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Martin H. Kay, MD, PhD; Ronald P. Rapini, MD
Department of Dermatology; Departments of Dermatology and Pathology University of Texas Medical School 6431 Fannin Houston, TX 77030

Arch Dermatol. 1986;122(5):503-504.

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In Reply.—

Aphthous stomatitis is a clinical diagnosis for which there is no specific diagnostic test. Challacombe et al¹ state that "...the differential diagnosis of recurrent oral ulceration has been confused because of the tendency to apply the term `aphtha' uncritically to any oral ulcer." They prefer to use the term "pseudo-aphthous ulcers" when such ulcers appear to be due to systemic disease. Occasional authors have made the statement that the histologic changes seen in a preulcerative aphthous lesion are "more unique" than the nonspecific changes seen once an ulcer has formed.² Biopsy specimens in the preulcerative phase show prominent spongiosis, exocytosis of inflammatory cells, and a submucosal inflammatory infiltrate of neutrophils, mast cells, lymphocytes, histiocytes, and plasma cells.³ We do not regard such changes as specific or diagnostic.

The criteria used to define aphthous ulcers vary according to author. Most references stress that the ulcers are painful, . . . [Full Text PDF of this Article]

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