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The Diagnosis and Management of Recurrent Aphthous Stomatitis: A Consensus Approach
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
This paper builds upon the work of earlier papers, such as those by Scully and Porter,3 published in 1989, covering the aetiology, pathogenesis, and management of RAS. Although many papers have been published since 1989, the description of the clinical features of minor, major, and herpetiform RAS described in this paper remain a useful and eloquent description. This can be easily visualised in the table in the later paper by Porter et al.4 which highlights the differences between minor RAS, major RAS, and herpetiform RAS.
The gastrointestinal system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sharon J. White, Francis A. Carey
Recurrent aphthous stomatitis (RAS) involves recurrent oral ulcers seen in the absence of systemic disease. RAS is very common occurring in about 20%–25% of the population. Painful fibrin-covered ulcers arise, either singly or in crops, and of variable size (minor, major, or herpetiform). The pathogenesis is not fully determined; however, immunological factors appear to play a role. Ulcers similar to those in RAS can be seen as recurrent oral ulceration associated with systemic diseases. Recurrent aphthous stomatitis/recurrent oral ulceration may be associated with haematinic deficiencies, gastrointestinal disorders such as Crohn's disease, stress, stopping tobacco smoking, or hypersensitivity to foods.
Regulators of Signal Transduction: Families of GTP-Binding Proteins
Published in Robert I. Glazer, Developments in Cancer Chemotherapy, 2019
Further impetus was given to the research in the field of membrane-associated regulatory GTP-binding proteins when it was discovered that the protein product of the retroviral ras gene was also a GTP-binding protein (termed p21) localized at the plasmalemma. The viral form of ras is an oncogene. Slightly altered forms of ras were subsequently shown to be a normal constituent of the human genome. Activation of the human ras gene can result from a single point mutation and may be sufficient to cause growth of tumors in man. Activated ras genes have been found in an estimated 20 to 30% of all human tumors.
N-acetylcysteine versus chlorhexidine in treatment of aphthous ulcers: a preliminary clinical trial
Published in Journal of Dermatological Treatment, 2021
Esam Halboub, Baleegh Alkadasi, Mohammed Alakhali, Ali AlKhairat, Huda Mdabesh, Somaya Alkahsah, Saleem Abdulrab
Aphthous ulcers, or recurrent aphthous stomatitis (RAS), is a benign oral ulcerative disease and the most common ulcerative disorder of the oral mucosa. The point prevalence is 1.5%, but the annual and lifelong prevalence rates in general population are 20% and 40%, respectively, with higher figures reported for specific population segments (1–3). A RAS episode is characterized by one or more round shallow ulcers with a well-demarcated erythematous margin and a yellowish to grayish pseudomembranous central area. The associated pain ranges from very mild to very severe (4). On the basis of their size and number, RAS can be classified as minor, major, and herpetiform. Minor recurrent aphthous stomatitis (usually less than 10 mm) is the most common form accounting for 80% RAS patients (2).
Effectiveness of booster dose of tetanus and diphtheria toxoids (Td) vaccine in management of recurrent aphthous stomatitis: a prospective, randomized, triple-blind and placebo-controlled clinical trial
Published in Journal of Dermatological Treatment, 2021
Shahram Habibzadeh, Mehdi Sheikh Rahimi, Hasan Edalatkhah, Hadi Piri, Nasrollah Maleki
There are three different clinical variants of RAS (4):Minor RAS is the most common variant of RAS and approximately 85% of patients have lesions of this type. The ulcers are concentrated in the anterior part of the mouth, usually <1 cm in diameter, their size is approximately 4–5 mm in diameter. The classification of minor RAS does not depend on the dimensions of the lesions alone, but on a number of other clinical features such number of ulcers from 1 to 5. Ulcers heal within 10–14 days without scarring (5,6).Major RAS is similar in appearance to those of minor RAS; however, they are larger than 1 cm in diameter, and are deeper. It affects approximately 10–15% of all RAS. These lesions persist for up to 6 weeks and heal with scarring (7,8).Herpetiform ulceration constitutes only 5–10% of all RAS cases. These lesions are small in size, measure 1–3 mm in diameter, and may be up to 100 in number. These ulcers last for approximately 7–14 days, and the period of remission between attacks is variable. The patients affected are mostly women and have a later age of onset than other clinical forms of RAS (1)
Developments in the treatment of HCV genotype 3 infection
Published in Expert Review of Anti-infective Therapy, 2019
In a recent German Hepatitis C-Registry presentation, all (N = 25) prior GT3 DAA-treatment failures responded to retreatment with SOF/VEL/VOX±RBV [94]. This is a promising result although details such as disease status, prior treatment regimen, and RAS status of these specific patients were not described. Over 50% of patients in the pan-genotypic study had failed NS5A drug-based regimens and the majority of those included LDV, which infrequently selects for drug resistance due to its sub-optimal antiviral activity. In a small Spanish study, 80% (24/30) of prior GT3 DAA-treatment failures achieved SVR [95]. All six failures had prior experience to DCV- or VEL-based regimens; four had cirrhosis and one had baseline Y93H suggesting that these two factors can still impact response. More data is required to understand SVR rates to SOF/VEL/VOX in certain GT3 patient populations with prior failure to approved GT3 NS5A-containing regimens.