18th July 2023

You see a 26-year-old woman in a Rheumatology clinic with a long history of painful oral ulceration

You see a 26-year-old woman in a Rheumatology clinic with a long history of painful oral ulceration. She tends to develop crops of 2-3 oral ulcers <1 cm in diameter every month or so since adolescence. The ulcers heal within a week with no scarring. She reports that her mother also suffered with similar ulcers when she was younger. She denies any arthralgia, weight loss, diarrhoea, genital ulceration, fevers, or rashes.

Blood tests, including FBC, CRP, ESR, TTG, autoantibody screen and haematinics, are within normal range. A faecal calprotectin was also normal. On examination, you note two 5mm ulcers on the oral labial mucosa with an erythematous halo and central yellow exudate.

Which of the following is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.