Review Article

Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree

Table 3

Clinical characteristics of recurrent oral ulceration [24, 11, 20, 2932].

LesionGender predominanceAge predilectionLocationShape of ulcerNumber of ulcersDistinguishing features

Recurrent aphthous stomatitisWomenBeginning at 2nd decadeNonkeratinized mucosa in healthy patientsSymmetricalSolitary/multipleProdromal burning, painful, round fibrin covered with erythematous borders, 3 clinical types: minor, major, herpetiform, self-limiting

Recurrent herpetic stomatitisNANAKeratinized mucosa especially hard palate in healthy patientsScalloped bordersMultipleTwo subgroups: recurrent herpes simplex labialis, recurrent intraoral herpes, unilateral

Herpes-associated erythema multiformMen20–40 yearsLipsMap-likeMultipleBullae and ulcerations with irregular borders and inflammatory halo, bloody encrustations on the lips

Cyclic neutropeniaNABegins in childhoodAny oral mucosa exposed to traumaAphthous-likeMultipleEpisodic ulcers with erythematous halo, concomitant fever, periodontitis, marked gingival recession, and systemic infections

Behçet’s diseaseBalanced male/female ratioBetween the ages of 25 and 40Anywhere on the oral or pharyngeal mucosaAphthous-likeMultipleConcomitant genital ulcers, ocular inflammation, and skin lesions

NA: not assigned.