Which clinical history findings are characteristic of pediatric aphthous ulcers?

Updated: Feb 25, 2019
  • Author: Michael C Plewa, MD; Chief Editor: Russell W Steele, MD  more...
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The diagnosis of aphthous ulcers (canker sores) is primarily clinical. Patients typically describe a prodromal stage of a burning or pricking sensation of the oral mucosa 1-2 days before the ulcer appears. Patients with recurrent aphthous ulcers (RAUs), or canker sores, often mention precipitating factors, such as local trauma or food hypersensitivity.

  • During the review of systems, infants and small children should be assessed for decreased feeding, weight, and urine output. Associated symptoms, such as those below, suggest other diagnoses and are not associated with recurrent aphthous ulcers (canker sores).

    • Fever

    • Malaise

    • Myalgias

    • Arthralgias

    • Headache

    • Cough

    • Nausea

    • Vomiting

    • Abdominal pain

    • Diarrhea

    • Sore throat

    • Swollen or painful lymphadenopathy

    • Rash

    • Genital or conjunctival lesions

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