What are characteristics of herpetiform recurrent aphthous ulcers?

Updated: Sep 25, 2020
  • Author: Ginat W Mirowski, MD, DMD; Chief Editor: William D James, MD  more...
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In this rare form (<5% of cases), ulcers are typically about 1-2 mm in diameter. The aphthae tend to occur in clusters or crops consisting of 10-100 ulcers. Clusters may be small and localized, or they may be distributed throughout the soft mucosa of the oral cavity. These too occur predominantly on unkeratinized mucosa, as shown in the image below. It is important to differentiate these ulcers from herpes simplex virus (HSV), which also may appear as recurrent crops. HSV is an infectious disease that often presents with vesicles that quickly ulcerate and involve the keratinized mucosa of the hard palate, dorsal tongue and attached gingiva.

Herpetiform aphthous ulcer: Grouped and single tin Herpetiform aphthous ulcer: Grouped and single tiny white to yellow ulcers scattered on the labial mucosa and on the ventral aspect of the tongue.

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