Recurrent Aphthous Ulcers: Experience from a Tertiary Care Center

Background. The frequency of recurrent aphthous ulcers (RAU) and their relationship with comorbidities has been scarcely described. Methods. We conducted a retrospective analytical study of patients with a presumptive diagnosis of RAU, in order to know the frequency of misdiagnosis of RAU, to delineate the clinical and biochemical characteristics of RAU, and to analyze their correlation with systemic diseases. Three groups of recurrent ulcers were analyzed: a) RAU, b) RAU associated to Beh？et′s disease, and c) other recurrent ulcers misdiagnosed as RAU (OU). We recorded clinical and laboratory data. Statistics included Mantel-Haenszel chi square test, Kruskall-Wallis test, and Student′s t test. Results. A total of 141 patients (106 women) were referred with a presumptive diagnosis of RAU: 56 cases (39.7%) with RAU; 10 (7.1%) with RAU in Beh？et′s disease, and 75 (53.2%) with OU. RAU subjects presented a lower frequency of rheumatologic diseases than patients with Beh？et′s disease ulcers [30.4% vs 70.0%; (p=0.03)] and patients with OU [30.4% vs 54.7%; (p=0.007)]. Additionally, immunodeficiency was less common among patients with RAU in comparison to Beh？et′s disease [3.6% vs 40.0%; (p=0.003)] and OU [3.6% vs 28.0%; (p？0.001)]. Higher levels of serum leukocytes were seen in Beh？et′s disease [median=8.9 (range 5.3-9.7) x103 cells/mm3] when compared to RAU [median=6.0 (range 3.2-21.2) x103 cells/mm3] and OU [median=6.0 (range 2.3-14.8) x103 cells/mm3] (p<0.04)