Clinico-Histopathological features and investigations of oral aphthous stomatitis including Behcet’s Disease

Abstract

The three clinical subtypes of oral recurrent aphthous stomatitis (RAS) i.e. minor, major and herpetiform share certain common features - namely the patients affected are otherwise well, their ulcers have a tendency to recur, are generally associated with varyng degrees of pain and preferentially occur in nonkeratinized mucosa. These subsets of RAS differ from one another by the size and number of ulcers at each bout and wether or not permanent scarring occurs upon healing. Histopathologically RAS presents as a non specific ulcer characterized by a fibrinopurulent membrane covering an area of epithelial loss and deep to it granulation tissue showing a chronic inflammatory response and attempts at organization. Immunofluorescence of lesional tissue is rarely of diagnostic benefit. Haematological investigation may reveal an underlying haematinic deficiency.

           In Behcet's disease, RAS-like ulceration is seen in patients with multisystem disease involving other mucocutaneous surfaces, eyes (uveitis), musculoskeletal, neurological, haemotological and gastrointestinal systems. Thorough systematic work-up is necessary for these patients.