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Aphthous ulcer - Management
Topical corticosteroids
- Hydrocortisone 2.5 mg lozenges are licensed for use in aphthous ulcers [BNF 53, 2007]. Triamcinolone in an adhesive paste (Adcortyl in Orabase®) has been discontinued.
- Encourage individuals with prodromal symptoms to apply corticosteroids at this stage. Otherwise, corticosteroids should be applied as soon as the ulcers appear [Scully et al, 2003].
- Concerns have been raised that long-term or repeated application could cause adrenal suppression. However, there is little evidence that even some of the more potent steroids (such as fluocinonide or betamethasone) cause significant problems in this respect [Scully et al, 2002].
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