Aphthous ulcers


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Aphthous ulcers

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Nasal and nasopharyngeal disorders

Choanal atresia

Allergic rhinitis

Nasal polyps

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Oral cavity and oropharyngeal disorders



Ludwig angina

Aphthous ulcers

Temporomandibular joint dysfunction

Oral cancer

Warthin tumor

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Eyes, ears, nose and throat pathology review

Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review

Eye conditions: Retinal disorders: Pathology review

Eye conditions: Inflammation, infections and trauma: Pathology review

Vertigo: Pathology review

Nasal, oral and pharyngeal diseases: Pathology review

Thyroid nodules and thyroid cancer: Pathology review

Parathyroid disorders and calcium imbalance: Pathology review


Aphthous ulcers


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High Yield Notes

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Aphthous ulcers

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External References

First Aid






Aphthous stomatitis


Content Reviewers

Rishi Desai, MD, MPH


Aphthous ulcers, often called canker sores, are painful inflammatory lesions or spots on the inside of the mouth.

Most often, people develop minor aphthous ulcers, which is where the lesions are a few millimeters across, round or oval in shape, and disappear within a week.

There are also two other unusual variations, however, major aphthous ulcers and herpetiform ulcers, which are much more severe and debilitating.

The underlying cause of this inflammatory disease is not well understood. One theory suggests tissue specific autoimmunity, where a localized cell-mediated immune reaction happens in the oral mucosa creating an accumulation of T-cells, specifically T helper cells Th1 cells, and macrophages, as well as chemokines like interferon-gamma and tumor necrosis factor.

Aphthous ulcers typically arise, either singly, or a few at a time, on the inside of the lips and cheeks or under the tongue.

Initially there is a small raised bump of inflammation in your mouth, and as it heals it turns into an ulcer covered by a fibrous membrane “cap” that looks yellowish-white or gray with well defined margins.

The ulcer is typically surrounded by a characteristic red halo due to inflammation in neighbouring blood vessels.

Aphthous ulcers are usually mildly painful and annoying, with individual lesions measuring a few millimeters across and healing within 7 to 10 days without scarring. And these usually recur 3-4 times per year.

There are some variations on this general pattern. Some individuals have recurrent aphthous ulcers which is where the recurrence is more frequent - sometimes each month, and this starts during childhood and resolves around age 40.

Another variation is major aphthous ulcers which describes lesions that measure over one centimeter in size and are generally more painful, last longer, and recur frequently.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Recurrent aphthous stomatitis" Journal of Oral and Maxillofacial Pathology (2011)
  6. "Innate immune system is implicated in recurrent aphthous ulcer pathogenesis" Journal of Oral Pathology & Medicine (2003)

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