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,
Kay MH, Rapini RP. Oral Lesions Associated With Pityriasis Rosea-Reply. Arch Dermatol. 1986;122(5):503–504. doi:10.1001/archderm.1986.01660170027007
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