At a Glance - Minor aphthous ulcer vs hand, foot and mouth

Minor aphthous ulcer
Discriminatory signs

  • Small and round or oval.
  • Affects cheeks, lips or gums.
  • Pale centre surrounded by erythematous swollen mucosa.
  • Lasts seven to 10 days; resolves without scarring.
  • Women affected more than men.
  • Family history of mouth ulcers.
  • Recurrent.
  • Usually first occur between the ages of 10 and 40.
  • Not usually associated with systemic illness.
  • When recurrent, can be associated with lack of iron and vitamins, hormonal changes, stress, or inflammatory bowel disease.


Management

  • Avoid spicy, acidic or salty foods.
  • Use a soft toothbrush.
  • Chlorhexidine mouthwash.
  • Steroid lozenges or gel.


Hand, foot and mouth
Discriminatory signs

  • Usually caused by coxsackievirus A, can also be due to enterovirus 71.
  • Very contagious.
  • Affects children under the age of 10.
  • Patient feels unwell.
  • Affects both sexes but boys have more symptoms.
  • Yellow-red ulcers affecting palate, tongue and cheek.
  • Can be very sore.
  • Hands and feet are affected a few days later.
  • Lasts seven days.


Management

  • Advice about adequate analgesia and hydration.
  • Reassure not related to the condition affecting cattle.
  • Text contributed by Dr Vasa Gnanapragasam, GP in Sutton, Surrey

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