Causes of aphthous ulcers are unclear

A painful inflamed lesion on the oral mucosa, which often seems to be burning at the periphery: every third individual has at one point had such a lesion—an aphthous ulcer. Often they resolve after a brief period of time. In 2% to 10% of patients these lesions are recurrent and require medical treatment. Unfortunately, as Andreas Altenberg and co-authors point out in a current review on the therapy of aphthous ulcers, the etiology of these lesions is unclear. Thus aphthous ulcers can only be treated symptomatically.

Even though we do not know how aphthous ulcers develop, a number of predisposing factors have been identified: iron, folic acid and vitamin B12 deficiency as well as mucosal injuries can lead to aphthous ulcers.  Patients are advised as a prophylactic measure to avoid firm, acidic and salty foods, alcohol and carbonated beverages. According to the authors, most cases should be treated with a topical agent, usually an ointment. Only in severe forms of the disease is the use of systemic medications necessary.

More information:
Altenburg A, El-Haj N, Micheli C, Puttkammer M, Abdel-Naser MB, Zouboulis CC: "The treatment of chronic recurrent oral aphthous ulcers." Dtsch Arztebl Int 2014; 111: 665–73. www.aerzteblatt.de/pdf.asp?id=162421

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