Recurrent Aphthous Stomatitis — SCE Dermatology MCQ

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ModerateInflammatory DermatosesRecurrent Aphthous StomatitisSCE Dermatology

A 40-year-old man presents with recurrent painful aphthous ulcers. He has major aphthae (>10 mm) on his soft palate. They take weeks to heal and leave scars. What is the first-line systemic treatment for recurrent major aphthous ulceration?

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Correct answer: B — Colchicine

For recurrent aphthous stomatitis, Colchicine is considered a first-line systemic agent for prophylaxis of recurrent episodes. Topical therapy (topical corticosteroids, Benzydamine mouthwash) is appropriate for minor aphthae. For major aphthae (Sutton ulcers, >10 mm with scarring), systemic therapy may be needed. Colchicine 0.5 mg BD-TDS reduces recurrence frequency. For refractory cases, Dapsone, Pentoxifylline, or Thalidomide (most effective but teratogenic/neuropathic) may be considered. Behçet disease should be excluded in patients with recurrent aphthae, particularly with genital ulcers or eye involvement.

Reference: BAD 2019 Patient Information; BJD Aphthous Review