Aphthous Ulcers Differential Diagnoses

Updated: May 11, 2020
  • Author: Jaisri R Thoppay, DDS, MBA, MS; Chief Editor: Arlen D Meyers, MD, MBA  more...
  • Print
DDx

Diagnostic Considerations

Mouth ulcers can arise from local causes, malignancy, drug adverse effects, and systemic conditions (particularly infections, blood disorders, gastrointestinal disorders, and skin diseases).

Recurrent multiple ulcers are most typical of the following conditions (before making a diagnosis of recurrent aphthous stomatitis [RAS], potentially overlooked causes of oral ulcers must be considered):

  • Hematinic deficiency (eg, iron, folate, vitamin B-12)

  • Celiac disease

  • Neumann bipolar aphthosis

  • Behçet syndrome

  • Sweet syndrome

  • HIV infection, neutropenia, and other immunodeficiencies

  • Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA) in children