Aphthous stomatitis

Clinic

• Recurrent aphthous stomatitis (RAS) or canker sore is characterized by the repeated formation of benign and non-contagious mouth ulcers.
• Ulcers occur periodically and heal completely between attacks
• Individual ulcers last about 7–10 days, and ulceration episodes occur 3–6 times per year.
• The severe forms may be debilitating, even causing weight loss due to malnutrition.
• Very common, affecting about 20% of the general population
• Thrush, Mouth Candidiasis are its inter related entities.

Signs / Symptoms

• They have no detectable systemic symptoms or signs
• Prodromal sensations such as burning, itching, or stinging, which may precede the appearance of any lesion by some hours
• Pain, which is often out of proportion to the extent of the ulceration and is worsened by physical contact, especially with certain foods and drinks
• Pain is worst in the days immediately following the initial formation of the ulcer, and then recedes as healing progresses.
• Speaking, chewing and swallowing can be uncomfortable due to lesions
• Aphthous ulcers typically begin as erythematous macules which develop into ulcers that are covered with a yellow-grey fibrinous membrane that can be scraped away.
• A reddish "halo" surrounds the ulcer. The size, number, location, healing time, and periodicity between episodes of ulcer formation are all dependent upon the subtype of aphthous stomatitis.
• RAS is thought to be multifactorial

Related disease

• Systemic lupus erythematosus
• Behçet's disease
• Inflammatory bowel diseases
• Celiac disease
• Cyclic neutropenia
• Immunocompromised states
• MAGIC syndrome
• PFAPA syndrome: Periodic Fever, Aphthae, Pharyngitis and cervical adenitis
• Reactive arthritis
• Sweet's syndrome
• Ulcus vulvae acutum

Remedies

• Am-c
• Kreos
• Lach
• Merc: Oral halitosis + Lichen planus + Salivation
• Merc-c
• Nit-ac

Tissue Salt Remedies

• KM: When the color is gray-white
• NP: When it turns yellow