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Aphthous Ulcers (Canker Sores)

Aphthous Ulcers (Canker Sores)

oral aphthosis
A 27-year-old woman intermittently experienced painful oral lesions such as this one on her upper lip. She denied a history of genital lesions or ophthalmologic problems. She otherwise was in superb health.

Key point: The shallow ulceration surrounded by a ring of erythema is characteristic for aphthous ulcers (canker sores). Her otherwise negative history rules out Behcet’s disease.

Treatment: The patient was given desoximetasone ointment to apply to the lesion 3 or 4 times daily. This led to prompt ulcer resolution.

Note: Prolonged administration of 1000 µg/d of sublingual vitamin B12 reportedly has been effective for reducing, or even preventing, oral aphthosis in those who have very frequent outbreaks of this often debilitating disease.   

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