Differential Diagnosis for Recurrent Aphthous Ulcers in a 9-Year-Old
Single Most Likely Diagnosis
- Recurrent Aphthous Stomatitis (RAS): This is the most common cause of recurrent oral ulcers in children, characterized by periodic appearance of painful, shallow ulcers on the mucous membranes of the mouth. The exact cause is unknown, but it is thought to be related to a combination of genetic, immune, and environmental factors.
Other Likely Diagnoses
- Viral Infections (e.g., Herpes Simplex Virus): Viral infections can cause oral ulcers that may resemble aphthous ulcers. Herpes simplex virus, in particular, can cause recurrent oral ulcers.
- Trauma: Accidental bites or other forms of oral trauma can lead to the formation of ulcers that may be mistaken for aphthous ulcers.
- Nutritional Deficiencies (e.g., Vitamin B12, Iron, or Folate Deficiency): Deficiencies in certain nutrients can lead to oral ulcers, although this is less common in children.
- Allergic Reactions or Sensitivities: Allergic reactions to certain foods, toothpastes, or other substances can cause oral ulcers.
Do Not Miss Diagnoses
- Behçet's Disease: A rare autoimmune disorder that can cause recurrent oral ulcers, along with other systemic symptoms such as genital ulcers and eye inflammation. Although rare, it is important to consider due to its potential for serious complications.
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause oral ulcers as part of their extraintestinal manifestations.
- Autoimmune Disorders (e.g., Systemic Lupus Erythematosus): Certain autoimmune diseases can cause oral ulcers, and early diagnosis is crucial for managing these conditions.
- HIV Infection: Oral ulcers can be a symptom of HIV infection, especially in children who may have acquired the virus perinatally.
Rare Diagnoses
- Cyclic Neutropenia: A rare condition characterized by periodic decreases in neutrophil count, which can lead to recurrent oral ulcers.
- PFAPA Syndrome (Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis): A rare syndrome that presents with periodic episodes of fever, aphthous ulcers, pharyngitis, and adenitis.
- Sweet Syndrome (Acute Febrile Neutrophilic Dermatosis): A rare condition that can cause oral ulcers, along with fever, neutrophilia, and skin lesions.