DIFFERENTIAL DIAGNOSIS OF APHTHOUS STOMATITIS AND EPIDEMIC STOMATITIS

Аннотация

This article examines the issues of differential diagnosis of aphthous stomatitis and epidemic stomatitis. The article analyzes in detail the clinical signs, course, pathogenesis and diagnostic criteria of both diseases. The differences between the single ulcers of aphthous stomatitis and the multiple mucosal lesions of epidemic stomatitis are shown. Keywords: Aphthous stomatitis, epidemic stomatitis, differential diagnosis, mucosal diseases, oral ulcers, viral stomatitis, laboratory diagnostics, clinical signs, treatment methods,pathogenesis. Login Aphthous stomatitis and epidemic stomatitis are the most common diseases of the oral mucosa. Despite the similarities in the clinical manifestations of these diseases, their etiology, pathogenesis and treatment methods differ significantly. Timely and correct diagnosis of these diseases, manifested by lesions of the oral mucosa, is important. Today, improving differential diagnostic methods, improving the course of diseases and preventing complications are among the urgent issues in dentistry. Aphthous stomatitis develops mainly as a result of disorders in the immune system and often has a chronic course. Epidemic stomatitis, on the other hand, has a mainly viral etiology and, as an infectious disease, is characterized by rapid spread. This article discusses the differential diagnosis, clinical symptoms, development mechanisms and treatment methods of both diseases. The diagnostic value of modern laboratory and instrumental examination methods, the possibilitiesof early detection ofdiseases and preventivemeasures are also highlighted. Mainpart Aphthous stomatitis and epidemic stomatitis are diseases characterized by pathological changes in the oral mucosa. In order to differentiate these two diseases, it is necessary to analyze in depth their clinical symptoms, etiology, pathogenesis, diagnostic criteria, and treatment methods. 98,7:ROTCAFTCAPMI.SECNEICSLACIDEM ,5202 ,hcraM,5emuloV gro.srehsilbupcimedaca.www Aphthousstomatitis Aphthous stomatitis (recurrent aphthous stomatitis, RAS) is one of the most common diseases of the oral mucosa. According to the World Health Organization, 20-25% of the population suffers from recurrent aphthous stomatitis. Nikiforova (2018) states that "Aphthous stomatitis is an inflammatory disease of the oral mucosa, characterized by the appearance ofself-healing ulcers onthe oral mucosa." From the point of view of etiopathogenesis, aphthous stomatitis is a polyetiological disease that develops under the influence of several factors. In the studies conducted by Mirzaeva and Rakhimov (2020), "The main factors that lead to the development of aphthous stomatitis include genetic predisposition, disorders of the immune system, micronutrient deficiencies, allergic reactions, and microbial factors." Rakhmanova (2019) concluded that "The imbalance of T-lymphocytes, impaired cytokine production, and the development of autoimmune processes against the mucous membrane play an important role in the pathogenesis ofaphthous stomatitis." Clinically, three clinical forms of aphthous stomatitis are distinguished: minor, major, and herpetiform. Otaboev and Kholikov (2021) based on clinical observations, "Minor aphthous stomatitis is characterized by superficial ulcers with a diameter of 2-5 mm, located singly, with a red inflamed border around them. Major aphthous stomatitis is characterized by deep ulcers with a diameter of more than 10 mm and ends with scarring. Herpetiform aphthous stomatitis is manifested by numerous small (1-2 mm) superficial ulcers and is clinically similarto herpes viral stomatitis." The diagnosis of aphthous stomatitis is based mainly on clinical signs. Turdiev et al. (2022) note the following: "The diagnostic criteria for aphthous stomatitis are: the presence of painful, round or oval, white-yellow fibrinous lesions on the oral mucosa, surrounded by a red inflamed border; the lesions are most often located on the lips, tongue, gums, and floor 98,7:ROTCAFTCAPMI.SECNEICSLACIDEM ,5202 ,hcraM,5emuloV gro.srehsilbupcimedaca.www of the mouth; the patient's body temperature is normal; the lymph nodes are not enlarged; thedisease tendstoheal spontaneously within7-14 days; andthe diseaserelapses." Laboratory diagnostic methods also play an important role in the diagnosis of aphthous stomatitis. Jumaev and Sobirova (2023) noted that "In the diagnosis of aphthous stomatitis, the normal number of leukocytes in the blood, a slight increase in the erythrocyte sedimentation rate (ESR), changes in the immunoglobulin and cytokine profile are of important diagnostic importance." Scientific studies have shown that in patients with aphthous stomatitis, the concentration of IL-1 β , TNF- α and IL-6 cytokines is increased, which confirms theimmunopathogenesis of thisdisease. Treatment methods for aphthous stomatitis require a comprehensive approach. According to the results of a study by Saidov et al. (2021), "Anti-inflammatory, immunomodulatory, an