• Juliana Dumet FernandesEmail author
  • Marcello Menta S. Nico


Aphthosis is an inflammatory disease characterized by painful recurrent oral ulcerations. The cause of aphthosis is unknown, and several studies indicate a role for the immune system in the physiopathogenesis of this disease. Oral lesions appear mainly on nonkeratinized mucosa as painful, regular, round or oval ulcers covered with a gray pseudomembrane and surrounded by an erythematous halo. The diagnosis of aphthosis is mainly established on clinical grounds. Treatment depends on the severity, recurrence rate, and response to previous therapies.


Recurrent aphthous stomatitis Oral ulcers Aphthosis 




Synonymous to aphthosis. Also used as the description of the individual ulcer of the disease.


A disease characterized by bursts of oral ulcerations, accompanied or not by ulcerations elsewhere (usually genitals) and systemic complaints.


Diaminodiphenyl sulfone (DDS), an antibiotic used in the treatment of leprosy and as an anti-inflammatory drug in several noninfectious skin diseases.

Herpetiform ulceration

One of several clinical types of aphthae, i.e., one that presents as multiple subintrant small ulcerations.

Oral ulcer

Any lesion characterized by loss of the oral epithelium.


An immunomodulatory drug that is the prototype of the thalidomide class of drugs.


  1. 1.
    Tarakji B, Gazal G, Al-Maweri SA, Azzeghaiby SN, Alaizari N. Guideline for the diagnosis and treatment of recurrent aphthous stomatitis for dental practitioners. J Int Oral Health. 2015;7(5):74–80.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Barrons RW. Treatment strategies for recurrent oral aphthous ulcers. Am J Health Syst Pharm. 2001;58(1):41–50. quiz 51–3PubMedGoogle Scholar
  3. 3.
    Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc. 2003;134:200–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Natah SS, Konttinen YT, Enattah NS, et al. Recurrent aphthous ulcers today: a review of the growing knowledge. Int J Oral Maxillofac Surg. 2004;33:221–34.CrossRefPubMedGoogle Scholar
  5. 5.
    Nico MMS, Brito AE, Martins LEAM, Boggio P, Lourenco SV. Oral ulcers in an immunosuppressed 5-year-old boy. Clin Exp Dermatol. 2008;33:367–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Sampaio S, Rivitti E. Afecções dos lábios e da mucosa oral. In: Dermatologia. 3rd ed. Sao Paulo: Artes Médicas, 2007.p 1339–58.Google Scholar
  7. 7.
    Mahe E, Morelon E, Lechaton S, et al. Cutaneous adverse events in renal transplant recipients receiving sirolimus-based therapy. Transplantation. 2005;79:476–82.CrossRefPubMedGoogle Scholar
  8. 8.
    Gupta A, Morris G. Major aphthous ulcers induced by nicorandil. Age Ageing. 2000;29:372–3.CrossRefPubMedGoogle Scholar
  9. 9.
    L Preeti, KT Magesh,1 K Rajkumar, and Raghavendhar Karthik. Recurrent aphthous stomatitis. J Oral Maxillofac Pathol. 2011 Sep-Dec; 15(3): 252–256Google Scholar
  10. 10.
    Scully C, Porter S. Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg. 2008;46:198–206.CrossRefPubMedGoogle Scholar
  11. 11.
    Hill SC, Stavrakoglou A, Coutts IR. Nicotine replacement therapy as a treatment for complex aphthosis. J Dermatol Treat. 2010;21(5):317–8.CrossRefGoogle Scholar
  12. 12.
    Chavan M, Jain H, Diwan N, Khedkar S, Shete A, Durkar S. Recurrent aphthous stomatitis: a review. J Oral Pathol Med. 2012;41(8):577–83.CrossRefPubMedGoogle Scholar
  13. 13.
    Burns T, Breathnach S, Cox N, Griffiths C. The oral cavity and lips. In: Rook’s textbook of dermatology. 8th ed. Oxford: Wiley-Blackwell, 2010. p.69.44–46Google Scholar
  14. 14.
    Rogers RS. Recurrent aphthous stomatitis and Behçet’s syndrome. In: Safai R, Good RA, editors. Immunodermatology. New York: Plenum Press; 1981. p. 345.CrossRefGoogle Scholar
  15. 15.
    Marshall GS, Edwards KM, Butler J, et al. Syndrome of periodic fever, pharyngitis and aphthous stomatitis. J Pediatr. 1987;110:43–6.CrossRefPubMedGoogle Scholar
  16. 16.
    Pakfetrat A, Mansourian A, Momen-Heravi F, Delavarian Z, Momen-Beitollahi J, Khalilzadeh O, et al. Comparison of colchicine versus prednisolone in recurrent aphthous stomatitis: a double-blind randomized clinical trial. Clin Invest Med. 2010;33(3):E189–95.CrossRefPubMedGoogle Scholar
  17. 17.
    Letsinger JA, McCarty MA, Jorizzo JL. Complex aphthosis: a large case series with evaluation algorithm and therapeutic ladder from topicals to thalidomide. J Am Acad Dermatol. 2005;52:500–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Slebioda Z, Szponar E, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp (Warsz). 2014 Jun;62(3):205–15.CrossRefGoogle Scholar
  19. 19.
    Georgakopoulou EA, Andreadis D, Arvanitidis E, Loumou P. Biologic agents and oral diseases – an update on clinical applications. Acta Dermatovenerol Croat. 2013;21(1):24–34.Google Scholar
  20. 20.
    Brocklehurst P, Tickle M, Glenny AM, Lewis MA, Pemberton MN, Taylor J, et al. Systemic interventions for recurrent aphthous stomatitis (mouth ulcers). Cochrane Database Syst Rev. 2012;9:CD005411.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2018

Authors and Affiliations

  • Juliana Dumet Fernandes
    • 1
    Email author
  • Marcello Menta S. Nico
    • 2
  1. 1.School of Medicine - São Paulo University, Hospital das ClínicasSão PauloBrazil
  2. 2.School of Medicine, University of São PauloSão PauloBrazil

Personalised recommendations