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chronic recurrent, benign aphtosis is the most common ulcerative diseasis of
the mouth. The most important difference to other diseases like herpes simplex
is the absence of a vesicel. There are three different forms of aphtosis
regarding the amount, seize and dephth of ulceration. The time table can also
be used to differentiate the 3 forms. The etiology is not yet clear, zytoxic
immunreactians against the epithelic and/or the mucosal glands are assumed
beside that, intolerance reactions against becterias or an imuncomplex
vasculitis are possible. Factors of risks are trauma, stress, infecrion and
some food. Nicotine has apearantly a protective affect. The aim of therapy is
avoidence of pain, a reduction of aphtae and a prolongation of aphtae free
time. The therapy depends of the frequency and duration of aphtae, the pain and
the triggerfactors. In type A only local desinfective treatment is necessary,
whereas in type B additionaly local corticosteroids are important. The
persistant aphtae in type C need a systemic treatment with imunsuppresiv
medications. We have made good experiences with fumarate, a drug which is used
in treating the psoriasis. Mobus Behcet or malignant aphtosis has an
unfavorable course, because different organs will be attacked, as mucous
membrans, the eye, vessels and joints. Pathogenetically the disease is caused
by a diffuse immuncomplex vasculitis. The therapy of choice is the treatment
with colchicin. |
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