Last reviewed: June 2018
Last updated: July  2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • oral ulcers
  • afebrile
  • absence of genital or ocular ulceration
  • no history of immunodeficiency
  • absence of pallor

Risk factors

  • positive family history
  • non-smoker or cessation of smoking
  • trauma
  • age <30 years
  • Streptococcus sanguis infection
  • cows' milk-fed children
  • female gender
  • white ethnicity
  • higher socioeconomic status
  • high stress levels
  • food intolerance
  • hormonal imbalance
  • use of SLS-containing toothpaste

Diagnostic investigations

Investigations to consider

  • FBC
  • serum ferritin
  • serum folate
  • serum vitamin B12
  • serum IgA-tTG
  • viral serology (e.g., HIV or Epstein-Barr virus)
  • erythrocyte sedimentation rate and CRP
  • biopsy
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Consultant and Honorary Senior Lecturer in Oral Medicine

Glasgow Dental Hospital and School

Glasgow

Scotland

UK

Disclosures

JT declares that she has no competing interests.

We would like to gratefully acknowledge the late Professor Crispian Scully for his contribution to this topic.

Peer reviewers VIEW ALL

Consultant for Oral Pathology and Oral Medicine

The Milton J. Dance Head and Neck Center

Greater Baltimore Medical Center

Baltimore

MD

Disclosures

JJS declares that he has no competing interests.

Consultant in Oral Medicine

Guy’s Hospital

Great Maze Pond

London

UK

Disclosures

PS declares that she has no competing interests.

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