Aphthous Stomatitis Current Perspective复发性阿弗他口炎流视角课件.ppt

Recurrent Aphthous Stomatitis-Current Perspective Dr. Prabhakar M Sangolli Dept of Dermatology Dr.B.R.AMBEDKAR MEDICAL COLLEGE Bangalore Canker Sore Recurring ulcers in the oral mucous membrane with no signs of systemic disease. Common manifestation of haematological, immunological and psychological disorders. Aetiopathogenesis Genetic ( HLA)-40% cases Nutritional-Iron,folic acid,B1,B2,B3, B12,C Endocrinal-Premenstrual,pregnancy Infective-Strep.sanguis(Hsp), HIV Stress Smoking cessation Trauma Immunological(ADCC) Clinical Features -20% of general population -Precipitated by trauma,menses -Prodrome 2-48 hrs Pre ulcerative Ulcerative Resolving TYPES DISEASES SIMULATING RAS Behcet’s: oral, genital, neuro-ocular Sweet’s syndrome Blood dyscrasias GIT malabsorption (Coeliac disease,IBD) Collagen vascular diseases Cyclic neutropenia Reiter’s Disease Recurrent Intra oral Herpes MANAGEMENT History : Stress Trauma Smoking Premenstrual flare Clinical examination: Eye Genital Rectal CNS Investigations MaRAS,onset 25yrs age,pt with syst.symptoms CBC Serum iron,B12,RBC folate levels,ferritin ANA GENERAL MEASURES Stress avoidance Nicotine patches Soft tooth brush B12 supplements:1000mcg twice wkly-6wks 1000mcg once a month-1 yr (low serum B12 level) Folic acid, Iron, B-complex, C supplements Pre Probiotics TOPICAL THERAPY Mild cases - To promote healing, use 0.1% Triamcinolone with orabase, qid 2% xylocaine viscous to relieve pain Severe cases :Clobetasol, Flucinolone Tetracycline in 30 ml water q.i.d 5% Amlexanox paste-Accelerate healing . SEVERE CASES Prednisolone 1mg/kg/day, taper over 2 weeks Azathioprine - 50mg b.i.