Rogers R S
Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905-0001, USA.
Yonsei Med J. 1997 Dec;38(6):370-9. doi: 10.3349/ymj.1997.38.6.370.
Recurrent aphthous stomatits (RAS) is also known as recurrent oral ulcers, recurrent aphthous ulcers, or simple or complex aphthosis. RAS is the most common inflammatory ulcerative condition of the oral mucosa in North American patients. RAS has been the subject of active investigation along multiple lines of research including epidemiology, immunology, clinical correlations and therapy. Clinical evaluation of the patient requires correct diagnosis of RAS and classification of the disease based on morphology (MIAU, MJAU, HU) and severity (simple versus complex). In order to properly diagnose and treat a patient with lesions of RAS, the clinician must exclude other causes of acute oral ulcers. Complex aphthosis and complex aphthosis variants associated with systemic disorders should be considered. The aphthous-like oral ulcerations of patients with HIV disease represent a challenging differential diagnosis. The association of lesions of RAS with hematinic deficiencies and gastrointestinal diseases provides an opportunity to identify a "correctable cause" which, with appropriate treatment, can result in a remission or substantial lessening of disease activity. Finally, when all of these factors are considered, the evaluation of the patient for Behçet's disease can be continued on firm grounds that one of the major criteria for the diagnosis of Behçet's disease has been met.
复发性阿弗他口炎(RAS)也被称为复发性口腔溃疡、复发性阿弗他溃疡或单纯性或复杂性口疮病。RAS是北美患者口腔黏膜最常见的炎性溃疡性疾病。RAS一直是包括流行病学、免疫学、临床相关性和治疗等多方面积极研究的对象。对患者的临床评估需要正确诊断RAS并根据形态学(微小阿弗他溃疡、重型阿弗他溃疡、疱疹样溃疡)和严重程度(单纯性与复杂性)对疾病进行分类。为了正确诊断和治疗患有RAS病变的患者,临床医生必须排除急性口腔溃疡的其他病因。应考虑与全身性疾病相关的复杂性口疮病和复杂性口疮病变体。HIV疾病患者的阿弗他样口腔溃疡是一个具有挑战性的鉴别诊断。RAS病变与造血物质缺乏和胃肠道疾病的关联提供了一个识别“可纠正病因”的机会,通过适当治疗,可导致病情缓解或疾病活动度大幅降低。最后,当考虑到所有这些因素时,就可以在满足白塞病诊断的主要标准之一的坚实基础上继续对患者进行白塞病评估。