Sutton’s Disease: causes, symptoms, diagnosis, treatment

Last Updated on January 26, 2023 by Dr. Saqib Mueed

Again and again, the formation of benign and non-contagious mouth ulcers is called the Sutton’s Disease.


There are three other names of Sutton disease these are aphthous ulcer, aphthae, and canker sore. The word aphthae come from a Greek word that means mouth ulcer. Almost 15 sores are present at the same time.

Sutton disease located in the mouth. This disease is present in the inner part of lips, throat, soft palate, and sometimes in the esophagus. This disease is caused by many factors.

These factors are local trauma, depression, hormonal influences, different allergies, and some foods. The duration of this ulcer is about 7-10 days and this disease may occur 3-6 times in a year.

 About 20% of the world’s population affected by this disease. The term aphthous ulcer is usually used in North America. The word canker is originated from Latin. In Latin cancer mean “malignant tumor”.

The term aphtha is usually used for mouth ulcers. The word aphtha is a Greek word which mean “eruption “or “ulcer”. These are the synonyms of Sutton disease.

Signs and symptoms of Sutton’s Disease

  • People affected by aphthous stomatitis have no detectable systematic symptoms. There are the following symptoms in the person affected by this disease.
  • These symptoms are burning, itching, or stinging and these symptoms may increase the pain or any lesions. These lesions present on the tongue, throat, and inner part of lips.
  • Due to these lesions on the tongue, throat, and soft palate these causes uncomfortable and difficulty in eating food and also chewing. If we eat spicy foods and beverages, it causes burning in our mouths.
  • If the ulcer is present on the palatal velum or back of the esophagus it can conduct the hatred swallowing. This disease affected more females than males.
  • The shape of the aphthous ulcers is reddened and flat area of mucosa these develop ulcer and it surrounded with a yellow-grey fibrinous membrane.

Causes of Sutton’s disease

There are many causes of mouth ulcer these include:

  • Herpes simplex
  • Herpangina
  • Erythema multiform
  • Fixed drug eruption

The causes of Sutton disease recently not known. About 40% inhabitants of this earth prey aphthous ulcers have a family history.

 Many researchers said that this disease causes due to an abnormal immune response of bacteria. These bacteria present in the mouth. Cytokinin such as IL-2, IL10 and the TN alpha cause deficiencies of iron, vitamin B12 and folic acid increase in individuals to Sutton disease.

Herpes virus is the main cause of cancer sores. The factors which are included in this disease are following

  • Oral trauma
  • Stress
  • Food particularly chocolate, coffee, peanuts, eggs, cereals, almonds, cheese, tomatoes.
  • Drinking of alcohols


  • The diagnosis of diseases prescribed by examining the condition of the disease. If any person may get injured or prey on an ulcer the diagnose based on the appearance and history of the injury or disease.
  • The diagnosis of the ulcer is to blood tests, deficiencies of iron, vitaminB12, or celiac disease. The early observed lesions show aphthous stomatitis wrapped by a fibrinous membrane.
  • Sometimes aphthous stomatitis shows spongiosis and has so many uninuclear cells in the basal third. The blood vessels are present in the aphthous stomatitis and sometimes these vessels surrounded it.

Classification of aphthous stomatitis

Aphthous stomatitis has been classified in different stages. The first one is “common aphthous ulcer” which contains ninety-five percent of all cases and three to six attacks per year. The complex aphtha accounts for five percent of cases.

We can distinguish aphthous stomatitis on the basis of size, number, and the location where the lesions are present. There are the following classes of aphthous stomatitis the first one is

Minor aphthous ulceration

  • Minor aphthous ulceration is about eighty to eighty-five percent of all cases and that is the much simple type of mouth ulcer.
  • We can write this type as minor recurrent aphthous stomatitis (MIRAS). The size of the lesions is small. Size of the minor scratch is about less than 10 millimeters in diameter.
  • Usually, a different ulcer appears at the same time. The process of healing of minor aphthous ulceration is about seven to ten days.

Major aphthous ulceration

This type of aphthous stomatitis contain 10% of all cases. This type can be written as major recurrent aphthous stomatitis (MARAS). It is similar to minor aphthous ulcers.

The size of a major aphthous ulcer more than 10mm in diameter. The size of major lesions is larger than minor and takes much time for healing almost twenty to twenty-five days.

These major aphthous are present on the throat and soft palate. These lesions are present in an irregular outline.

Herpetiform scratches

This is the type of mouth ulcer that shows a primary infection with the herpes simplex virus. The size of the herpetiform ulceration is one millimeter in diameter and occurs in hundred at a time.

 These smaller lesions merge with each other and form a big lesion. The process of healing is 15 days. This type is very painful and ulceration is virtually continuous. Herpetiform ulceration affected more in women’s than men.

Recurrent oral ulceration or Ras’s type ulceration

  • Recurrent oral ulceration is termed as “RAS-type ulceration”. This disease occurs in a person with no systemic disease. These people may be prone to mouth ulcers.
  • The Source of this disease is oral ulceration and caused by lowering of blood volume or foods deficiencies as aphthous stomatitis.
  • In the mouth the lesions appear and cause difficulty in eating, swallowing, and chewing.

Treatment of Sutton’s Disease

These ulcers heal within 1-2 weeks without any treatment. If we do not use any medicine these ulcers will be the cure. And if we use medicine and other sprays for healing of ulceration then the disease will be early finished.

The main goal to use medicine is to lessen pain and discomfort and promote healing. Application of topical anesthetic is beneficial for the healing of the ulcer.

If we use it on the wound or place of ulcer in mouth, tongue and soft palate the ulcer may be healed in 3-5 days. Many people have small signs and they do not need any special therapy.

If we avoid the spicy and acidic foods and beverages, then we can feel lesser pain or in tolerable range of pain. If we use these things in much quantity, then we feel pain and Un comfortability.

Almost small canker sores do not require medication because they are clear and heal within a week. If the sores are larger and painful and cause of uncomfortable, then we should go to the doctor and take the medicine for healing.

In the treatment of these ulcers tetracycline and minocycline mostly used for healing. One capsule of 250mg antibiotic of tetracycline dissolved in 180ml water and used as swish and spit almost 4 times per day.

And use this antibiotic tetracycline capsule for almost 4 days continuously. After this, the patient feels comfort and less pain.

Standard therapy

In this method of treatment, we use the lido cane viscous directly on the affected areas of the mouth such as the tongue, soft palate, and inner part of lips to reduce the pain and irritation.

In some serious cases of Sutton disease oral and topical steroids administered. After that we rinse the mouth that contains antibiotic tetracycline.


In this disease, there is no critical medical condition and aphthous stomatitis do not show oral cancer. This causes very critical distress.

Due to pain during engulfing food, weight loss may increase as a result of not eating in critical cases of aphthous stomatitis. [1]Sutton’s disease – ScienceDirect[2]Management of patients with persistent recurrent aphthous stomatitis and Sutton’s disease – ScienceDirect[3]Sutton Disease : Journal of Craniofacial Surgery (

Reviewed by:

Dr. Shahid Bukhari

MBBS, FCPS (Medicine)

Ex. Registrar DOW Medical College Karachi

Medical Officer Aga Khan University Hospital Karachi

Our reviewers’ details, Click Here

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