Provide me with a good recent review article on aphthous ulcer in children.
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aphthous ulcer children recurrent
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recurrent aphthous stomatitis children etiology treatment review
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PMID: 36354659
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recurrent aphthous stomatitis pediatric pathogenesis management
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aphthous stomatitis oral ulcers pediatric review
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PMID: 40358941
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recent review article recurrent aphthous stomatitis children 2022 2023 2024 2025
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\"recurrent aphthous stomatitis\" review etiology immunology treatment
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Lau Smith recurrent aphthous stomatitis comprehensive review recommendations therapeutic
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Recent Review Articles on Aphthous Ulcers (RAS) in Children
Here is a curated set of the best recent review articles on recurrent aphthous stomatitis (RAS) in children, ranked by relevance and recency:
1. TOP PICK (2025) - Pediatric-Specific Review
"Recurrent Aphthous Stomatitis (RAS)"
Snipaitiene A et al.
Sveikatos Mokslai / Health Sciences in Eastern Europe, 2025; 35(6):31-37
Full PDF available here
This is the most directly relevant recent review for your purposes. It is explicitly focused on children and adolescents, covers the etiology, classification, clinical features, and management of RAS in the pediatric age group, and includes two difficult pediatric case reports that illustrate diagnostic and management complexity. Key points covered:
- Etiology in children: local trauma (mastication, toothbrushing), nutritional deficiencies (iron, folate, zinc, B12/B6), food intolerances/allergies, genetic predisposition, hormonal fluctuations at puberty, NSAIDs and folate antagonists, bacterial triggers
- Classification: minor aphthae, major aphthae, herpetiform aphthae - with note that herpetiform lesions have no actual association with herpes viruses despite the name
- Key differentials: PFAPA syndrome, Behcet disease, celiac disease, cyclic neutropenia, IBD, juvenile SLE
- Treatment: topical corticosteroids, hyaluronic acid, colchicine (especially in PFAPA/Behcet overlap), photobiomodulation/laser therapy, adalimumab for refractory severe cases in adolescents
- Practical clinical guideline format suitable for pediatric practitioners
2. Comprehensive Review on RAS Treatment (2025)
"Treatments for Recurrent Aphthous Stomatitis: A Literature Review"
MDPI Dentistry Journal, 2025; 13(2):66
Full open-access article
Covers 45 randomized trials (2013-2023) examining pharmacological and non-pharmacological treatments. Key findings:
- Non-pharmacological therapies (especially laser/photobiomodulation therapy) showed positive outcomes with minimal adverse effects, even vs. corticosteroids
- Topical corticosteroids remain a mainstay for pain and healing
- Includes a section on photobiomodulation in children (Bardellini et al., 2020 - RCT showing effectiveness and parental satisfaction in pediatric RAS)
- T cell-mediated immune response with TNF-alpha as the central inflammatory mediator is the dominant pathogenic model
- Etiology remains multifactorial and not fully established
3. Comprehensive Therapeutic Review (2022)
"Recurrent Aphthous Stomatitis: A Comprehensive Review and Recommendations on Therapeutic Options"
Lau CB, Smith GP.
Dermatol Ther, 2022; 35(6):e15500 [PMID: 35395126]
A well-cited, broad review covering pathogenesis, trigger factors, and a tiered therapeutic approach. While not pediatric-specific, it is widely referenced in the pediatric RAS literature (cited in the 2025 Snipaitiene article above). Addresses:
- Topical agents (corticosteroids, anesthetics, antiseptics)
- Systemic agents for severe/refractory cases
- Evidence grading for each treatment
4. Oral Mucosal Lesions in Childhood (2022)
"Oral Mucosal Lesions in Childhood"
Horvat Aleksijevic L et al.
Dentistry Journal (Basel), 2022 Nov; 10(11):214 [PMID: 36354659, PMC: PMC9689283]
A pediatric-specific review covering the full spectrum of childhood oral mucosal lesions, with RAS described as "the most common type of ulceration in childhood" with multifactorial etiology. Open access. Useful for placing RAS within the broader differential of pediatric oral lesions.
5. Pediatric Practical Guideline (2020 - still highly cited)
"Recurrent Aphthous Stomatitis in Children: A Practical Guideline for Paediatric Practitioners"
Koberova R, Merglova V, Radochova V.
Acta Medica (Hradec Kralove), 2020; 63(4):145-149
Though just outside the 5-year window, this is widely cited in all 2025 pediatric RAS reviews as a foundational practical clinical guide written specifically for pediatricians. Worth including.
Summary Table
| Year | Article | Focus | Open Access |
|---|---|---|---|
| 2025 | Snipaitiene et al., Health Sciences Eastern Europe | Pediatric RAS - etiology, classification, treatment + cases | Yes (PDF) |
| 2025 | MDPI Dent J 13(2):66 | RAS treatments, includes pediatric laser data | Yes |
| 2022 | Lau & Smith, Dermatol Ther | Comprehensive RAS therapeutic review | No |
| 2022 | Horvat Aleksijevic et al., Dent J (Basel) | Oral mucosal lesions in childhood | Yes (PMC) |
| 2020 | Koberova et al., Acta Medica | Practical pediatric RAS guideline | No |
Clinical bottom line from these reviews: RAS in children is the most common non-traumatic oral ulceration, with a multifactorial and incompletely understood etiology. In children, it is essential to rule out underlying systemic conditions - particularly PFAPA syndrome, celiac disease, IBD, and hematologic deficiencies (iron, B12, folate). First-line treatment remains topical corticosteroids and analgesics; laser therapy has emerging evidence in children with good parental satisfaction. Refractory or severe cases warrant evaluation for autoinflammatory/systemic disease and may require systemic therapy.
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