Skip to main content

Aphthous Ulcers, Emergency Medicine

Matthew R. Berkman Reviewed 06/2017



Painful ovoid or round ulcerations on the mucous membranes of the mouth, tongue or genitals: 
  • Commonly referred to as “canker sores”


  • Unknown

  • Etiology likely multifactorial with ...


Signs and Symptoms

  • Minor aphthous ulcers:

    • 70–90% of all aphthae

    • <5 mm in diameter; up to 5 appear at a time

    • Painful, shallow ulcers with necrotic centers

    • Raised, circumscribed margins and eryt...


Ed Treatment/Procedures

  • Treatment guided by severity and duration of symptoms

  • Goal is for symptomatic pain relief and reduction of inflammation.


  • Mild to moderate disease:

    • Avoid oral tr...



Admission Criteria

  • Unable to eat or drink after appropriate analgesia

  • Abnormal vital signs or evidence of dehydration

Discharge Criteria

  • Tolerating fluids

  • Adequate analgesia

  • Normal vita...

Pearls and Pitfalls

  • The vast majority of aphthous ulcers are benign, self-limited, and treated symptomatically

  • ED physicians must consider underlying systemic cause of ulcers.

Additional Reading

  • Akintoye  SO, Greenberg  MS. Recurrent aphthous stomatitis. Dent Clin North Am.  2005;49:31–47.

  • Brocklehurst  P, Tickle  M, Glenny  AM, et al. Systemic interventions for recurre...



  • 528.2 Oral aphthae

  • 608.89 Other specified disorders of male genital organs

  • 616.50 Ulceration of vulva, unspecified


  • K12.0 Recurrent oral aphthae

  • N50.8 Other specified disorders of male genit...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.