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Acquired, continued
Ulcers
There are 3 types of ulcers:
 
1.
Traumatic: Typically result from mechanical or thermal injury. Usually seen on the buccal mucosa, tongue, lips, or palate.
 
2.
Infectious: Usually caused by HSV (primary or recurrent) or Coxsackie infections. (Refer to Chapter 9: Common Oral Pathology for more information).
 
3.
Aphthous: Disintegration and necrosis of epithelial tissue on a mucous membrane; usually painful.
Aphthous: Most common type of oral ulcer in the United States.

Aphthous Ulcers
Aphthous ulcers or stomatitis (“canker sores”) are round, yellowish-grey ulcers with surrounding erythema (halo) usually located on mucous membranes. These lesions are often painful.


Aphthous ulcers are divided into 3 categories::
 
1.
Aphthous Minor Ulcers: Characterized by small (usually 1-5 mm) lesions, very common, accounting for 80% of cases. Minor ulcers last 5-12 days and heal without scarring
 
2.
Aphthous Major Ulcers: Greater than 1 cm in diameter and account for approximately 15% of cases. Recurrent major
Aphthae: A speck or blister on the mucous membranes characteristic of some diseases.
aphthae may take up to 4 weeks to heal and may scar.
 
3.
Herpetiform Ulcers: Grouped 1-2 mm papules, vesicles, or ulcers. This is the least common type.

The etiology of aphthous ulcers is unknown, but they may be infectious, autoimmune, allergic, nutritional, or traumatic in nature. Aphthous ulcers are more common in individuals with inflammatory bowel disease, celiac disease, immunosuppression, cyclic
Neutropenia: Leukopenia in which the decrease in white blood cells is chiefly in neutrophils.
neutropenia, rheumatologic disorders (eg, JRA, SLE) or vitamin deficiencies (B12, folate, iron, zinc).

Common medication triggers are NSAIDs and ACE inhibitors. Treatment of aphthous ulcers includes supportive care, such as topical anesthetic creams or mouthrinses, although the benefits of using these products is not well-established. Recurrence is likely.
 
 
There are 3 types of oral ulcers: traumatic, infectious, and aphthous.
 
Aphthous ulcers are the most common type of oral ulcer in the United States.
 
The etiology of aphthous ulcers is unknown.
 
The 3 subtypes of aphthous ulcers can be distinguished clinically.
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