It is interesting to note that the prevalence of presentation has been found to be five times greater in children with high socioeconomic status.
Minor aphthous ulcers (Mi AUs) are usually self-limiting, with the usual duration being about 10-14 days without any active treatment.
Gamma-delta T cells may be involved in antibody-dependent cell mediated cytotoxicity (ADCC).
Compared with control subjects, individuals with RAS have raised serum levels of cytokines such as interleukin (IL)–6 and IL-2R, soluble intercellular adhesion modules (ICAM), vascular cell adhesion modules (VCAM), and E-selectin; however, some of these do not correlate with disease activity.
A wide spectrum of agents has been suggested as beneficial, but few studies have been performed to assess the efficacy of these drugs (or their adverse effects are significant).
Key points include the following: Despite many studies trying to identify a causal microorganism, RAS does not appear to be infectious, contagious, or sexually transmitted.
The investigators found significantly lower serum levels of superoxide dismutase, catalase, and glutathione peroxidase in active lesion RAS patients than in patients in the remission stage of RAS or in healthy controls.
Not all recurring ulcers represent RAS, however, so the clinician must distinguish localized RAS from lesions arising from an underlying systemic disorder.
Proposed causative factors for RAS include nutritional deficiency, immunologic factors, psychological stress, and dietary allergies, as well as trauma in patients with genetic susceptibility to RAS.
Cross-reactivity between a streptococcal 60- to 65-kd heat shock protein (hsp) and the oral mucosa has been demonstrated, and significantly elevated levels of serum antibodies to hsp are found in patients with RAS.
Lymphocytes of patients with RAS have reactivity to a peptide of , which cross-react with the mitochondrial hsp and induce oral mucosal damage.
Francisco Talavera, Pharm D, Ph D Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. Robert M Kellman, MD Professor and Chair, Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University Robert M Kellman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Head and Neck Society, American Rhinologic Society, Triological Society, American Neurotology Society, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, Medical Society of the State of New York Disclosure: Nothing to disclose.