Differential diagnosis

• Oral malignancy
  • ? if solitary ulcer or swelling of oral muscosa persisting beyond 3 weeks
  • Early lesions are often asymptomatic and appear as erythroplakia or leukpplakia, may be ulcerated or exophytic
  • As the lesion grows it becomes more symptomatic
  • R/F: smoking, alcohol, age>45, male
• Apthous ulcers
• Apthous like ulcers
  • Apthous ulcers but associated with an underlying systemic disorder
  • Vitamin B12 deficiency, folate deficiency, iron deficiency, coeliac disease, IBD, reiters syndrome, immunodeficiency, EBV
• Herpes simplex infection
• Adverse drug reactions - NSAIDs, nicrorandil, beta blockers
• Chicken pox

Children specific:

• Hand, foot and mouth disease
• Periodic syndrome (PFAPA) - periodic fever, apthous stomatitis, pharyngitis, adenitis