Dawaa Reference

Clinical reference

Aphthous Stomatitis (Recurrent mouth ulcers)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

British Association of Oral Surgeons Guidelines 2019 · Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529) · Egyptian National Drug Formulary, endocrine 2024, triamcinolone monograph, oral paste (printed p. 177)

Verified against2 documents
  • Egyptian National Drug Formulary, endocrine 2024, triamcinolone monograph, oral paste (printed p. 177)
  • Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • The hallmark is recurring, painful mouth ulcers that can last from a few days up to several months [mouth ulcers]
  • Oral discomfort can precede the ulcer appearing, in the minor form

Signs — what you find (8)

  • Minor ulcers are small, usually under 5 mm, oval or round, 1 to 6 at a time, ringed by erythema, and covered by a gray-white pseudomembrane [mouth ulcers · redness]
  • Minor ulcers mainly occur on non-keratinized mucosa - buccal, labial, floor of mouth - and heal within two weeks without scarring
  • Major ulcers are bigger, over 10 mm, and persist 5 to 10 weeks, usually healing with a scar [mouth ulcers · scarring]
  • Major ulcers can appear anywhere in the mouth, including the oropharynx
  • Major ulcers do not usually follow a cyclical pattern [mouth ulcers]
  • Herpetiform ulcers are painful, small, and numerous, up to 100 at once, each 2 to 3 mm and lasting one to two weeks [mouth ulcers]
  • Herpetiform ulcers favor the floor of the mouth and the tip and edges of the tongue
  • Herpetiform ulcers can merge into one large, irregular ulcer that heals with scarring [mouth ulcers · scarring]

Tests (2)

  • Diagnosis is clinical, but Behcet disease, nutritional deficiency, or inflammatory bowel disease should be excluded, especially with sudden adult onset
  • Work-up for anemia or deficiency often checks CBC, red cell folate, ferritin, and vitamin B12, which can also flag GI disease

If not this — what else fits (4)

  • Behcet disease brings recurrent genital ulcers, skin lesions, posterior uveitis, and neuro/GI/renal/hematologic/joint involvement
  • MAGIC/Sweet syndrome brings sudden fever, leukocytosis, and plum-colored papules or plaques, with malignancy in about half of patients
  • PFAPA syndrome brings periodic fever, pharyngitis, aphthae, and cervical adenitis in young children; most improve with tonsillectomy
  • Cyclic neutropenia brings fever, skin abscesses, lymphadenopathy, and respiratory infections, plus severe gingivitis and aggressive periodontitis

SourceStatPearls "Recurrent Aphthous Stomatitis" - disease-level clinical article

Presentation findings are traced to the source above.

1

TRIAMCINOLONE

1st line

Formoromucosal.paste

Adult dose and duration

Coat the ulcer with a thin film of 0.1% oral paste - just enough to cover it, not rubbed in - two or three times a day, preferably after meals

Paediatric dose

Children: same oral paste dose as adults; the monograph carries no age restriction for the oral paste.

Dose source

Egyptian National Drug Formulary, endocrine 2024, triamcinolone monograph, oral paste (printed p. 177)

Why

Topical corticosteroid paste that damps local mucosal inflammation, easing pain and speeding healing of aphthous ulcers; withheld from ulcers that are actually fungal or viral, since suppressing local immunity there would let those infections worsen.

Cautions
  • Press a small dab onto ulcer without rubbing until thin film forms.
  • Do not apply inside fungal or viral oral infections (e.g. herpes, thrush).
  • Investigate for iron, folate, B12 deficiency or IBD if ulcers are recurrent/intractable.
Egyptian brands
Egyptian brandManufacturerIndicative price
TOPICORT 0.1% CREAM 20 GM? different route - not oromucosal.pastePHARCO6.00 EGP
PHARCOCINOLONE 40MG/ML I.M AMP.? different route - not oromucosal.pasteCHEMIPHARM > PHARCO B8.00 EGP
AMCINOL 40MG/ML I.M AMP.? different route - not oromucosal.pasteSIGMA TEC11.00 EGP
EPIRELEFAN 40MG/ML I.M AMP.? different route - not oromucosal.pasteEIPICO38.00 EGP
SYNTHECORTIN 40MG/ML I.M AMP.? different route - not oromucosal.pasteMUP54.00 EGP
2

CHLORHEXIDINE

add-on - not a substitute

Formtopical

Adult dose and duration

Rinse with 10 mL of 0.2% mouthwash for 1 minute twice daily - Continue for 48 hours after clinical resolution

Paediatric dose

Children under 12 years of age should not use the product unless recommended by a healthcare professional.

Dose source

Corsodyl 0.2% Mouthwash SmPC sections 4.2 and 4.4 (eMC product 529)

Why

Antiseptic mouthwash added alongside the topical steroid to reduce the bacterial load over the ulcer and guard against secondary infection; supports the anti-inflammatory treatment rather than replacing it.

Cautions
  • Accelerates healing and prevents secondary bacterial infection of ulcers.
  • May cause reversible brown staining of teeth and tongue with prolonged use.
  • Do not rinse with water or use toothpaste immediately after rinsing.
  • Do not use straight after toothpaste - it inactivates chlorhexidine. Separate the two, rinsing the mouth in between, or use them at different times of day. A course of about one month is what the label describes; staining of the teeth is temporary.
Egyptian brands
Egyptian brandManufacturerIndicative price
ELUGEL ORAL GEL 20 GMGLOBAL NAPI PHARMACEUTICALS > PIERRE FRANCE6.50 EGP
RECARE ORAL GEL 30 GMUNIPHARMA CO. > UNIPHARMA14.95 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.