Herpetiform Aphthae — MFDS Part 1 MCQ
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Correct answer: A — Numerous 1–2 mm pinpoint ulcers that may coalesce into a larger irregular ulcer
Explanation lettering: D = shown as C · E = shown as D · C = shown as E
A is correct. Herpetiform recurrent aphthous ulceration produces crops of numerous tiny, approximately 1–2 mm ulcers, often numbering around 20–30 or more, which may coalesce into a larger irregular ulcerated area. Minor aphthae usually occur as only one to five ulcers and remain discrete. One or two ulcers at least 10 mm across, prolonged healing and scarring are characteristic of major aphthae, making B and E incorrect. Aphthae are not confined to keratinised mucosa, so C is false. Although recurrent aphthous-like ulceration may accompany systemic disease, uncomplicated recurrent aphthous stomatitis does not invariably indicate systemic disease; therefore D is incorrect. Despite the name, herpetiform aphthae are not caused by herpesvirus.
Reference: University Hospitals of Leicester NHS Trust, Recurring mouth ulcers, section: Aphthous ulcers, last reviewed July 2025. https://yourhealth.leicestershospitals.nhs.uk/library/musculoskeletal-specialist-surgery-mss/maxillofacial/1992-recurring-mouth-ulcers/file