Differential Diagnosis for Aphthous Ulcer
Single Most Likely Diagnosis
- Recurrent Aphthous Stomatitis (RAS): This is the most common cause of aphthous ulcers, characterized by recurrent, self-limiting, and painful ulcers in the oral cavity. The diagnosis is often clinical, based on the patient's history and physical examination.
Other Likely Diagnoses
- Traumatic Ulcer: These ulcers can occur due to accidental bites, dental procedures, or other forms of oral trauma. The history of trauma and the location of the ulcer can help differentiate it from RAS.
- Infectious Ulcers: Caused by viruses (e.g., herpes simplex), bacteria (e.g., syphilis), or fungi (e.g., histoplasmosis). The presence of systemic symptoms or specific findings on physical examination can suggest an infectious cause.
- Mucocutaneous Disorders: Conditions like pemphigus vulgaris or lichen planus can present with oral ulcers. These disorders often have characteristic skin or other mucosal involvement.
Do Not Miss Diagnoses
- Oral Cancer: Although less common, ulcers that do not heal or have atypical features (e.g., irregular borders, firm base) could be indicative of oral cancer. A biopsy is essential for diagnosis.
- Behçet's Disease: A form of vasculitis that can present with recurrent aphthous-like ulcers, along with genital ulcers and ocular inflammation. Missing this diagnosis could lead to significant morbidity due to its systemic nature.
- HIV/AIDS: Patients with HIV/AIDS can present with atypical or persistent aphthous ulcers. The diagnosis is crucial due to the implications for treatment and management of the underlying condition.
Rare Diagnoses
- Eosinophilic Ulcer: A rare condition characterized by an eosinophilic infiltration of the oral mucosa, presenting as an ulcer. It is often associated with eosinophilia and can be a diagnostic challenge.
- Neutropenic Ulcers: Occur in the context of neutropenia, often due to chemotherapy or bone marrow disorders. These ulcers can be deep and necrotic, requiring prompt treatment to prevent complications.
- Autoimmune Disorders: Such as systemic lupus erythematosus (SLE) or Crohn's disease, which can rarely present with oral ulcers as part of their systemic manifestations.