Treating recurrent aphthous ulcers in patients with AIDS

Article Abstract:

Large ulcers of the esophagus are a common occurrence in AIDS patients. In healthy individuals, these ulcers normally clear up in a matter of weeks, but they take much longer to heal in AIDS patients. This study reports the case of an AIDS patient with major esophageal ulcers. The patient was a 38-year-old male in poor health, but otherwise having no other oral lesions or dental problems. An indwelling catheter had been placed in his esophagus a few weeks before the ulcer appeared so that drugs for another problem could be easily delivered. The ulcer showed the classic signs of an aphthous ulcer. A hydrocortisone ointment was prescribed and within four days after treatment began, the ulcer began to heal, completely healing within one week. Subsequently, the patient developed some minor ulcers on the floor of his mouth, which were successfully treated. Eight months after the initial ulcer, two major ulcers appeared. The patient's overall condition had greatly deteriorated by this time. Treatment with Orabase HCA was unsuccessful and steroid therapy was begun. The ulcers healed within two weeks. Steroid therapy was continued to prevent further ulceration. Continued therapy was justified based upon the patient's short life expectancy. The exact cause of recurrent aphthous ulcers is unknown, but the high incidence of these ulcers in AIDS patients indicated an immunologic contribution. In AIDS patients, the ulcers take longer to heal and require more aggressive treatment; they can also contribute to poor nutrition by interfering with eating. AIDS patients should be monitored closely for these ulcers and treated quickly and aggressively when they are discovered. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Ulcers, AIDS (Disease)

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Managing aphthous ulcers: laser treatment applied

Article Abstract:

Aphthous ulcers (whitish sores), or recurrent aphthous stomatitis (RAS), in the mouth can be classified as minor (MiRAS), major (MaRAS), or herpetiform. MiRAS, or canker sores, are 5 millimeters or less in diameter, and last as long as two weeks, while MaRAS are larger and may last several weeks, often leaving scars. Herpetiform ulcers appear as a cluster of pinpoint lesions and last as long as 10 days. The causes of RAS are unknown, although hereditary, psychological, nutritional, hormonal, and immunological factors have been implicated. Treatment approaches include tetracycline oral rinses, vitamin therapy, application of prostaglandins (drugs with several physiologic effects), and the use of human interferon alpha-2a. A method that shows promise is the carbon dioxide (CO2) laser. Results from treating 25 MiRAS in 18 patients are reported. Treatment took place within three days of an ulcer outbreak. Patients received medication for controlling pain and local anesthesia prior to laser surgery, and pain medication was available for use afterward. Sixteen patients experienced no further pain when the anesthesia wore off, and no pain medication was requested by any subject. The sores healed within 10 days of treatment and did not recur in 13 cases. In five cases, an ulcer recurred in another site; four were successfully treated, and the fifth patient was found to have irritable bowel syndrome (a condition associated with mouth ulcers). The results indicate that the CO2 laser is an effective tool to reduce the pain associated with canker sores. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Usage, Lasers in dentistry, Laser dentistry, Mouth diseases, Carbon dioxide lasers

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Evaluation of a bioadhesive device for the management of aphthous ulcers

Article Abstract:

A tissue adhesive containing 2-octyl cyanoacrylate appears to be effective in treating aphthous ulcers in the mouth, which are commonly called canker sores. This adhesive is used to close surgical wounds, and was effective in reducing pain from canker sores in 200 patients.

Evaluation, Dental adhesives

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