The 3 Clinical Forms of Aphthous Stomatitis

WARNING: This post contains images of aphthous ulcers that some people may find disturbing. 

The classic categorization of recurrent aphthous ulcer is divided into 3 clinical forms: 

1. Recurrent aphthous ulcer minor
2. Recurrent aphthous ulcer major
3. Herpetiform recurrent aphthous ulcer

Recurrent aphthous ulcer minor:

• Recurrent aphthous ulcer minor is the most common form, accounting for 80% of all cases. 
• Discrete, painful, shallow, recurrent ulcers smaller than 1 cm in diameter characterize this form. 
• At any time, one or more ulcers can be present. 
• Lesions heal without scarring within 7-10 days. 
• The periodicity varies between individuals, with some having longer ulcer-free episodes and some never being free from ulcers.

These ulcers are relatively small and shallow.

Recurrent aphthous ulcer major:

• Recurrent aphthous ulcer is formerly known as periadenitis mucosa necrotica recurrens. 
• This form is less common than the others and is characterized by oval ulcers greater than 1 cm in diameter. 
• In this relatively severe form, many major aphthae may be present simultaneously. 
• Ulcers are large and deep, may have irregular borders, and may coalesce. 
• Upon healing, which may take as long as 6 weeks, ulcers can leave scarring, and severe distortion of oral and pharyngeal mucosa may occur.

Notice the significant difference in depth and irregular shape
of a major ulcer in comparison to a minor ulcer. 

Herpetiform recurrent aphthous ulcer:

• This least common form (5-10% of cases) has the smallest of the aphthae, commonly no larger than 1 mm in diameter. 
• The aphthae tend to occur in clusters that may consist of tens or hundreds of minute ulcers. 
• Clusters may be small and localized, or they may be distributed throughout the soft mucosa of the oral cavity.

It's worse than you imagine it is.