$Unique_ID{BRK04245}
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$Title{Sutton's Disease II}
$Subject{Sutton's Disease II von Mikulicz's Aphthae Periadenitis Mucosa
Necrotica Recurrent Scarring Aphthae Major Aphthous Ulcer Major Ulcerative
Stomatitis Major Canker Sore Recurrent Aphthous Ulcer Von Zahorsky's Disease
Recurrent Aphthous Stomatitis }
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Copyright (C) 1986 National Organization for Rare Disorders, Inc.

203:
Sutton's Disease II

** IMPORTANT **
It is possible the main title of the article (Sutton's Disease II) is not
the name you expected.  Please check the SYNONYMS listing to find the
alternate names and disorder subdivisions covered by this article.

Synonyms

     von Mikulicz's Aphthae
     Periadenitis Mucosa Necrotica
     Recurrent Scarring Aphthae
     Major Aphthous Ulcer
     Major Ulcerative Stomatitis Major Canker Sore
     Recurrent Aphthous Ulcer
     Von Zahorsky's Disease
     Recurrent Aphthous Stomatitis

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.


Sutton's Disease II, also known as Recurrent Aphthous Stomatitis, is
characterized by recurrent and painful attacks of major canker sores in the
mouth (aphthous stomatitis).  This disorder of unknown cause affects both
males and females.

Symptoms

The major ulcers in the mouth of Sutton's Disease II vary in size from 7 to
15 mm.  Up to 15 ulcers may be present at once in affected individuals.  The
ulcers begin as a shallow oval erosion or kind of ulceration filled with a
slightly yellowish opaque material.  This material is composed of coagulated
tissue fluids, oral bacteria and white blood cells.  The ulcers leave
scarring when they heal.

Causes

The precise cause of Sutton's Disease II is unknown, but several factors
point toward a localized immune reaction.  Deficiencies of iron, vitamin B12,
and folic acid increase susceptibility to the disease.  Stress is usually the
predominant factor which triggers the attacks.

Affected Population

Sutton's Disease II affects males and females equally before puberty; after
puberty, females are affected in greater numbers than males.  The disease
occurs most frequently in undernourished children and weakened adults.

Related Disorders

Pemphigus is the name of a distinctive group of skin disorders characterized
by successive crops of bullae (blisters).  (For more information on
Pemphigus, choose "Pemphigus" as your search term in the Rare Disease
Database.  Herpetic ulcers of the mouth, caused by a herpes virus, occur
mainly on the immovable mucosa (hard palate and attached gums), while the
aphthae of Sutton's Disease II rarely appear in those locations.

Therapies:  Standard

Treatment of Sutton's Disease II involves application of a topical anesthetic
such as 2% lidocaine viscous or as an oral rinse providing short-time relief
and facilitating eating.  A dental protective paste such as OrabaseR prevents
teeth, dental appliances and oral fluids from irritating the ulcers.
Application of triamcinolone acetonide in emollient dental paste (a soothing
agent) reduces discomfort and promotes healing.  Tetracycline oral suspension
may be used to treat multiple lesions.  If started early after onset of the
disease, symptomatic relief may occur during the first day of treatment and
new lesions may be aborted.  Treatment must be repeated for each new attack.

Occasionally, this therapy may result in oral candidiasis which is an
infection caused by a fungus of the genus Candida.

Therapies:  Investigational

This disease entry is based upon medical information available through May
1990.  Since NORD's resources are limited, it is not possible to keep every
entry in the Rare Disease Database completely current and accurate.  Please
check with the agencies listed in the Resources section for the most current
information about this disorder.

Resources

For more information on Sutton's Disease II, please contact:

     National Organization for Rare Disorders (NORD)
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     (203) 746-6518

     NIH/National Institute of Dental Research
     9000 Rockville Pike
     Bethesda, MD  20892
     (301) 496-4261

References

THE MERCK MANUAL, 15th ed., Robert Berkow, M.D., ed in chief, published by
Merck, Sharp & Dohme Research Labs, Rahway, NJ, 1987.  Pp. 2325.

THE CECIL TEXTBOOK OF MEDICINE, 18th Ed.:  James B. Wyngaarden and Lloyd
H. Smith, Jr., Eds; W.B. Saunders Co., 1988.  Pp. 675-676, 1664, 2347.