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Recurrent Aphthous Stomatitis — SCE Dermatology MCQ

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HardInflammatory DermatosesRecurrent Aphthous StomatitisSCE Dermatology

A 45-year-old woman has recurrent aphthous stomatitis not responding to topical treatment. She has microcytic anaemia with low ferritin and low serum B12. Which nutritional deficiencies should be investigated as causes of recurrent aphthae?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Iron, vitamin B12, and folate deficiency — all can cause recurrent aphthous ulceration

The best answer is “Iron, vitamin B12, and folate deficiency — all can cause recurrent aphthous ulceration”. The diagnosis follows the defining morphology, distribution, histopathology and time course; management changes when red flags, scarring, systemic disease or malignancy risk are present. The alternatives “iron deficiency, after clinicopathological correlation, after specialist assessment, when the full phenotype supports it”, “No nutritional cause exists, after specialist assessment, when the full phenotype supports it”, “zinc, when the full phenotype supports it, within an appropriate UK pathway”, “vitamin C, within an appropriate UK pathway, after clinicopathological correlation, after specialist assessment” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: British Association of Dermatologists clinical resources: https://www.bad.org.uk/