Rekürren Aftöz Stomatit
Özet
Rekürren Aftöz Stomatit (RAS) tipik olarak iki hafta içinde iyileşen soliter ya da multiple olabilen oral mukozanın tekrarlayıcı, en sık görülen hastalığıdır. Popülasyonun yaklaşık %20’sini etkiler ve kadınlarda biraz daha yaygındır. Minör aft, majör aft, herpetiform aft ve şiddetli aftöz stomatit olmak üzere klinik alt tipleri vardır. RAS tanısı genellikle tipik öykü ve fizik muayeneye dayalı klinik olarak konur. Şiddetli veya tedaviye dirençli hastalık durumunda altta yatabilecek hastalıkların değerlendirmesi önerilir. Majör aft hastalarında özellikle Behçet hastalığı dışlanmalıdır. Ağız hijyeni, oral mukozanın travmasının önlenmesi, topikal anestezik ve antiinflamatuvar ilaçların kullanımı tedavi seçenekleridir.
Recurrent Aphthous Stomatitis (RAS) is the most common diseases of the oral mucosa characterized by the recurrent development of solitary or multiple ulcers that typically heals within two weeks. Clinical subtypes of RAS: minor, major herpetiform and severe aphthous stomatitis. It affect about %20 of the population and slighty more common in females. The diagnosis of RAS is usually made clinically based on typical history and physical examination. In cases of severe or treatment-resistant disease, evaluation of possible underlying diseases is recommended. Behçet's disease should be excluded, especially in patients with major aphthous ulcers. Oral hygiene, prevention of trauma to the oral mucosa, use of topical anesthetics and anti-inflammatory drugs are treatment options.
Referanslar
Lau CB, Smith GP. Recurrent aphthous stomatitis: A comprehensive review and recommendations on therapeutic options. Dermatol Ther. 2022 Jun;35(6):e15500.
Soner Uzun, Erosive, Ulcerative, Vesicular, and Bullous Lesions of Oral Mucosa, Turkderm 2012; 46 Suppl 2: 77-85.
Chattopadhyay A, Shetty KV. Recurrent aphthous stomatitis. Otolaryngol Clin North Am. 2011 Feb;44(1):79-88.
Shen C, Ye W, Gong L, Lv K, Gao B, Yao H. Serum interleukin-6, interleukin-17A, and tumor necrosis factor-alpha in patients with recurrent aphthous stomatitis. J Oral Pathol Med. 2021;50(4):418- 423
Tarakji B, Gazal G, Al-Maweri SA, Azzeghaiby SN, Alaizari N. Guide- line for the diagnosis and treatment of recurrent aphthous stomatitis for dental practitioners. J Int Oral Health JIOH. 2015;7(5):74-80.
Zeynep Topkarcı, Current Treatment Options in Challenging Oral Diseases: Recurrent Oral Aphthosis, Turkderm 2012; 46 Suppl 2: 123-9.
Belenguer-Guallar I, Jimenez-Soriano Y, Claramunt-Lozano A. Treat- ment of recurrent aphthous stomatitis. A literature review. J Clin Exp Dent. 2014;6:e168-e174.
Sawair. Does smoking really protect from recurrent aphthous stomati- tis?Ther Clin Risk Manag. 2010;6:573-577.
Edgar NR, Saleh D, Miller RA. Recurrent aphthous stomatitis: a review. J Clin Aesthetic Dermatol. 2017;10(3):26-36
Tüzün Y: Aftöz stomatitis. Dermatolojide Tedavi. Ed. Tüzün Y, Serdaroğlu S, Erdem C, Özpoyraz M, Ö10nder M, Öztürkcan S. 1.baskı. İstanbul, Nobel Tıp Kitapevi, 2010; 17-20.
Nolan A, Lamey PJ, Milligan KA, Forsyth A: Recurrent aphthous ulceration and food sensitivity. J Oral Pathol Med 1991;20:473-5.
Alli BY, Erinoso OA, Olawuyi AB. Effect of sodium lauryl sulfate on recurrent aphthous stomatitis: a systematic review. J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol.2019;48(5):358- 364.
Al-Maweri SA, Halboub E, Al-Sufyani G, Alqutaibi AY, Shamala A, Alsalhani A. Is vitamin D deficiency a risk factor for recurrent aphthous stomatitis? A systematic review and meta-analysis [publi- shed online ahead of print, 2019 Sep 6]. Oral Dis. 2019; 10.1111/odi.13189
Casale M, Moffa A, Vella P, et al. Systematic review: the efficacy of topical hyaluronic acid on oral ulcers. J Biol Regul Homeost Agents. 2017;31(4 suppl 2):63-69.
Descroix V, Coudert AE, Vigé A, et al. Efficacy of topical 1% lidocaine in the symptomatic treatment of pain associated with oral mucosal trauma or minor oral aphthous ulcer: a randomized, double-blind, placebo-controlled, parallel-group, single-dose study. J Orofac Pain. 2011;25(4):327-332.
Femiano F, Buonaiuto C, Gombos F, Lanza A, Cirillo N. Pilot study on recurrent aphthous stomatitis (RAS): a randomized placebo-controlled trial for the comparative therapeutic effects of systemic prednisone and systemic montelukast in subjects unresponsive to topical therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(3):402- 407.
Graykowski EA, Kingman A: Double-blind trial of tetracycline in recurrent aphthous ulceration. J Oral Pathol 1978;7:376-82.
Rattan J, Schneider M, Arber N, Gorsky M, Dayan D: Sucralfate suspension as a treatment of recurrent aphthous stomatitis. J Intern Med 1994;236:341-3.
Oh J, Lee JW, Chung KB, Bang D, Kim DY. Safety, Efficacy, and Drug Survival of Colchicine in Recurrent Aphthous Stomatitis in a Real-World Setting. Ann Dermatol. 2022 Feb;34(1):22-27.
Lynde CB, Bruce AJ, Rogers RS 3rd. Successful treatment of complex aphthosis with colchicine and dapsone. Arch Dermatol. 2009 Mar;145(3):273-6
Gulcan E, Toker S, Hatipoğlu H, Gulcan A, Toker A. Cyanocobalamin may be beneficial in the treatment of recurrent aphthous ulcers even when vitamin B12 levels are normal. Am J Med Sci. 2008 Nov;336(5):379-82.
Behçet H: Über rezidivierende aphthöse, durch ein Virus Verur- sachte Geschwüre am Mund, am auge, und an den Genitalien. Dermatol Wochenschr 1937;105:1152.
International Study Group for Behçet's Disease. Criteria for diag- nosis of Behçet's disease. Lancet 1990;335(8697):1078-1080.
O'Neill TW, Rigby AS, Silman AJ, Barnes C. Validation of the In- ternational Study Group criteria for Behcet's disease. Br J Rhe- umatol 1994;33(2):115-117.
Zouboulis CC. Epidemiology of Adamantiades-Behcet's disease. Ann Med Interne 1999;150(6):488-498
Alpsoy E. Mucocutaneous lesions of Behçet’s disease. TÜRKDERM 2003; 37: 92-99
Lehner T. Immunopathogenesis of Behcet’s disease. Ann Med In- terne (Paris) 1999;150:483-487.
Bang D, Yoon KH, Chong HO, Choi EH, Lee E-S, Lee S. Epidemiological and clinical features of Behçet's disease in Korea. Yonsei Med J 1997;38:428-436.
Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease. Lancet. 1990 May 5;335(8697):1078-80.
Demirkesen C, Tüzüner N, Mat C, Senocak M, Büyükbabani N, Tüzün Y, Yazici H. Clinicopathologic evaluation of nodular cutaneous lesions of Behçet syndrome. Am J Clin Pathol. 2001 Sep;116(3):341-6.
Alpsoy E, Zouboulis CC, Ehrlich GE. Mucocutaneous lesions of Behcet's disease. Yonsei Med J. 2007 Aug 31;48(4):573-85. doi: 10.3349/ymj.2007.48.4.573.
Assar S, Sadegh B, Davatchi F, Ghodsi SZ, Nadji A, Shahram F, Ashofte F, Larimi SR, Sadeghi M. The association of pathergy reaction and active clinical presentations of Behçet's disease. Reumatologia. 2017;55(2):79-83.
Khanfir MS, Belfeki N, Said F, Ben Salem T, Ben Ghorbel I, Lamloum M, Hamzaoui A, Houman MH. Inflammatory optic neuropathy in Behçet's disease. Reumatismo. 2015 Dec 23;67(4):156-60.
Benamour S, Naji T, Alaoui FZ, El-Kabli H, El-Aidouni S. Manifestations neurologiques de la maladie de Behçet [Neurological involvement in Behçet's disease. 154 cases from a cohort of 925 patients and review of the literature]. Rev Neurol (Paris). 2006 Nov;162(11):1084-90.
Ames PR, Steuer A, Pap A, Denman AM. Thrombosis in Behçet's disease: a retrospective survey from a single UK centre. Rheumatology (Oxford). 2001 Jun;40(6):652-5.
Kim HA, Choi KW, Song YW. Arthropathy in Behçet's disease. Scand J Rheumatol. 1997;26(2):125-9. doi: 10.3109/03009749709115831.
Alpsoy E, Er H, Durusoy C, Yilmaz E: The use of sucralfate suspension in the treatment of oral and genital ulceration of Behcet disease: a randomized, placebo-controlled, double-blind study. Arch Dermatol 1999;135:529-32.
Hatemi G, Christensen R, Bang D, Bodaghi B, Celik AF, Fortune F, Gaudric J, Gul A, Kötter I, Leccese P, Mahr A, Moots R, Ozguler Y, Richter J, Saadoun D, Salvarani C, Scuderi F, Sfikakis PP, Siva A, Stanford M, Tugal-Tutkun I, West R, Yurdakul S, Olivieri I, Yazici H. 2018 update of the EULAR recommendations for the management of Behçet's syndrome. Ann Rheum Dis. 2018 Jun;77(6):808-818.
Sollecito TP, Stoopler ET (Eds.): Clinical approaches to oral mucosal disorders. Dent Clin North Am 2013; 57: 561.
Referanslar
Lau CB, Smith GP. Recurrent aphthous stomatitis: A comprehensive review and recommendations on therapeutic options. Dermatol Ther. 2022 Jun;35(6):e15500.
Soner Uzun, Erosive, Ulcerative, Vesicular, and Bullous Lesions of Oral Mucosa, Turkderm 2012; 46 Suppl 2: 77-85.
Chattopadhyay A, Shetty KV. Recurrent aphthous stomatitis. Otolaryngol Clin North Am. 2011 Feb;44(1):79-88.
Shen C, Ye W, Gong L, Lv K, Gao B, Yao H. Serum interleukin-6, interleukin-17A, and tumor necrosis factor-alpha in patients with recurrent aphthous stomatitis. J Oral Pathol Med. 2021;50(4):418- 423
Tarakji B, Gazal G, Al-Maweri SA, Azzeghaiby SN, Alaizari N. Guide- line for the diagnosis and treatment of recurrent aphthous stomatitis for dental practitioners. J Int Oral Health JIOH. 2015;7(5):74-80.
Zeynep Topkarcı, Current Treatment Options in Challenging Oral Diseases: Recurrent Oral Aphthosis, Turkderm 2012; 46 Suppl 2: 123-9.
Belenguer-Guallar I, Jimenez-Soriano Y, Claramunt-Lozano A. Treat- ment of recurrent aphthous stomatitis. A literature review. J Clin Exp Dent. 2014;6:e168-e174.
Sawair. Does smoking really protect from recurrent aphthous stomati- tis?Ther Clin Risk Manag. 2010;6:573-577.
Edgar NR, Saleh D, Miller RA. Recurrent aphthous stomatitis: a review. J Clin Aesthetic Dermatol. 2017;10(3):26-36
Tüzün Y: Aftöz stomatitis. Dermatolojide Tedavi. Ed. Tüzün Y, Serdaroğlu S, Erdem C, Özpoyraz M, Ö10nder M, Öztürkcan S. 1.baskı. İstanbul, Nobel Tıp Kitapevi, 2010; 17-20.
Nolan A, Lamey PJ, Milligan KA, Forsyth A: Recurrent aphthous ulceration and food sensitivity. J Oral Pathol Med 1991;20:473-5.
Alli BY, Erinoso OA, Olawuyi AB. Effect of sodium lauryl sulfate on recurrent aphthous stomatitis: a systematic review. J Oral Pathol Med Off Publ Int Assoc Oral Pathol Am Acad Oral Pathol.2019;48(5):358- 364.
Al-Maweri SA, Halboub E, Al-Sufyani G, Alqutaibi AY, Shamala A, Alsalhani A. Is vitamin D deficiency a risk factor for recurrent aphthous stomatitis? A systematic review and meta-analysis [publi- shed online ahead of print, 2019 Sep 6]. Oral Dis. 2019; 10.1111/odi.13189
Casale M, Moffa A, Vella P, et al. Systematic review: the efficacy of topical hyaluronic acid on oral ulcers. J Biol Regul Homeost Agents. 2017;31(4 suppl 2):63-69.
Descroix V, Coudert AE, Vigé A, et al. Efficacy of topical 1% lidocaine in the symptomatic treatment of pain associated with oral mucosal trauma or minor oral aphthous ulcer: a randomized, double-blind, placebo-controlled, parallel-group, single-dose study. J Orofac Pain. 2011;25(4):327-332.
Femiano F, Buonaiuto C, Gombos F, Lanza A, Cirillo N. Pilot study on recurrent aphthous stomatitis (RAS): a randomized placebo-controlled trial for the comparative therapeutic effects of systemic prednisone and systemic montelukast in subjects unresponsive to topical therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(3):402- 407.
Graykowski EA, Kingman A: Double-blind trial of tetracycline in recurrent aphthous ulceration. J Oral Pathol 1978;7:376-82.
Rattan J, Schneider M, Arber N, Gorsky M, Dayan D: Sucralfate suspension as a treatment of recurrent aphthous stomatitis. J Intern Med 1994;236:341-3.
Oh J, Lee JW, Chung KB, Bang D, Kim DY. Safety, Efficacy, and Drug Survival of Colchicine in Recurrent Aphthous Stomatitis in a Real-World Setting. Ann Dermatol. 2022 Feb;34(1):22-27.
Lynde CB, Bruce AJ, Rogers RS 3rd. Successful treatment of complex aphthosis with colchicine and dapsone. Arch Dermatol. 2009 Mar;145(3):273-6
Gulcan E, Toker S, Hatipoğlu H, Gulcan A, Toker A. Cyanocobalamin may be beneficial in the treatment of recurrent aphthous ulcers even when vitamin B12 levels are normal. Am J Med Sci. 2008 Nov;336(5):379-82.
Behçet H: Über rezidivierende aphthöse, durch ein Virus Verur- sachte Geschwüre am Mund, am auge, und an den Genitalien. Dermatol Wochenschr 1937;105:1152.
International Study Group for Behçet's Disease. Criteria for diag- nosis of Behçet's disease. Lancet 1990;335(8697):1078-1080.
O'Neill TW, Rigby AS, Silman AJ, Barnes C. Validation of the In- ternational Study Group criteria for Behcet's disease. Br J Rhe- umatol 1994;33(2):115-117.
Zouboulis CC. Epidemiology of Adamantiades-Behcet's disease. Ann Med Interne 1999;150(6):488-498
Alpsoy E. Mucocutaneous lesions of Behçet’s disease. TÜRKDERM 2003; 37: 92-99
Lehner T. Immunopathogenesis of Behcet’s disease. Ann Med In- terne (Paris) 1999;150:483-487.
Bang D, Yoon KH, Chong HO, Choi EH, Lee E-S, Lee S. Epidemiological and clinical features of Behçet's disease in Korea. Yonsei Med J 1997;38:428-436.
Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease. Lancet. 1990 May 5;335(8697):1078-80.
Demirkesen C, Tüzüner N, Mat C, Senocak M, Büyükbabani N, Tüzün Y, Yazici H. Clinicopathologic evaluation of nodular cutaneous lesions of Behçet syndrome. Am J Clin Pathol. 2001 Sep;116(3):341-6.
Alpsoy E, Zouboulis CC, Ehrlich GE. Mucocutaneous lesions of Behcet's disease. Yonsei Med J. 2007 Aug 31;48(4):573-85. doi: 10.3349/ymj.2007.48.4.573.
Assar S, Sadegh B, Davatchi F, Ghodsi SZ, Nadji A, Shahram F, Ashofte F, Larimi SR, Sadeghi M. The association of pathergy reaction and active clinical presentations of Behçet's disease. Reumatologia. 2017;55(2):79-83.
Khanfir MS, Belfeki N, Said F, Ben Salem T, Ben Ghorbel I, Lamloum M, Hamzaoui A, Houman MH. Inflammatory optic neuropathy in Behçet's disease. Reumatismo. 2015 Dec 23;67(4):156-60.
Benamour S, Naji T, Alaoui FZ, El-Kabli H, El-Aidouni S. Manifestations neurologiques de la maladie de Behçet [Neurological involvement in Behçet's disease. 154 cases from a cohort of 925 patients and review of the literature]. Rev Neurol (Paris). 2006 Nov;162(11):1084-90.
Ames PR, Steuer A, Pap A, Denman AM. Thrombosis in Behçet's disease: a retrospective survey from a single UK centre. Rheumatology (Oxford). 2001 Jun;40(6):652-5.
Kim HA, Choi KW, Song YW. Arthropathy in Behçet's disease. Scand J Rheumatol. 1997;26(2):125-9. doi: 10.3109/03009749709115831.
Alpsoy E, Er H, Durusoy C, Yilmaz E: The use of sucralfate suspension in the treatment of oral and genital ulceration of Behcet disease: a randomized, placebo-controlled, double-blind study. Arch Dermatol 1999;135:529-32.
Hatemi G, Christensen R, Bang D, Bodaghi B, Celik AF, Fortune F, Gaudric J, Gul A, Kötter I, Leccese P, Mahr A, Moots R, Ozguler Y, Richter J, Saadoun D, Salvarani C, Scuderi F, Sfikakis PP, Siva A, Stanford M, Tugal-Tutkun I, West R, Yurdakul S, Olivieri I, Yazici H. 2018 update of the EULAR recommendations for the management of Behçet's syndrome. Ann Rheum Dis. 2018 Jun;77(6):808-818.
Sollecito TP, Stoopler ET (Eds.): Clinical approaches to oral mucosal disorders. Dent Clin North Am 2013; 57: 561.
