Recurrent aphthous stomatitis or aphtha in layman’s terms is a disease characterized by the repeated appearance of ulcers limited to the mucous membrane of the oral cavity in patients without other signs of the disease. It affects approximately 20% of the general population, more often women. The cause of canker sores is unknown, and according to the clinical forms, RAS can be divided into 3 forms: 1) small canker sores, 2) large aphthae and 3) herpetiform aphthae.

Etiology. RAS is caused by several factors, the most important of which are heredity, allergies, and diseases of the immune and circulatory systems. Patients with canker sores may have low levels of Fe, B12, folic acid, food allergy, Crohn’s disease, celiac disease, ulcerative colitis, and autoimmune disorders.

Clinical picture. Minor aphthae are the most common form of aphthous stomatitis, up to 1 cm in diameter. They often begin with a burning sensation on the mucous membrane of the cheeks or lips, followed by the formation of ulcers on a reddish base. The number of canker sores varies from one to several and they appear several times a year. They last 10-14 days and are whole without a scar.

Large canker sores are larger than 1 cm in diameter, last longer (up to several weeks), are painful and heal with scars. They are often found on the palatal arches, tongue, cheek and labial mucosa. Lymph nodes are present and enlarged.

Herpetiform aphthae are multiple, very painful ulcers, 1-2 mm in diameter. They can appear anywhere on the mucous membrane, but they most often occur on the front part of the tongue, the edges of the tongue and the mucous membrane of the lips.

Differential diagnosis: carcinoma of the oral cavity

Therapy. Treatment is etiological; supplementation of iron, vitamin B12, folic acid. Symptomatic treatment includes topical application of corticosteroids (solutions, ointments, orabaz). Immunostimulating drugs are recommended.