An 18-year-old sexually active woman presents with a two small ulcers located on the lower lip which are painful. She is a smoker and has noticed that the ulcers have been recurrent and correlate with the onset of menses. The most likely diagnosis is
A) Kawasaki disease
B) Aphthous stomatitis
C) Squamous cell carcinoma of the lip
D) Syphilis
E) Koplik’s spot
The answer is
B. (Aphthous stomatitis)
Discussion: Aphthous stomatitis, also known as canker sores, are painful eruptions that affect the mucosal surface of the mouth. The cause is unknown. Lesions typically develop at the same time and resolve in 5 to 10 days. A viral cause has not been proved. A streptococcal bacterium has been implicated. The lesions recur at regular intervals and may correlate with the onset of menses in some women.
Treatment consists of toothpaste swish therapy, triamcinolone acetonide (Kenalog in Orabase), or tetracycline solution swish and swallow. Severe cases may respond to systemic corticosteroids.