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Aphthous stomatitis - Anogenital in
See also in: Overview,Oral Mucosal Lesion
Other Resources UpToDate PubMed

Aphthous stomatitis - Anogenital in

See also in: Overview,Oral Mucosal Lesion
Contributors: Vivian Wong MD, PhD, Susan Burgin MD, David Foster MD, Mary Gail Mercurio MD, Lynne Margesson MD
Other Resources UpToDate PubMed


Aphthous ulcers occur mostly in the mouth but can be present as very painful, relapsing, vulvar ulcers of unknown etiology. Recurrent oral and genital aphthae in the absence of Behçet disease is complex aphthosis. Epstein-Barr virus (EBV) may be associated. In the absence of oral ulcers, complex aphthosis is sometimes called Lipschütz disease. The entity of juvenile gangrenous vasculitis of the scrotum is thought by many authors to be the male counterpart of Lipschütz ulcers. Lipschütz disease may be idiopathic in 90% of cases, and 10% of cases are associated with underlying conditions. The age of onset is typically between 9 and 18 years.


K12.0 – Recurrent oral aphthae

426965005 – Aphthous ulcer of mouth

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Ten percent of vulvar aphthous ulcers are associated with inflammatory bowel disease (Ulcerative colitis, Crohn disease), Human immunodeficiency virus disease, or myeloproliferative diseases.
  • Celiac disease
  • Behçet syndrome
  • Erosive Lichen planus
  • Granuloma inguinale
  • Primary syphilis
  • Chemotherapy-induced mucositis
  • Genital herpes simplex virus, including primary Orofacial herpes simplex virus
  • Vulvovaginal candidiasis – typically painless
  • Pemphigus vulgaris
  • Mucous membrane pemphigoid (cicatricial pemphigoid)
  • Herpes zoster
  • Varicella
  • Cutaneous squamous cell carcinoma
  • Systemic lupus erythematosus
  • Nutritional / hematinic deficiencies – Iron deficiency anemia, Acquired acrodermatitis enteropathica, Folate deficiency, Beriberi, Vitamin B2 deficiency, Vitamin B6 deficiency, Vitamin B12 deficiency
  • Cyclic neutropenia
  • Acute febrile neutrophilic dermatosis (Sweet syndrome)
  • PFAPA syndrome (periodic fever, aphthae, pharyngitis, cervical adenitis)
  • MAGIC syndrome (mouth and genital ulcers with inflamed cartilage)
  • Pyoderma gangrenosum

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:08/11/2020
Last Updated:08/11/2020
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Aphthous stomatitis - Anogenital in
See also in: Overview,Oral Mucosal Lesion
A medical illustration showing key findings of Aphthous stomatitis (Oral) : Oral mucosa, Oral white plaque, Painful oral ulcers, Tongue
Clinical image of Aphthous stomatitis - imageId=2173448. Click to open in gallery.  caption: 'Two large, deep ulcers with overlying yellowish slough on the lower labial mucosa.'
Two large, deep ulcers with overlying yellowish slough on the lower labial mucosa.
Copyright © 2024 VisualDx®. All rights reserved.