Oral mucosal disease: recurrent aphthous stomatitis

Br J Oral Maxillofac Surg. 2008 Apr;46(3):198-206. doi: 10.1016/j.bjoms.2007.07.201. Epub 2007 Sep 11.


Recurrent aphthous stomatitis (RAS; aphthae; canker sores) is common worldwide. Characterised by multiple, recurrent, small, round, or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow or grey floors, it usually presents first in childhood or adolescence. Its aetiology and pathogenesis is not entirely clear, but there is genetic predisposition, with strong associations with interleukin genotypes, and sometimes a family history. Diagnosis is on clinical grounds alone, and must be differentiated from other causes of recurrent ulceration, particularly Behçet disease - a systemic disorder in which aphthous-like ulcers are associated with genital ulceration, and eye disease (particularly posterior uveitis). Management remains unsatisfactory, as topical corticosteroids and most other treatments only reduce the severity of the ulceration, but do not stop recurrence.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Behcet Syndrome / complications
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Mouth Mucosa / drug effects
  • Mouth Mucosa / pathology
  • Recurrence
  • Stomatitis, Aphthous / drug therapy*
  • Stomatitis, Aphthous / etiology
  • Stomatitis, Aphthous / pathology


  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunosuppressive Agents