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ClassificationK12.0dentistry

Aphthous Stomatitis — Classification

Recurrent painful oral ulcers of unknown etiology — the most common oral mucosal disease

Classification

Minor Aphthous Ulcers (Mikulicz's aphthae) — 80% of cases

Small, shallow ulcers that heal without scarring.

  • <10 mm diameter
  • Non-keratinized mucosa (buccal, labial, floor of mouth, soft palate)
  • 1-5 ulcers per episode
  • Heal in 7-14 days without scarring
  • Recurrence every 1-4 months

Major Aphthous Ulcers (Sutton's disease) — 10-15% of cases

Large, deep, painful ulcers that heal with scarring.

  • >10 mm diameter (can be 1-3 cm)
  • Can affect any oral site including keratinized mucosa
  • 1-10 ulcers per episode
  • Heal in 2-6 weeks with scarring
  • Can cause significant pain and eating difficulty

Herpetiform Ulcers — 5-10% of cases

Multiple tiny ulcers that coalesce — despite name, NOT caused by herpesvirus.

  • 1-3 mm, appear in clusters of 10-100
  • Start as vesicle-like lesions that rapidly ulcerate
  • Coalesce into irregular, ragged larger ulcers
  • Extremely painful; may affect any oral mucosa
  • More common in women and older patients