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Aphthous: Ulcer
Aphthous: Ulcer
Aphthous: Ulcer
PRESENTED BY DR.ManjulaMuthuraj
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SYNONYMS -
APHTHAE
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APHTHOUS /CANKER
BUT NOT A TYPE OF CANCER
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DEFINITION
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ETIOLOGY
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PRIMARY
REDDUCTION
DECREASE
INCREASEIMMUNO
PATHOGENESIS
NUTRITIONAL
TRAUMAIN OFDYSRETIONGULA
CD4BARRIER
IN ANTIGENIC
MUCOSAL + T LYMPHOCYTE
DEFICIENCY
EXPOSURE
SURBHI
TYPES
RECURRENT HERPETIFORM
APHTHOUS MAJOR
MINOR
ULCERATIONS
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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
MINOR
APHTHOUS
ULCER
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. MINOR APHHOUS ULCER
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RECURRRNT APHTHOUS
MAJOR
Previously it represent a separate disease entity
k/n as periadenitis mucosa necrotica recurrens
(mikuliczs scarring aphthae or suttons 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.
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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.
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MAJOR APHTHOUS ULCER
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MAJOR APHTHOUS ULCER
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RECURRENT HERPETIFORM
ULCERS
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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
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RECURRENT HERPETIFORM ULCERATIONS
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CONTRASTING
FEATURES
MINOR MAJOR HERPETIFORM
SIZE <0.5 cm >0.5 cm <0.5 cm
SHAPE Oval Ragged oval
oval,crateriform
NUMBER 1-5 1-10 10-100
LOCATION Non-keratinized Non-keratinized Any intra oral
mucosa mucosa site
TREATMENT Topical Topical/systemic Topical/systemic
corticosteroids, /intralesional corticosteroids,
tetracycline corticosteroids, tetracycline
mouthrinse immunosuppressiv mouthrinse
es
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HISTOPATHOLOGY
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THANKS.
SURBHI