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Major Aphthous Ulceration — MFDS Part 1 MCQ

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EasyOral MedicineMajor Aphthous UlcerationMFDS Part 1

Which clinical pattern is most characteristic of major recurrent aphthous ulceration rather than minor recurrent aphthous ulceration?

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

Reveal the answer and explanation

Correct answer: E — Usually at least 10 mm, deep and painful, persisting for weeks and sometimes healing with scarring

Explanation lettering: C = shown as A · D = shown as B · E = shown as C · B = shown as D · A = shown as E

A is correct. Major aphthae are typically at least 10 mm in diameter, deeper and more painful than minor aphthae. They persist for weeks and occasionally several months and may heal with scarring. In contrast, minor aphthae are usually under 10 mm and heal within approximately 7–14 days without scarring, as described in B. Option C describes herpetiform aphthous ulceration, which produces numerous pinpoint ulcers that may coalesce. Option D is more consistent with recurrent intraoral herpes: aphthous ulcers are not preceded by vesicles and are not confined to keratinised mucosa. Aphthous ulceration is painful, making E incorrect.

Reference: University Hospitals of Leicester NHS Trust, Recurring mouth ulcers, reviewed July 2025. https://yourhealth.leicestershospitals.nhs.uk/library/musculoskeletal-specialist-surgery-mss/maxillofacial/1992-recurring-mouth-ulcers/file