Aphthous stomatitis: Difference between revisions
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**[[Dexamethasone]] 0.01% elixir as mouth rinse '''OR''' | **[[Dexamethasone]] 0.01% elixir as mouth rinse '''OR''' | ||
**Fluocinonide 0.05% gel applied topically to isolated lesions | **Fluocinonide 0.05% gel applied topically to isolated lesions | ||
*Biopsy to evaluate for malignancy or immune-mediated disease is recommended if lesion does not respond appropriately to steroids | |||
==Disposition== | ==Disposition== | ||
Revision as of 17:34, 4 June 2019
Background
- Affects 20% of the normal population
- Unclear etiology. Common triggers: stress, hormonal changes, smoking, certain food such as coffee, chocolate.
- Resolve spontaneously in 10-14d
Clinical Features
- Involves the nonkeratinized epithelium (especially labial and buccal mucosa)
- Begins as erythematous macule that ulcerates and forms a central fibropurulent eschar
- Lesions measure from 2-3mm to several cm in diameter
Differential Diagnosis
Oral rashes and lesions
- Angioedema
- Aphthous stomatitis
- Herpes gingivostomatitis
- Herpes labialis
- Measles (Koplik's spots)
- Perioral dermatitis
- Oral thrush
- Steven Johnson syndrome
- Streptococcal pharyngitis
- Tongue diagnoses
- Vincent's angina
Evaluation
- Clinical diagnosis
Management
- Topical corticosteroids
- Betamethasone syrup OR
- Dexamethasone 0.01% elixir as mouth rinse OR
- Fluocinonide 0.05% gel applied topically to isolated lesions
- Biopsy to evaluate for malignancy or immune-mediated disease is recommended if lesion does not respond appropriately to steroids
Disposition
Discharge