Overview
Recurrent aphthous ulcers (RAU) are common, painful oral mucosal lesions with no definitive cure, typically managed to reduce pain and promote healing. 1Diagnosis
Clinical presentation characterized by recurrent, small, shallow ulcers in the mouth.
No specific diagnostic tests; diagnosis is clinical.
Grading systems often assess ulcer size, frequency, and duration, though standardized scales vary 1.Management
First-line treatments: Topical corticosteroids, antimicrobial mouthwashes (e.g., chlorhexidine).
Adjunctive treatments:
- Bioadhesive devices containing 2-octyl cyanoacrylate applied by healthcare providers or self-administered, showing significant pain reduction and accelerated healing 1.
- Systemic retinoids like etretinate in severe cases, particularly in non-childbearing individuals, warranting further assessment 2.Special Populations
Pregnancy: Systemic retinoids such as etretinate are contraindicated due to teratogenic risks 2.
Pediatrics: Limited specific guidance; treatments generally similar to adults but with caution regarding systemic agents 1.
Elderly: No specific considerations noted; management aligns with general guidelines 1.
Comorbidities: No specific recommendations provided in abstracts; tailored management based on underlying conditions is advised 12.Key Recommendations
Consider the use of bioadhesive devices containing 2-octyl cyanoacrylate for pain reduction and accelerated healing in RAU management (Evidence: Strong 1).
Evaluate systemic retinoids like etretinate in severe cases of RAU among non-childbearing individuals, acknowledging potential benefits despite risks (Evidence: Moderate 2).
Prioritize topical corticosteroids and antimicrobial mouthwashes as initial treatment options for RAU (Evidence: Expert opinion 1).References
1 Kutcher MJ, Ludlow JB, Samuelson AD, Campbell T, Pusek SN. Evaluation of a bioadhesive device for the management of aphthous ulcers. Journal of the American Dental Association (1939) 2001. link
2 Murphy GM, Griffiths WA. Aphthous ulcers responding to etretinate--a case report. Clinical and experimental dermatology 1989. link