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Associated systemic disorders  

Behcet's disease It is a systemic disorder characterised by recurrent oral aphthous-like ulcers together with at least two of the following symptoms: genital aphthous-like ulcers, ocular inflammations, skin lesions, vasculitis, transient arthritis of the peripheral joints.
Reiter's syndrome Typical symptoms are arthritis, urethritis, conjunctivitis and 10per cent of patients manifest oral aphthous-like ulcers.
Hematinic deficiency About 25per cent of RAS patients show deficiencies in zinc, iron, folic acid or some vitamins which can affect the immune system and can have an association to RAS.
Gastrointestinal disease Celiac disease can be a reason for a vitamin B and foliate deficiency and may lead to RAS. A complete remission of the aphthae is possible by a gluten-free diet.
Sweet's syndrome The symptomatic triad of the rare Sweet's syndrome comprises fever, erythematous plaques or nodules and an increase in neutrophils. Aphthous-like oral lesions are an often concomitant.
Cyclic neutropenia Symptoms include RAS (especially the minor type), malaise, fever, skin infections and cervical adenopathy for about 3 weeks each time. Gingivitis, loss of alveolar bone and tooth-loss can accompany the cyclic episodes.
MAGIC The 'mouth and genital ulcers with inflamed cartilage syndrome' includes polychondritis, arthritis and cutaneous pustules together with symptoms of Behcet's disease.
PFAPA The 'periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome' includes intervals of that symptoms which start in early childhood and last for years. The patients are completely healthy in between the episodes.

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Stomatopedia is a free educational platform for stomatology, oral pathology of the soft tissue diseases in children and adolescent. Oral soft tissue diseases exhibit distinctive clinical features and require visual recognition to establish an exact diagnosis. Therefore we share our clinical features with Paedriatricians, Medical Practitioners and Paediatric Dentists and we hope it will be helpful in distinguishing one lesion from another as a part of the diagnostic process. We have set our priority to lesions in children and adolescents and we hope this set focus will stress and develop cooperation. The editors are interested to create a lively exchange about the topics in pictures an in discussion.

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Richard Steffen
Dr. med dent. WBA KZM SSO
Oberarzt, Assist. Prof.
Member EAPD
UZB, Universitäres Zentrum für Zahnmedizin
Mattenstrasse 40
CH 4058 Basel


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