Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- úlceras orais
- paciente afebril
- ausência de ulceração genital ou ocular
- sem história de imunodeficiência
- ausência de palidez
Risk factors
- história familiar positiva
- não fumante ou abandono do hábito de fumar
- trauma
- idade <30 anos
- crianças alimentadas com leite de vaca
- sexo feminino
- altos níveis de estresse
- intolerância alimentar
- desequilíbrio hormonal
- uso de creme dental contendo lauril sulfato de sódio
Diagnostic tests
Tests to consider
- Hemograma completo
- ferritina sérica
- folato sérico
- vitamina B12 sérica
- imunoglobulina A-transglutaminase tecidual (IgA-tTG) sérica
- sorologia viral (por exemplo, HIV ou vírus Epstein-Barr)
- velocidade de hemossedimentação e proteína C-reativa
- biópsia
- teste de fator antinuclear
- teste sorológico para HIV
Treatment algorithm
todos os pacientes
Contributors
Authors
Jennifer Taylor, BDS, MFDS RCS, MBChB FDS (OM), PhD
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.
Acknowledgements
We would like to gratefully acknowledge the late Professor Crispian Scully for his contribution to this topic.
Peer reviewers
James J. Sciubba, DMD, PhD
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.
Pepe Shirlaw, BDS, FDS RCPS
Consultant in Oral Medicine
Guy’s Hospital
Great Maze Pond
London
UK
Disclosures
PS declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Scully C. Clinical practice. Aphthous ulceration. N Engl J Med. 2006 Jul 13;355(2):165-72. Abstract
Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc. 2003 Feb;134(2):200-7. Abstract
Brocklehurst P, Tickle M, Glenny AM, et al. Systemic interventions for recurrent aphthous stomatitis (mouth ulcers). Cochrane Database Syst Rev. 2012 Sep 12;(9):CD005411.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Síndrome de Behçet
- Úlcera maligna
- Deficiência de folato
More DifferentialsGuidelines
- The diagnosis and management of recurrent aphthous stomatitis: a consensus approach
More GuidelinesPatient information
Úlceras orais
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