Slide 1: Test your knowledge! Among patients with recurrent aphthous ulcers (canker sores), which of the following underlying disease is most often present? A) Crohns disease. B) Celiac disease. C) Bechets disease. D) HIV. E) No identifiable underlying disease.

Slide 2: Answer? E) No identifiable underlying disease. All of the other conditions are associated with aphthous ulcers, but no clear underlying condition is present in most patients. Patients who present with recurrent aphthous ulcers at an older age (beyond 20s) are more likely to have an underlying systemic disease.

Slide 3: Bonus! Aphthous ulcers are mediated by T-cell activity, but the antigen is unknown. Factors predisposing to aphthous ulcers include: family history, emotional stress, trauma to the mouth, vitamin deficiencies (B12 and iron), certain underlying systemic conditions.

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