Major Aphthous Ulcers Research Articles

Major recurrent aphthous ulcers treated with 5% amlexanox oral paste and rebamipide tablets- A case report with a brief literature review

Major recurrent aphthous ulcers treated with 5% amlexanox oral paste and rebamipide tablets- A case report with a brief literature review

Management of major recurrent aphthous ulcers with 5% amlexanox oral paste and rebamipide tablets- A case report with a brief literature review

Recurrent aphthous stomatitis (RAS) is a common chronic inflammatory oral mucosal disorder marked by the presence of painful, recurring ulcers, occurring either as solitary lesions or in multiple clusters. While the clinical features of this condition are easily recognizable, the precise etiology remains obscure. The disorder manifests in three forms, of which minor RAS are the commonest and heal within 10-14 days. Major RAS presents as larger, painful chronic ulcerations and heals with scarring in 6-8 weeks. A comprehensive medical history and a thorough systemic examination can aid the physician in determining whether the condition is idiopathic or linked to a underlying systemic disorder. The management of oral aphthous ulcers poses a significant challenge and there is no established and defined therapeutic regimen available for RAS. We present a case of major RAS in a 37-year-old patient who was unresponsive to topical and systemic steroid therapy. 5% Amlexenox paste and rebamipide tablets were used in the present case. The patient showed favourable healing within a week therapy with no recurrences during the 6-month follow up.

A Case Report of Major Aphthous Ulcer

A Case Report of Major Aphthous Ulcer

Case Study of Korean Medical Treatment for Major Aphthous Oral Ulcers

Objective: This case study reports on the results of the Korean medical treatment of a major aphthous oral ulcer patient.Methods: A 19-year-old male Korean patient with a major aphthous oral ulcer received acupuncture, herbal medicine, and moxibustion for three weeks in a hospital.Results: After treatment, changes were observed in the numeric rating scale (NRS) from 8 to 5, World Health Organization oral toxicity scale (WHO OTS) from grades 3 to 2, oral perception guide from 11 to 15, and Oral Health Impact Profile-14 (OHIP-14) from 19 to 34.Conclusion: It is worth examining the progress of Korean medical treatment for a major aphthous oral ulcer patient.

Association of Surfactant Protein D Single Nucleotide Polymorphisms rs721917, rs2243639, rs3088308 with Recurrent Aphthous Stomatitis in Pakistani Population.

Recurrent aphthous stomatitis (RAS) is a benign ulcerative condition, defined by the recurrent formation of non-contagious mucosal ulcers. Surfactant protein D (SP-D) is secreted frequently at surfaces exposed directly to body fluids. This study aims to investigate the association of SP-D single nucleotide polymorphisms (SNPs) with the onset of RAS. Blood samples from 212 subjects (106 cases/controls each) were collected during 2019 and genotyped for SP-D SNPs (rs721917, rs2243639, rs3088308) by polymerase chain reaction and restriction fragment length polymorphism followed by 12% polyacrylamide gel electrophoresis. Minor aphthous (75.5%) was the commonly observed ulcer type as compared to herpetiform (21.7%) and major aphthous ulcers (2.8%). A family history of RAS was reported in 70% of cases. RAS was found significantly associated with rs3088308 genotypes T/A (95% (Cl): 1.57-5.03, p = 0.0005), A/A (95% (Cl): 1.8-6.7, p = 0.0002), T-allele (95% (Cl): 1.09-2.36, p = 0.01), A-allele (95% (Cl): 1.42-3.91, p = 0.01), rs721917 genotype T/T (95% (Cl): 1.15-25.35, p = 0.03), and T-allele (95% (Cl): 1.28-3.10, p = 0.002). Female gender and obese body mass index (BMI) were significantly associated with rs3088308 genotypes T/A (95% (CI): 1.89-15.7, p = 0.001), T/T (95% (Cl): 1.52-11.9, p = 0.005), A-allele (95% (Cl): 1.65-7.58, p < 0.001), and T-allele (95% (Cl): 1.4-10.1, p <0.001) and rs721917 genotype T/T (95% (CI) = 1.3-33, p = 0.02), respectively. This study describes the association of SP-D SNPs (rs721917, rs3088308) with RAS in the Pakistani population.

Clinical characteristics and risk factors of major oral ulcers in the mandibular retromolar region in children.

To describe the characteristics of major aphthous ulcers (MjOU) in children and analyze its potential risk factors. Data were collected from the National Clinical Research Center for Oral Diseases of China between 2012 and 2017. Children younger than 15 years old, who had a giant mucosa ulcer (≥ 1 cm in diameter) and met the diagnostic criteria for MjOU were included in this study. Differences were compared between two subgroups of patients based on the location of the ulcerous lesions. A measurement of ratio (TBR) between the length of the mandibular second molar tooth germ and the height of the mandible was performed in children with MjOU lesions located in the mandibular retromolar pad region (MjOU-P) and their age- and sex-matched controls. A total of 1067 children were diagnosed with oral ulcers during the study period, of which 125 (11.7%, 95% CI: 9.8%-13.7%) met the diagnostic criteria for MjOU. More than half (n = 64, 51.2%) of the MjOU cases were MjOU-P, which had a male predilection (n = 52, 81.3%) with a significant majority at 7 to 9 years of age (n = 43, 67.2%). In comparison to the MjOU located in other regions, MjOU-P lasted longer in duration and had more comorbidities. Logistic regression analysis showed that MjOU-P was statistically significantly associated with TBR controlling age and gender. MjOU-P is a predominant form of MjOU in children and is a distinct subgroup of major ulcers that is likely associated with the development of the mandibular second molars. This study is the first to describe the demographic and clinical features of MjOU in children, which may facilitate the identification and treatment of these patients.

Therapeutic Effect of Chemically Synthesized Silver Nanoparticles on Aphthous Stomatitis in Some Iraqi Patients

Silver nanoparticles (AgNPs) were synthesized by a chemical reduction method. The particles were synthesized using silver nitrate solution with sodium borohydride as the reducer. The resulting colloidal AgNPs were characterized by UV-Visible spectroscopy, and FTIR. Aphthous stomatitis is a common and recurrent painful disease of the oral mucous membrane, classified in to three different aphthous types: minor, major and herpetiform. It may appear due to a variety of causes including: stress, food, hypersensitivities, infection, trauma, drug allergy, nutrition deficiencies (Iron, zinc & vitamin B12) or it could be a symptom of serious disease such as carcinoma. In this study, (75) young Iraqi patients aged (18-24) years divided in to two groups according to their gender (25 male and 50 female) all of them are suffering from major Aphthous ulcers in the mouth. The solution of (10 µg/ml) concentration of silver nanoparticles showed a uniform cycle inhibition around the ulcer growth zone while, increasing of (AgNPs) solution to (20 µg/ml) showed a highly and significant inhibitory effect against isolates from Aphthous stomatitis during the first 24 hours only in both male and female groups. Further studies is needed to investigate the inhibitory mechanism of (AgNPs) against Aphthous stomatitis.

MAJOR APHTHOUS ULCER IN A PATIENT WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME

Oral manifestations in acquired immune deficiency syndrome (AIDS) occur in a large proportion of patients. A 28-year-old man with AIDS was referred from medicine service due to multiple oral lesions of unknown clinical progress. The patient presented with lymphopenia (a CD4+ T-cell count of 11 cell/μL) and noncompliance with antiretroviral treatment (viral load 59,100 copies/mL). An extensive ulcer of 30 × 14 mm with a marked erythematous halo on the left buccal mucosa was observed. An incisional biopsy and a culture were performed to evaluate for the presence of infectious diseases. Definitive diagnosis was major aphthous ulcer in an AIDS patient. Oral hygiene was carried out together with highly active antiretroviral treatment. Complete healing was observed within 6 weeks’ follow-up, improvement of the CD4+ count, a decrease in the viral load, and absence of recurrence signs. It is important to make a differential diagnosis of oral lesions in patients with AIDS to establish the proper treatment.

Multiple Major Aphthous Ulcers: An Uncommon Presentation

Multiple Major Aphthous Ulcers: An Uncommon Presentation

Recurrent aphthous ulcer among family members affected with HIV/AIDS infection-A case report

Recurrent aphthous ulcer is a clinical condition characterized by painful ulcer with different size affecting the mucosa of oral cavity. Its etiology and pathogenesis is not clearly known and the diagnosis is based on the clinical picture. These lesions may be classified into minor, major and herpetiformis. The aphthous ulcers in the oral cavity affect speech and feeding, leading to poor quality of life. The aphthous ulcers in immunocompromised patients like AIDS cause severe type of ulceration. Here we are presenting a report of two patients (daughter and mother) in a family suffering from AIDS with major recurrent aphthous ulcers in the oral cavity.

Prevalence of aphthous and aphthous like ulcers and their relation to precipitating factors among a sample of Egyptian Population

Introduction: Recurrent aphthous ulcer is one of the most common oral diseases worldwide. The prevalence ranges from 2% to 66% in different populations. Detection of the prevalence of oral ulcerations in the general population is very important as the ulcers have significant negative effects on the oral health, irrespective to the etiology. Moreover, many syndromes were known to be associated with recurrent aphthous ulcers. Aim: the present study was performed to detect RAU prevalence among a sample of Egyptian population and to find out its incidence in relation to the precipitating factors.Subjects & Methods: The present study was performed on a total of 4362 subjects, 1874 males and 2488 females. The subjects were recruited from the outpatient clinic of Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University. For patients with RAU, the diagnostic sheets were provided. Data obtained from the questionnaire was analyzed using software SPSS 16.0 for windowsResults: There were 50/4362 cases with aphthous ulcer giving a prevalence of 1.15%. Ten cases (20.0%) had major aphthous ulcer while 40 cases (80.0%) had minor aphthous ulcer and no herpetiform aphthous ulcers were reported. Conclusions: The present study shed the light on the prevalence of recurrent aphthous ulcers and also pointed to the importance of a thorough history taking to identify the main risk factors of the ulceration and then to get the needed preventive measures.

Aphtes et ulcérations buccales

Aphthous ulcers are painful ulcerations located on the mucous membrane, generally in the mouth, less often in the genital area. Three clinical forms of aphthous ulcers have been described: minor aphthous ulcers, herpetiform aphthous ulcers and major aphthous ulcers. Many other conditions presenting with oral bullous or vesiculous lesions orulcerations and erosions can be mistaken for aphthous ulcers. Currently, treatment of aphthous ulcers is palliative and symptomatic. Topical treatments (topical anesthetics, topical steroids and sucralfate) are the first line therapy. Recurrent aphthous stomatitis (RAS) is defined by the recurrence of oral aphthous ulcers at least 4 times per year. RAS is often idiopathic but can be associated with gastro-intestinal diseases (i.e. celiac disease, inflammatory bowel diseases), nutritional deficiencies (iron, folates...), immune disorders (HIV infection, neutropenia) and rare syndromes. Behçet's disease is a chronic, inflammatory, disease whose main clinical feature is recurrent bipolar aphthosis. Colchicine associated with topical treatments constitutes a suitable treatment of most RAS. Thalidomide is the most effective treatment of RAS but its use is limited by frequent adverse effects. Oral ulcers can be related to a wide range of conditions that constitute the differential diagnoses of aphthous ulcers. Oral ulcers are classified into three main groups: acute ulcers with abrupt onset and short duration, recurrent ulcers (mainly due to postherpetic erythema multiforme) and chronic ulcers (with slow onset and insidious progression). Acute oral ulcers are due to trauma, bacterial infections (including acute necrotizing ulcerative gingivitis), deep fungal infection, gastro-intestinal (namely inflammatory bowel disease) or systemic diseases. Chronic oral ulcers may be drug-induced, or due to benign or malignant tumors. Every oral solitary chronic ulcer should be biopsied to rule out squamous cell carcinoma. A solitary palatal ulcer can be related with necrotizing sialometaplasia.

Thalidomide for the Treatment of Recurrent Major Aphthous Ulcers Resistant to Conventional Treatments: A Case Report

Thalidomide for the Treatment of Recurrent Major Aphthous Ulcers Resistant to Conventional Treatments: A Case Report

An Alternative Approach for the Treatment of Major Aphthosis: Case Report

An effective treatment for aphthous stomatitis is not still available and its treatment consists only of therapeutic measures to suppress its symptoms. We report a case of a 60-year caucasian woman presented a 16-year history of episodes of multiple major recurrent ulcers in the oral mucosa. Topical application of Oralmedic® caused an improvement of pain, discomfort and healing of the aphthous ulcer. No adverse events or side effects were recorded. Oralmedic® is an effective topical device for the major aphthous ulcers treatment.

Anticoagulant and Fibrinolytic Disorders in Patients with Behçet's Disease and Recurrent Aphthous Ulcer

Behçet's disease (BD) is a chronic multisystemic inflammatory disorder characterized by recurrent oral and genital aphthous ulcers, uveitis and skin lesions. Recurrent aphthous ulcer (RAU) is the most prevalent oral mucosal disease in humans. The pathogenesis and thrombopoiesis of BD and RAU have not been fully clarified. To reveal the haemostatic dysfunctions in the patients with BD and RAU, we evaluated the levels of coagulant, anticoagulant and fibrinolytic parameters in these patients.Factor VIII clotting activity (FVIII:c), protein C antigen (PC:Ag), total protein S antigen (TPS: Ag), tissue-type plasminogen activator antigen (t-PA:Ag), plasminogen activator inhibitor-1 antigen (PAI-1:Ag) and D-dimer were detected in 24 BD, 58 RAU patients and 50 controls. Results showed that levels of PC:Ag, TPS:Ag, PAI-1:Ag and D-dimer were significantly elevated in both BD and RAU patients compared with controls (P<0.01). PAI-1:Ag was even higher in BD patients than in RAU patients (74.99±12.28 vs. 69.57±13.11, P<0.05), whereas the level of t-PA:Ag was significantly reduced in patients with BD and RAU (P<0.01). In patients with RAU, PC:Ag was lower in major aphthous ulcer (MjAU) group than in minor aphthous ulcer (MiAU) group (P<0.05). The expression of FVIII:c was significantly elevated in MiAU patients compared with controls (P<0.01), while no difference was observed between MjAU patients and controls (P>0.05). Our studies showed that there were anticoagulant and fibrinolytic disorders in BD patients, which may be responsible for diminished fibrinolysis in BD. Some haemostatic parameters may be correlated with the severity of RAU.

Investigate the curative effect on treatment of 40 major aphthous ulcer patients by combined use povidone-iodine,H2O2 and levamisole liniment

目的 探索碘伏,双氧水和左旋咪唑涂布剂联合治疗重型阿弗它溃疡的效果.方法 按重型阿弗它溃疡诊断标准,将患者随机分为两组,治疗组患者用碘伏、双氧水和左旋咪唑涂布剂联合治疗.对照组采用口服甲硝唑、抗生素、复合维生素B、维生素C治疗,定期随访,观察疗效.结果 治疗组患者治疗有效率85%,对照组为55%,差异有统计学意义(P＜0.01).结论 碘伏、双氧水和左旋咪唑涂布剂联合治疗重型阿弗它溃疡,有确切疗效。

Management strategies for HIV-associated aphthous stomatitis.

Recurrent aphthous stomatitis (RAS) is the most common oral mucosal disorder found in men and women of all ages, races, and geographic regions. There are three forms of the lesions (minor, major, and herpetiform), with major aphthous ulcers causing significant pain and potential for scarring. In HIV-infected individuals, these ulcers occur more frequently, last longer, and produce more painful symptoms than in immunocompetent persons. In addition, they may be associated with similar ulcerations involving the esophagus, rectum, anus, and genitals. The diagnosis of HIV-induced RAS requires a careful history of the condition, and a thorough extra- and intra-oral examination. Oral mucosal biopsies are required for non-healing ulcers in order to exclude the possibility of deep fungal infections, viral infections, and neoplasms. The cause of the ulcers in HIV-positive persons has not been elucidated--local diseases, genetic, immunologic, and infectious factors all probably play a role. The goals of current treatments are to promote ulcer healing, to reduce ulcer duration and pain while maintaining nutritional intake, and to prevent or diminish the frequency of recurrence. Initial therapy for infrequent RAS recurrences includes over-the-counter topical protective and analgesic products. Initial therapy for frequent RAS outbreaks requires topical anesthetics, binding agents, and corticosteroids. Major RAS and non-healing minor or herpetiform RAS may require intralesional corticosteroids and systemic prednisone. Second-line immunomodulators for frequent and non-healing ulcers includes thalidomide and other immunomodulators.

Organize for Multicentered Clinical Trials

Organize for Multicentered Clinical Trials

Major aphthous ulcer in an HIV-positive child

Major aphthous ulcer in an HIV-positive child

ORAL INFECTIONS AND OTHER MANIFESTATIONS OF HIV DISEASE

Oral lesions are important in the clinical spectrum of HIV/AIDS, arousing suspicion of acute seroconversion illness (aphthous ulceration and candidiasis), suggesting HIV infection in the undiagnosed individual (candidiasis, hairy leukoplakia, Kaposi's sarcoma, necrotizing ulcerative gingivitis), indicating clinical disease progression and predicting development of AIDS (candidiasis, hairy leukoplakia), and marking immune suppression in HIV-infected individuals (candidiasis, hairy leukoplakia, necrotizing periodontal disease, Kaposi's sarcoma, long-standing herpes infection, major aphthous ulcers). In addition, oral lesions are included in staging systems for HIV disease progression and as entry criteria or endpoints in clinical trials of antiretroviral drugs. Recognition and management of these oral conditions is important for the health and quality of life of the individual with HIV/AIDS. In keeping with this, the U.S. Department of Health Services Clinical Practice Guideline for Evaluation and Management of Early HIV Infection includes recommendations that an oral examination, emphasizing oral mucosal surfaces, be conducted by the primary care provider at each visit, a dental examination by a dentist should be done at least two times a year, and patients should be informed of the importance of oral care and educated about common HIV-related oral lesions and associated symptoms.