Aphthe

An aphtae – colloquially called an oral ulcer – (synonyms: Aphth; aphthosis; Bednar aphthae; chronic recurrent aphthae (minor form); chronic recurrent aphthae (major form); habitual aphthae; herpetiform stomatitis; oral mucosal aphthae; oral aphthae; oral aphthous ulceration; recurrent oral aphthae; periadenitis mucosa necrotica recurrens; recurrent aphthous ulcer; stomatitis herpetiformis; stomatitis recurrens major; stomatitis recurrens minor; ICD-10-GM K12. 0: Recurrent oral aphthae) is a painful, erosive mucosal lesion that occurs preferentially in the oral cavity in the region of the gums, oral mucosa, or tongue.

Aphthae are among the most common diseases of the oral mucosa. Less frequently, aphthae also occur in the genital mucosa.

Aphthae occur in families.

The following forms are distinguished:

  • Minor type (Mikulicz)
  • Major type (Sutton)
  • Herpetiform aphthae (Cooke)

For details, see below “Symptoms – Complaints”.

For more details, see below “Symptoms – Complaints”.

In addition, the following special forms are described:

  • Solitary giant aphthae
  • Bipolar aphthosis – in 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
  • HIV-associated aphthae

Furthermore, aphthae can be classified according to the course:

  • Acute solitary (a single or only a few) aphthae.
  • Chronic-recurrent aphthae (synonyms: habitual aphthae resp. habituelle aphthosis): 3-6 episodes/year, oral aphthae that heal less quickly but are not very painful; can also occur genitally and perigenitally (scrotum/scrotum, vulva/total external primary sex organs, anus, perineum/perineum, region between anus and external sex organs; possibly also inguinalin the groin region); frequency: 5-60%.

Sex ratio: women are more often affected by chronic recurrent aphthae than men.

Frequency peak: chronic recurrent aphthae occur predominantly in adults.

The lifetime prevalence (disease incidence throughout life) for chronic recurrent aphthae is 20%.

Course and prognosis: The inconspicuous-looking spots are usually very painful for the affected person and can lead to significant restrictions in speaking or eating. Acute solitary aphthae usually disappear spontaneously (by themselves) after 1-2 weeks. There is no risk of infection. If the aphthae occur in the context of a disease, the therapy of the underlying disease is the priority.