RAS key points Flashcards
1
Q
definition
A
recurrent episodes of oral ulceration in an otherwise healthy individual
2
Q
onset
A
often childhood/adolescence, natural history to improve with age
3
Q
prevalence
A
5-25%
4
Q
predisposing factors
A
genetic predisposition drugs - NSAIDs, nicorandil nutritional deficiencies stress smoking cessation chemicals - SLS food allergies trauma
5
Q
clinical appearance
A
round/ovoid
yellow/whitish floor (fibrin)
erythematous halo on non-keratinised mucosa
6
Q
prodrome S+S
A
itching
burning
stinging
erythema
7
Q
minor
A
<10mm <10 lesions round/oval shallow no scar 10-14 days duration 75-90% RAS non-keratinised
8
Q
major
A
>10mm 1-5lesions deep, can scar >14 days duration 10-15% RAS keratinised/non-keratinised oval/irregular
9
Q
herpetiform
A
<5mm (pinpoint) multiple >10 shallow, no scar 10-14 days duration 5-10% RAS NK mucosa round/oval, often coalesce
10
Q
systemic diseases that can cause ROU
A
Behcet syndrome Reactive arthritis (reiter's syndrome) MAGIC syndrome cyclic neutropenia PFAPA syndrome aphthous like ulcerations of HIV haematinic deficiencies coeliac disease IBD (UC, Crohns) SLE H pylori
11
Q
how is diagnosis made?
A
clinical - no biopsy required
but can mimic lots of conditions so need thorough work up
12
Q
causes of ulceration (not just RAS)
A
trauma ROU - non-aphthous - LP, viral, vesiculobullous - RAS - Behcet - Reiter syndrome carcinoma infections GI drugs
13
Q
overall management
A
identify and correct predisposing factors
identify possible systemic disease
medical management
14
Q
tx
A
mouthwashes - CHX, benzydamine topical steroids - hydrocortisone, triamcinolone, fluocinolone, beclomethasone, betamethasone systemic medication - prednisolone - azathioprine
15
Q
potential problems
A
infection
dehydration
