National Skin Centre, Singapore 308205.
Ann Acad Med Singap. 2012 Oct;41(10):463-70.
Though oral aphthosis is common, it has a significant impact on the quality of life in the patients. It is the most common oral ulcerative condition encountered in clinical practice. This study describes the characteristics and patterns of oral aphthosis seen at a tertiary dermatological centre in Singapore, with emphasis in evaluating the management gaps and in identifying underlying systemic diseases and nutritional deficiencies.
This is a retrospective review of medical records over a 10-year period between June 2000 and June 2010. Two hundred and thirteen patients were identified using the search terms 'oral ulcers', 'aphthous ulcers', 'oral aphthosis', and 'Behcet's disease'. Patients with Behcet's disease without oral ulcers and other diagnoses such as pemphigus vulgaris, lichen planus and herpes simplex were excluded. The remaining patients were evaluated with regard to demographic characteristics, characteristics of oral ulcers, associated connective tissue disorders and nutritional deficiencies, diagnostic tests results, treatment response as well as follow-up duration.
One hundred and seventy-fi ve patients were included in this study. One hundred and one patients had recurrent oral aphthosis, with 77 having simple aphthosis and 24 having complex aphthosis. Fourteen patients (8%) fulfilled the International Study Criteria (ISG) for Behcet's disease, of which, 85.71% had complex aphthosis. The therapeutic ladder for such patients ranged from topical steroids and colchicine through to oral corticosteroids and/or dapsone therapy.
Recurrent oral aphthosis is a niche condition in which dermatologists are well-poised to manage. This study demonstrates that a more definitive management and therapeutic algorithm for oral aphthosis are needed for better management patients in the future. In particular, complex aphthosis needs to be monitored for progression onto Behcet's disease.
口腔阿弗他溃疡虽常见，但对患者的生活质量有重大影响。它是临床实践中最常见的口腔溃疡性疾病。本研究描述了在新加坡一家三级皮肤科中心所见的口腔阿弗他溃疡的特征和模式，重点评估管理差距，并确定潜在的系统性疾病和营养缺乏。
这是一项回顾性病历研究，时间跨度为 2000 年 6 月至 2010 年 6 月的 10 年。通过搜索术语“口腔溃疡”、“阿弗他溃疡”、“口腔阿弗他溃疡”和“白塞病”，共确定了 213 名患者。排除了无口腔溃疡但患有白塞病以及其他诊断（如寻常型天疱疮、扁平苔藓和单纯疱疹）的患者。对其余患者进行了人口统计学特征、口腔溃疡特征、相关结缔组织疾病和营养缺乏、诊断试验结果、治疗反应以及随访时间的评估。
本研究共纳入 175 名患者。101 名患者患有复发性口腔阿弗他溃疡，其中 77 名患者为单纯性阿弗他溃疡，24 名患者为复杂性阿弗他溃疡。14 名患者（8%）符合白塞病国际研究标准（ISG），其中 85.71%患有复杂性阿弗他溃疡。此类患者的治疗阶梯从局部类固醇和秋水仙碱到口服皮质类固醇和/或氨苯砜治疗不等。
复发性口腔阿弗他溃疡是皮肤科医生能够很好管理的小众疾病。本研究表明，未来需要为口腔阿弗他溃疡制定更明确的管理和治疗方案，以更好地管理患者。特别是，需要监测复杂性阿弗他溃疡是否进展为白塞病。
