Herpetiform RAS — ORE Part 1 MCQ

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ModerateOral MedicineHerpetiform RASORE Part 1

A 20-year-old man presents with recurrent crops of ulcers that are very small (1–2 mm), numerous (10–100 at a time), and extremely painful. They affect the lateral tongue and floor of the mouth and tend to coalesce into larger irregular ulcers. Healing occurs within 2–3 weeks without scarring. What type of recurrent aphthous stomatitis is this?

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Correct answer: C — Herpetiform RAS

Herpetiform RAS is correctly identified by the combination of pinhead-sized lesions (1–3 mm), high numbers per episode (10–100), tendency to coalesce into larger irregular ulcers, healing within 2–3 weeks without scarring, and extreme pain. Minor RAS presents as 5 or fewer lesions <1 cm healing in 10–14 days. Major RAS involves fewer larger lesions (>1 cm) that scar and take weeks to months to heal. Behçet disease presents with systemic manifestations (genital ulcers, ocular involvement, vascular signs). Primary herpetic gingivostomatitis is an acute primary viral infection with gingival inflammation, not a recurrent pattern of small coalescent oral ulcers.

Reference: Prevalence of Aphthous Stomatitis: A Cross-Sectional Epidemiological Study, PMC10748215, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748215/