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28year old female presents with complaints of recurrent mouth ulcer , it started 10 days ago , one ulcer heals and other develops what it could be ?

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"Recurrent Aphthous Stomatitis"[MeSH Terms]

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recurrent mouth ulcers aphthous ulcers red flags oral cancer NHS

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The most likely cause is recurrent aphthous stomatitis, also called canker sores. These are painful round or oval ulcers, often with a white-yellow center and red rim. One may heal as another appears, and a single ulcer often lasts about 7 to 14 days.
Common triggers include stress, minor trauma from biting or sharp teeth, menstruation, acidic or spicy foods, and sometimes nutritional deficiencies such as iron, vitamin B12, folate, or zinc. Recurrent ulcers can also occasionally be associated with coeliac disease, inflammatory bowel disease, medication effects, or immune conditions. Cummings Otolaryngology Head and Neck Surgery, p. 1644.
What she can do now
  • Avoid spicy, sour, salty, and rough foods.
  • Use a soft toothbrush and avoid toothpaste containing sodium lauryl sulfate if it seems to trigger episodes.
  • Salt-water rinses and pharmacy pain-relieving oral gels may help.
  • A dentist or clinician can prescribe a topical corticosteroid mouth paste/rinse if lesions are frequent or painful. The NHS mouth-ulcer guidance also lists pain-relieving and corticosteroid options.
She should book a GP or dentist review soon if this is becoming recurrent, numerous, unusually severe, or interfering with food or fluids. They may assess for local trauma and consider tests such as CBC, ferritin/iron studies, vitamin B12, folate, and coeliac screening when indicated.
Seek prompt assessment if:
  • Any single ulcer does not heal within 2 to 3 weeks
  • It is hard, enlarging, bleeds, or is on the side/back of the tongue
  • There are neck lumps, unexplained weight loss, or difficulty swallowing
  • She also has genital ulcers, painful red eyes/blurred vision, swollen joints, chronic diarrhea, fever, or skin rashes. Recurrent oral ulcers plus genital, eye, skin, or joint symptoms need evaluation for conditions such as Behçet disease. The NHS Behçet overview describes these associated features.
At age 28, ordinary aphthous ulcers are much more likely than cancer, but an ulcer that persists beyond 3 weeks should not be ignored.
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