INTRODUCTION
Recurrent aphthous stomatitis (RAS) is the most common oral lesion; it has unknown etiology and is characterized by periodic oval, shallow, painful ulcers, gray or yellowish in color, which are surrounded by a red halo in keratinized or non-keratinized epithelium. These ulcers can interfere with eating and drinking, and they affect quality of life.1
The definitive cause of RAS is unclear. Multiple factors may be included in the etiology by activation of cellular mediated immunity, including: local trauma, microorganisms, nutritional deficiency, allergy, genetics, psychological stress, and systemic diseases.2 RAS can be divided clinically into: 1) minor RAS or Mikulicz's aphthae; 2) major RAS or Sutton's disease or periadenitis mucosa necrotica recurrens; and 3) herpetiform ulcers or Cooke's ulcers.3 The diagnosis of RAS depends on taking a careful and detailed patient history, with a clinical examination of the lesion, lymph nodes, and surrounding area. The periodicity of the ulcer is very important for the diagnosis.4 Some studies have found that the serum levels of interleukin (IL)-1B, IL-6, and tumor necrosis factor (TNF)-α were elevated in RAS patients.5,6
There are many treatment modalities for RAS, but until now no treatment has been curative so the most important targets are to decrease pain, shorten the period of ulcers by inducing re-epithelialization, decrease the number of ulcers in each episode, and decrease the frequency of ulceration.7
Steroids have been used for a long time to treat many autoimmune diseases including RAS.8 One commonly used steroid in the treatment of RAS is triamcinolone acetonide
The definitive cause of RAS is unclear. Multiple factors may be included in the etiology by activation of cellular mediated immunity, including: local trauma, microorganisms, nutritional deficiency, allergy, genetics, psychological stress, and systemic diseases.2 RAS can be divided clinically into: 1) minor RAS or Mikulicz's aphthae; 2) major RAS or Sutton's disease or periadenitis mucosa necrotica recurrens; and 3) herpetiform ulcers or Cooke's ulcers.3 The diagnosis of RAS depends on taking a careful and detailed patient history, with a clinical examination of the lesion, lymph nodes, and surrounding area. The periodicity of the ulcer is very important for the diagnosis.4 Some studies have found that the serum levels of interleukin (IL)-1B, IL-6, and tumor necrosis factor (TNF)-α were elevated in RAS patients.5,6
There are many treatment modalities for RAS, but until now no treatment has been curative so the most important targets are to decrease pain, shorten the period of ulcers by inducing re-epithelialization, decrease the number of ulcers in each episode, and decrease the frequency of ulceration.7
Steroids have been used for a long time to treat many autoimmune diseases including RAS.8 One commonly used steroid in the treatment of RAS is triamcinolone acetonide
