Recurrent aphthous ulcers in patients with HIV infection can cause significant morbidity, which makes successful diagnosis and treatment imperative. We have found that the diagnostic paradigm for recurrent aphthous ulcers in HIV-seronegative patients, which is based on the ulcers' clinical appearance, location, absence of other ulcer-causing pathogens or pathogenic processes, and response to therapy, may be successfully applied to recurrent aphthous ulcers in HIV-infected patients. However, one must be alert for ulcers with uncommon causes as well as ulcers with common causes that have atypical clinical appearances that may mimic recurrent aphthous ulcers. The topical glucocorticoids, which are used to treat recurrent aphthous ulcers in HIV-seronegative patients, proved very effective in HIV-infected patients for treatment of herpetiform and minor ulcers and most major ulcers and were without notable side effects. A few severe cases of major recurrent aphthous ulcers required treatment with systemic prednisone, and some side effects were encountered.

Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Clobetasol/ANALOGS & DERIVATIVES/THERAPEUTIC USE Dexamethasone/THERAPEUTIC USE Female Fluocinonide/THERAPEUTIC USE Glucocorticoids, Topical/THERAPEUTIC USE Human HIV Infections/*COMPLICATIONS Male Middle Age Prednisone/THERAPEUTIC USE Stomatitis, Aphthous/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE

www.aegis.org