Aphthe: Or something else? Differential Diagnosis

Blood, hematopoietic organs – immune system (D50-D90).

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Folic acid deficiency
  • Vitamin B12 deficiency

Skin and subcutaneous tissue (L00-L99)

  • Bullous erythema exsudativum multiforme (synonyms: Dermatostomatitis Baader, Fiessinger-Rendu syndrome, Erythema exsudativum multiforme majus) – infectious or drug-allergic skin disease.
  • Erosive (superficial tissue loss of the skin / mucosa) lichen ruber planus (nodular lichen).
  • Lichen planus mucosae (mucosal manifestation of lichen ruber planus).
  • Pemphigoid (blistering skin disease).
  • Pemphigus (blistering skin disease).
  • Sweet syndrome (synonym: acute febrile neutrophilic dermatosis) – clinical picture associated with fever and formation of multiple red nodules and plaques, especially on the face and extremities, there is also an increase in neutrophilic granulocytes (belong to the group of white blood cells); possible triggers are infectious diseases, drugs and neoplasms (neoplasms); possible hematological diseases (blood diseases): Myeloid leukemias, myelodysplastic and myeloproliferative diseases, chronic leukemias, paraproteinemias.

Infectious and parasitic diseases (A00-B99).

  • Angina Plaut-Vincent – relatively rare form of tonsillitis (inflammation of the tonsils) with pseudomembranous ulceration (ulceration) of the pharynx and tonsils (adenoids).
  • Candidiasis (fungal disease)
  • Hand-foot-mouth disease (HFMK; hand-foot-mouth exanthema) [most common cause: Coxsackie A16 viruses].
  • Herpangina (synonym: Zahorsky’s disease) – occurs predominantly in childhood; affects the oral mucosa and palatine tonsil; it is caused by infection with Coxsackie virus (type A)
  • Herpes simplex
  • Herpes zoster (shingles)
  • HIV infection
  • Infections caused by other pathogens such as Varicella zoster or bacteria.
  • Mononucleosis (Pfeiffer’s glandular fever)
  • Syphilis (lues; venereal disease)
  • Tuberculosis (consumption)

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • Bisphosphonate-induced ulcers.
  • Ulcerative colitis – chronic inflammatory disease of the mucosa of the colon (large intestine) or rectum (rectum).
  • Gingivitis (inflammation of the gums), acute necrotizing ulcerative.
  • Crohn’s disease – chronic inflammatory bowel disease; it usually progresses in relapses and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa (intestinal mucosa), that is, several intestinal segments may be affected, which are separated by healthy sections of each other
  • Oral allergic contact stomatitis – allergic reaction of the oral mucosa after contact with various substances.
  • Oral eosinophilic or traumatic ulcer – formation of a major ulceration in the oral region (including tongue and lip); benign (benign), reactive and self-limiting lesion of unclear pathogenesis (disease development).
  • Recurrent (recurring) aphthous ulceration.
  • Stomatitis, drug-related ulcerative (drug-related oral mucosal inflammation with ulceration).
  • Celiac disease (gluten-induced enteropathy) – chronic disease of the mucosa of the small intestine (small intestinal mucosa), which is based on hypersensitivity to the cereal protein gluten.

Musculoskeletal system and connective tissue (M00-M99).

  • MAGIC syndrome (“mouth and genital ulcers with inflamed cartilage“; systemic disease that has symptoms of both Behçet’s disease and recurrent polychondritis/cartilage inflammation).
  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the corpus ciliary (corpus ciliare) and the iris), is stated as typical for the disease; a defect in cellular immunity is suspected
  • Reactive arthritis (synonym: postinfectious arthritis / joint inflammation) – secondary disease after gastrointestinal (gastrointestinal tract concerning), urogenital (urinary and genital organs concerning) or pulmonary (lungs concerning) infections; denotes an arthritis, where pathogens in the joint (usually) can not be found (sterile synovialitis).
  • Reiter’s disease (synonyms: Reiter’s syndrome; Reiter’s disease; arthritis dysenterica; polyarthritis enterica; postenteritic arthritis; posturethritic arthritis; undifferentiated oligoarthritis; urethro-oculo-synovial syndrome; Fiessinger-Leroy syndrome; English Sexually acquired reactive arthritis (SARA)) – special form of a “reactive arthritis” (see above. ); secondary disease after gastrointestinal or urogenital infections, characterized by the symptoms of Reiter’s triad; seronegative spondyloarthropathy, which is triggered especially in HLA-B27 positive persons by an intestinal or urinary tract disease with bacteria (mostly chlamydia); Can manifest as arthritis (joint inflammation), conjunctivitis (conjunctivitis), urethritis (urethritis) and partly with typical skin changes.

Neoplasms – tumor diseases (C00-D48).

Further

  • Trauma (injuries)