Mouth ulcer/ cancer

Mouth ulcers with AUTOIMMUNE DISEASES Several autoimmune diseases may mimic benign aphthous ulcers. Behçet's syndrome is an autoimmune vasculitis that causes recurrent oral and genital ulcerations, uveitis and retinitis. Severe aphthae and Behçet's syndrome may be two points on a disease continuum. Non-oral symptoms of Behçet's syndrome may be present in 43 to 100 percent of patients with recurrent aphthous ulcers, depending on severity.6 Reiter's syndrome is associated with oral ulcers, uveitis, conjunctivitis and HLA B27-positive arthritis following nongonococcal urethritis or bacillary dysentery.3 Patients with inflammatory bowel disease, in particular Crohn's disease, may present with associated mouth ulcerations. Lupus erythematosus, bullous pemphigoid and pemphigus vulgaris are other diseases that may involve ulceration of the mouth. In all of these conditions, the associated symptoms should be elicited to make a differentiation from benign recurrent aphthae. ALTERNATIVE AGENTS Sucking on zinc gluconate lozenges is anecdotally reported to provide local relief and speeding of healing time for aphthous ulcers. Vitamin C, vitamin B complex and lysine may speed healing when taken orally at the onset of lesions. Sage and chamomile mouthwash, created by infusing equal amounts of the two herbs in water, may be helpful when used four to six times a day. Echinacea is reported to speed healing, perhaps through its immune modulatory effect. Carrot, celery and cantaloupe juices also have been reported as helpful complementary agents.12 None of these agents has been studied in randomized controlled trials.