthous ulceration is classified into three types.

• Recurrent minor aphthous ulcer (80%). It is less than 5 mm in diameter and heals in 1–2 weeks.
• Aphthous ulcer major, which is large (often more than 10 mm) and takes weeks or months to heal and leaves a scar.
• Herpetiform ulcers, which are multiple point ulcers that heal in a month. These are more common in the language.

What tests should be done in aphthous ulceration?

Most people affected by occasional minor aphthous ulcers do not require testing. They are carried out if there are recurrent attacks of multiple or severe oral ulcers or complex aphthosis.

Blood tests can include:

• Blood count, iron, B12 and folate studies.
• Gluten antibody celiac disease tests
• Fecal calprotectin test for Crohn's disease

Microbiology swabs assess the presence of Candida albicans, Herpes Simplex virus and Vincent organisms.

What is the treatment for an aphthous ulcer?

There is no cure for an aphthous ulcer. Most recurrent minor aphthous ulcers heal within 1 to 2 weeks without any treatment. The main goal of treatment is to decrease pain and discomfort and promote healing.

General measures

• Protective pastes that form a barrier over the ulcer to reduce exposure to irritating substances.
• Superficial cauterization of tissues with a silver nitrate bar.

• Local anesthetics benzocaine and lignocaine (lidocaine) to reduce pain.

• Medicated toothpaste without sodium laureth sulfate
• Antibacterial mouthwashes to reduce secondary infection.
• Avoid foods that trigger or exacerbate ulcers
• Dietary vitamin or mineral supplements, if diet is deficient.
• Stress reduction

Prescription drugs for foot and mouth ulcer

Current Prescription medications include:

• Tetracycline suspension as a mouthwash

• Topical corticosteroids such as lotions, creams, or paste, often triamcinolone in toothpaste

• Calcineurin inhibitors: topical pimecrolimus or tacrolimus.

In severe cases, particularly if there are systemic symptoms, anti-inflammatory Oral medications (use not indicated on the label) can be considered:

• Tetracycline, p. doxycycline 50-100mg daily for 3-6 months or more.

• Dapsone
• Colchicine
• Systemic steroids
• Immunosuppressive agents such as azathioprine, methotrexate, cyclosporine.
• Apremilast, which has been approved in the USA. USA To treat oral ulcers in Behçet's disease
• Tumor necrosis factor antagonists (TNF) (adalimumab, etanercept, infliximab)

• Thalidomide