1-46. RECURRENT APHTHOUS ULCERS
Recurrent aphthous ulcer (RAU) (figure 1-10) is a chronic inflammatory disease
with repeated episodes of ulcerations. Recent investigations seem to indicate that the
aphthous lesion is associated with an altered local immune response. This disease is
characterized by small, whitish ulcers with red borders. The disease normally occurs as
a single lesion or, infrequently, as multiple lesions on the wet mucous membranes of the
lip, tongue, cheek, or floor of the mouth. Lesions appear as depressions on the mucous
membrane and are covered by a grayish-white or light-yellow membrane. There is no
vesicle formation before the ulcer appears, distinguishing this disease from viral
diseases of the oral mucosa. Associated with the development of a recurrent aphthous
ulcer is generally trauma, endocrine change, psychic factors, or allergy. The lesions are
painful; however, the condition is self-limiting with the lesions usually healing in 10 to 14
days without leaving scars. Recurrent aphthous ulcerative lesions are similar to the
ulcerative herpes simplex lesions except that the herpes lesions can also occur on the
attached gingiva.
NOTE: The formation of ulcers on movable mucosal surfaces is extremely painful to
the affected individual. This condition can cause difficulty in eating. The
patient must maintain normal nutrition and oral health habits to limit bacteria
formation.
Figure 1-10. Recurrent aphthous ulcers.
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