Aphthous Ulcers (Canker Sores)

[[{"type":"media","view_mode":"media_crop","fid":"25062","attributes":{"alt":"oral aphthosis","class":"media-image","id":"media_crop_593438721462","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2240","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":"","typeof":"foaf:Image"}}]]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.