Almost everyone has had a mouth ulcer, but most people have a short-lived and episodic mouth ulcer, or accidentally bitten their own oral mucosa and produced, this mouth ulcer just need to pay attention to rest and eat more fruits and vegetables, more can be self-healing. But if it is a long-term recurring mouth ulcers, or even one after another, then you should pay attention to check for autoimmune diseases, especially leukodystrophy. Leuko is a kind of vasculitis, most patients only invade the small blood vessels under the mucosa, causing mucosal ulcers, but a few leuko will involve the whole body of large and small blood vessels, resulting in damage to large blood vessels or internal organs, it will be life-threatening. Overall, most female patients are milder and have mainly mucosal ulcers, while most male patients are more severe and often involve internal blood vessels. If you have more than 3 mouth ulcers per year with the following conditions, you need to be alert for leukoaraiosis. Although leukoaraiosis is still a non-curable disease, standardized anti-inflammatory and immunotherapy can often achieve remission. 1, oral ulcers + pubic ulcers The most common symptoms of leukoaraiosis are oral ulcers and vulvar ulcers. Vulvar ulcers include genital ulcers and perianal ulcers. In men, genital ulcers can be more pronounced if they occur on the glans and penis, while scrotal ulcers have less severe symptoms. In women, genital ulcers can occur on the labia majora and minora or the vaginal wall, with varying severity of symptoms, some of which are even asymptomatic and require gynecological examination to detect. Clinically, many genital ulcers in leukoplakia are often misdiagnosed as STDs and remain untreated for a long time. This kind of patient if accompanied by frequent oral ulcers, most likely not STD, but leukoplakia. 2, mouth ulcers + eye problems Leukoplakia also often invades the eyes, and in the early years it was called “eye, mouth, and genital syndrome”. The symptoms of the eye are varied, often involving the uvea in the early stages, with iridocyclitis as the prominent manifestation; those involving the posterior uvea often only have decreased vision, but no other eye symptoms, and can only be judged by ophthalmologic examination; leukoplakia can also be conjunctivitis, sclerositis, keratitis, etc., and in severe cases can be followed by glaucoma, vitreous clouding, fundus retinitis, optic neuritis. The clinical symptoms are redness and eye pain, vision loss, photophobia, foreign body sensation, flying mosquitoes and headache, etc. The disease is usually chronic, recurrent and progressive, with a blindness rate of 25%. If you have ophthalmologic disease, and the ophthalmology does not heal or recurrent, and accompanied by frequent oral ulcers (more than 3 times a year), you need to be alert to the white stuffy disease, it is recommended to consult the rheumatology department. 3. Oral ulcers + skin problems Leukoaraiosis may also manifest itself on the skin, such as severe acne, erythema nodosum, difficult wound healing, and pins and needles reaction. If there is a lot of acne, and most of the acne appears to be red and pustular for a long time, and accompanied by frequent oral ulcers, you should be highly alert to leukoplakia. Erythema nodosum occurs mostly in the lower extremities, but can also appear in other parts of the body. If erythema nodosum is accompanied by frequent oral ulcers, be aware of leukoaraiosis. Even if it is not accompanied by oral ulcers, it is important to pay attention to other rheumatologic diseases. One characteristic of leukoarthrosis is that the wound is difficult to heal. The doctor thought it was an infection and used a lot of antibiotics to no avail, but then followed up with a history and found that the patient had a history of frequent mouth ulcers and diagnosed it as leukoaraiosis, and redirected the treatment to make the wound heal. Similarly, when a patient with leukoaraiosis gets an injection or blood draw, a small redness or pus spot that lasts for more than two days will appear at the mouth of the needle, a phenomenon called “needle reaction”, which is an important feature of leukoaraiosis. 4, oral ulcers + joint pain Some patients with leukoaraiosis oral ulcers are relatively light, only 3 to 5 times a year, will not become a reason to seek medical attention, while joint pain is more troubling to the patient’s life. If joint pain and frequent mouth ulcers, be alert to leukoarthrosis. 5, oral ulcers + vascular problems Leukoarthritis itself is a vasculitis, its oral ulcers is due to inflammation of small blood vessels under the oral mucosa. While most patients only damage the mucosa, there are some patients who develop vasculitis in other parts of the body. The vasculitides of leukoaraiosis are mainly arteritis and phlebitis, which can lead to arterial stenosis and infarction, aneurysm, and venous thrombosis. Therefore, patients unfortunately suffering from vasculitis need to recall whether they have frequent mouth ulcers, and if so, tell your doctor in time so as to take fewer detours in the diagnosis and treatment process. 6, mouth ulcers + heart valve disease Most heart valve disease is due to rheumatic fever caused by streptococcal infection in the throat during childhood and adolescence, called “rheumatic heart disease”. According to Yang, leukoaraiosis can also cause severe heart valve disease, mostly after young adulthood, and the disease progresses rapidly, with intractable heart failure occurring within a few months, forcing cardiac surgeons to operate on the patient to replace the prosthetic heart valve. However, because leukoaraiosis itself is prone to aseptic abscesses and wounds that do not heal easily, it is often the case that “surgery is successful” but the prosthetic valve is unstable or falls out within a few months after surgery, resulting in the patient’s death. If the preoperative diagnosis of “heart valve disease due to leukoaraiosis” can be made correctly, rheumatology consultation can be invited, and anti-inflammatory and immunotherapy can be carried out to control the activity of the disease, the success rate of treatment can be greatly improved. 7. Oral ulcers + chronic pulmonary embolism Another characteristic of leukoaraiosis is that it is easy to produce blood clots. Blood clots in the venous system and dislodged blood clots in the right side of the heart can lead to pulmonary embolism. Chronic pulmonary embolism caused by leukoarthrosis, if the conventional treatment of chronic pulmonary embolism according to anticoagulation and thrombolysis, often difficult to work, must be synchronized with anti-inflammatory and immunotherapy to be effective. 8, oral ulcers + intestinal ulcers are commonly seen in some patients with abdominal pain and diarrhea or intestinal bleeding, who are diagnosed as ulcerative colitis or Crohn’s disease in the gastroenterology departments of several hospitals, but the treatment according to the methods for colitis or Crohn’s disease is not effective. Later, the diagnosis of leukoaraiosis was corrected after consultation with rheumatologists.