Aphthous Ulcer

1. APHTHOUS ULCER PRESENTED BY – DR.ManjulaMuthuraj manju

2. SYNONYMS - manju

3. manju Aphthous /canker

4. DEFINITION It is a most common disease charecterized by the development of painful, recurring ,solitary or multiple ulcerations of the oral mucosa. manju

5. ETIOLOGY manju

6. SURBHI

7. TYPES manju

8. CLINICAL FEATURES RECURRENT APHTHOUS MINOR AGE -10-30yr GENDER -women>men SITE -common on non-keratinized mucosa e.g – buccal &labial mucosa,buccal & lingual sulci,tongue,soft palate,pharynx,gingiva . APPEARANCE -begins as a single or multiple superficial erosions covered by greyish – white removable fibrinopurulent membrane encircled by erythematous halo. SIZE -2-3 mm to 10 mm in diameter. Persist for 7-14 days & heal without scarring. SURBHI

9. MINOR APHTHOUS ULCER Area of ulceration with surrounding erythema present on movable mucosa of left maxillary muco-buccal fold. manju

10. MINOR APHHOUS ULCER . manju

11. RECURRRNT APHTHOUS MAJOR Previously it represent a separate disease entity k/n as periadenitis mucosa necrotica recurrens ( mikulicz’s scarring aphthae or sutton’s disease) It is now regarded as severe expression of aphthous stomatitis. COMMON SITE- lips,cheeks,tongue,soft palate,fauces,cause severe pain & dysphagia. Also involve keratinized mucosa INCIDENCE – common in HIV patient. SIZE – Larger than the minor apthous ulcer diameter more than 10mm. manju

12. Continued...... NO.-1-10 in no. Takes 4-6 weeks to heal. Heal with scarring Recurrs in less than a month time. APPEARANCE - extend deeper and may present as crater-like ulcers with rolled margins which are indurated on palpation because of underlying fibrosis. manju

13. manju MAJOR APHTHOUS ULCER

14. MAJOR APHTHOUS ULCER manju

15. RECURRENT HERPETIFORM ULCERS manju

16. Clinical features SITE - any intra oral site SIZE- 1-3 mm in diameter APPEARANCE – charecterized by crop of small,shallow ulcers ,that may be joined together and form large ulcer. No . – 10 – 100 Healing occur in 1 to 2 weeks. Heal with scarring. Lesions persist for 1 to 3 year,with short remissions manju

17. RECURRENT HERPETIFORM ULCERATIONS manju

18. CONTRASTING FEATURES MINOR MAJOR HERPETIFORM SIZE <0.5 cm >0.5 cm <0.5 cm SHAPE Oval Ragged oval,crateriform oval NUMBER 1-5 1-10 10-100 LOCATION Non-keratinized mucosa Non-keratinized mucosa Any intra oral site TREATMENT Topical corticosteroids, tetracycline mouthrinse Topical/systemic/ intralesional corticosteroids, immunosuppressives Topical/systemic corticosteroids, tetracycline mouthrinse manju

19. HISTOPATHOLOGY manju

20. manju

21. SURBHI THANKS….