What is the focus of the clinical history to evaluate pediatric aphthous ulcers?

Updated: Feb 25, 2019
  • Author: Michael C Plewa, MD; Chief Editor: Russell W Steele, MD  more...
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Inquire about previous ulcers. The natural history of individual lesions is important because it is the benchmark against which treatment benefits are measured.

  • Age at onset should be noted because major recurrent aphthous ulcers (canker sores) begin after puberty, and herpetiform ulcers are uncommon in children.

  • The duration, location, and size of previous lesions should be noted, as well as the therapy received.

  • Having patients keep an ulcer diary for 1-3 months may be useful.

Ask the patient about medication use, chemotherapy, radiation therapy, vitamin supplementation, and recent dietary changes.

Assess for a family history of the following:

Review the patient's medical history. Consider Behçet disease; human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS); cancer; Crohn disease; immunocompromised state; cyclic neutropenia; mouth and genital ulcers with inflamed cartilage (MAGIC syndrome); and systemic lupus erythematosus.

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