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NEET MDS Exam Preparation – OMR
SUBJECT: OMR
Topic: RECURRENT APHTHAE
Recurrent aphthous stomatitis (RAS) is a common disorder characterized by recurring ulcers confined to the oral mucosa in patients with no other signs of systemic disease. RAS is classified based on the clinical characteristics into minor, major and herpetiform ulcers. Minor apthae is also called as Mikulicz aphthae. Synonyms for major aphthous ulcers are Sutton disease and periadenitis mucosa necrotica recurrens. Lesions wherein a clear distinction between minor and major ulcers cannot be made and those who experience severe discomfort from continuous episodes of ulcers, lesions are called as “severe” minor ulcers.
The major factors presently linked to RAS include genetic factors, hematologic or immunologic abnormalities, and local factors, such as trauma and smoking. Other factors that have been associated with RAS include anxiety, stress, menstruation, upper respiratory infections, and food allergy. Various systemic disorders associated with RAS include Behcet’s disease, cyclic neutropenia, PFAPFA syndrome, MAGIC syndrome, HIV, Sweet syndrome etc.
The first episodes of RAS most frequently begin during the second decade of life. The lesions are confined to the oral mucosa and begin with prodromal burning or stinging sensation. The individual lesions are round, symmetric, and shallow without tissue tags due to ruptured vesicles. Almost exclusively involves the non keratinized mucosa such as labial mucosa, buccal mucosa, vestibule etc. The ulceration demonstrates a yellow-white, removable fibrino purulent membrane that is encircled by an erythematous halo.
In mild RAS, the ulcers reach a size of 0.3–1.0 cm. Healing without scarring occurs within 7–14 days. Patients with major ulcers develop deep lesions that are larger than 1 cm in diameter and last for weeks to months. May heal with scarring. The least common variant of RAS is the herpetiform type. The patient presents with as many as 100 small pin point ulcers scattered over the mucosa.
Diagnosis of RAS is mainly clinical based on a detailed history and clinical examination. Management is based on the severity of the lesion. Symptomatic treatment is the mainstay of therapy.
The major factors presently linked to RAS include genetic factors, hematologic or immunologic abnormalities, and local factors, such as trauma and smoking. Other factors that have been associated with RAS include anxiety, stress, menstruation, upper respiratory infections, and food allergy. Various systemic disorders associated with RAS include Behcet’s disease, cyclic neutropenia, PFAPFA syndrome, MAGIC syndrome, HIV, Sweet syndrome etc.
The first episodes of RAS most frequently begin during the second decade of life. The lesions are confined to the oral mucosa and begin with prodromal burning or stinging sensation. The individual lesions are round, symmetric, and shallow without tissue tags due to ruptured vesicles. Almost exclusively involves the non keratinized mucosa such as labial mucosa, buccal mucosa, vestibule etc. The ulceration demonstrates a yellow-white, removable fibrino purulent membrane that is encircled by an erythematous halo.
In mild RAS, the ulcers reach a size of 0.3–1.0 cm. Healing without scarring occurs within 7–14 days. Patients with major ulcers develop deep lesions that are larger than 1 cm in diameter and last for weeks to months. May heal with scarring. The least common variant of RAS is the herpetiform type. The patient presents with as many as 100 small pin point ulcers scattered over the mucosa.
Diagnosis of RAS is mainly clinical based on a detailed history and clinical examination. Management is based on the severity of the lesion. Symptomatic treatment is the mainstay of therapy.
Questions
1. All are true regarding Sutton’s disease except
a) Ulcers greater than 1cm in diameter
b) May heal with scarring
c) May persists for weeks or months
d) None of the above
2. True regarding Recurrent aphthae
a) Stress is a major trigger factor
b) Mostly involves the non keratinized mucosa
c) Associated with a prodrome
d) All of the above
3. Syndrome associated with RAS
a) Gorlin syndrome
b) Down syndrome
c) Crouzon syndrome
d) MAGIC syndrome
a) Ulcers greater than 1cm in diameter
b) May heal with scarring
c) May persists for weeks or months
d) None of the above
2. True regarding Recurrent aphthae
a) Stress is a major trigger factor
b) Mostly involves the non keratinized mucosa
c) Associated with a prodrome
d) All of the above
3. Syndrome associated with RAS
a) Gorlin syndrome
b) Down syndrome
c) Crouzon syndrome
d) MAGIC syndrome
Answer
1 - (D)2 - (D)
3 - (D)
