Comprehensive treatment efficacy assessment of chronic recurrent aphthous stomatitis in patients with urogenital infections

Background: Infectious-allergic, neurogenic, occupational, immunological, and crossover factors play a significant role in the etiopathogenesis of chronic recurrent aphthous stomatitis (CRAS). Moreover, CRAS is associated with chronic kidney disease (CKD) and viral infections of the oral cavity secondary to urogenital pathologies.

Aim: To assess the efficacy of comprehensive diagnosis and treatment of CRAS in patients with urogenital infections.

Materials and methods: The study included 120 patients with CRAS aged 18–70 years. Of these, 80 had CRAS secondary to CKD with infectious complications: treatment group 1 (TG1, n=40) and reference group (RG, n=40). Forty patients with CRAS had no urogenital infections: treatment group 2 (TG2). The treatment protocol in the study groups included antihistamines, sedatives, immunomodulators, and multivitamins. Topical treatment included Eludril solution (irrigation, mouth wash, etc.), as well as ginger and myrrh extracts. The conditional control group (CCG) included 20 apparently healthy subjects.

Results: The study found that regional lymphadenitis, Mikulicz’s aphthae, swollen oral mucosa, severe dental caries, and a high periodontal disease index were more common in patients with CRAS secondary to CKD; patients with more prolonged and severe CRAS had the worst results. Immunodeficiency and abnormal blood chemistry findings associated with CKD were identified as the primary pathogenetic factors for recurrent infection in CRAS.

Conclusion: Patients with CRAS secondary to CKD may develop chronic inflammation caused by opportunistic pathogens in the oral cavity, resulting in local immunodeficiency, which is largely determined by the site and severity of inflammation.