i need help for solution of this case really?what is the best treatment with a case of 45 years old male patient with 1.5*2 cm large superfacial oral ulcers affecting unilateral buccal mucosa and lateral tongue surfaces with burrning pain with a history of recurrence every 3 months for 2 years peroid.The patient took topical and systemic steroids with out benefit, systemically he had drugs for colitis for the past 7months??
Possibly the patient has Behchet disease -ophthalmo-stomato-genital syndrome manifested by oral ulceration presented in 100% of cases and the patient needs supervision by rheumatologist and therapy by Cyclosporin A ,if not enough additional low doses of steroids
I agree with Marianne. Moreover, Have you considered other diagnosis? IBD? Celiac disease? Recurrent aphthous stomatitis (RAS)? Generally evidence shows the most efficacy from corticosteroids and antimicrobials used topically. Other agents may include: immunosuppressants, biologics, prostaglandin E2 (PGE2) and sucralfate.
In a recent randomized, single-blind, placebo-controlled trial, Albrektson et al showed that low-level laser therapy can relieve pain (Albrektson M, Hedström L, Bergh H. Recurrent aphthous stomatitis and pain management with low-level laser therapy: a randomized controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 May. 117(5):590-49).
I agree consulting a rheumatologist.
The best treatment for recurrent multiple oral ulcers undoubtedly is the gluten-free diet, followed strictly and for the whole life, because most of these patients are celiacs and they don´t know it
Aphta multiple erosions improved a lot following a gluten-free diet, strictly and for a long time
