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canker sore Ulcerous sores, also called aphthous
ulcers, that develop inside the MOUTH. The typical
canker sore is round, with a slightly white center
and a red rim. Sometimes a tingling or burning
sensation precedes the eruption of the sore. A
canker sore is painful and irritating for three to
five days, then begins to heal and generally goes
away in about three weeks. Researchers do not
know what causes canker sores, though the ten-
dency to develop canker sores appears to run in
families. Theories about the causes of canker sores
include immune function abnormalities, nutri-
tional deficiencies, and FOOD ALLERGIES. Some
women notice canker sores are more common
when they are menstruating.
Treatment targets relieving the discomfort and
may include

• frequently rinsing the mouth with a weak solu-
  tion of saltwater, hydrogen peroxide, diphen-
  hydramine liquid, or milk of magnesia (rinse
  and spit, do not swallow any of these solutions)


• applying milk of magnesia or a topical anes-
  thetic preparation for oral use directly to the
  canker sore with a cotton swab


• taking acetaminophen or a nonsteroidal anti-
  inflammatory DRUG (NSAID) for generalized
  pain relief


• taking a lysine supplement


• avoiding foods and seasonings that irritate the
  canker sores

Prescription medications containing amlexanox
(such as the brand-name product Aphthasol) may
reduce INFLAMMATIONand expedite HEALINGwhen
sores are large or occur frequently. Such medica-
tions come in topical and mouthrinse preparations.

Researchers have yet to identify any preventive

measures to keep canker sores from developing.

See also COLD SORE; NONSTEROIDAL ANTI-INFLAM-

MATORY DRUGS(NSAIDS); NUTRITIONAL NEEDS.

cauliflower ear A casual and descriptive term

for an auricle (external EAR) damaged and

deformed through trauma. Cauliflower ear is com-

monly associated with repeated injury such as

occurs with boxing. However, even a single blow

to the ear significant enough to cause bleeding can

result in deformity as the cartilaginous structure of

the external ear heals. CARTILAGEhas no BLOOD

supply of its own but instead draws nutrients from

the blood supply of the SKIN. Any damage that dis-

rupts blood flow (such as injury that causes bleed-

ing) causes cartilage tissue to die. Where cartilage

dies, the structure it supports shrinks as the skin

around it heals, forming the characteristic irregu-

larities of cauliflower ear.

Prompt treatment of any injury to the external

ear to minimize the interruption of blood flow and

control any INFECTIONthat may develop helps pre-

vent deformity. Ear PIERCINGSinto the upper ear

that become repeatedly infected or cause scarring

also can result in cauliflower ear. OTOPLASTY(sur-

gery to alter the appearance of the auricle) can

improve the auricle’s appearance though may not

be able to restore it to its natural structure. A key

preventive measure is wearing appropriate head-

gear during activities that expose the outer ears to

the risk of traumatic injury.

See also ATHLETIC INJURIES; BLEEDING CONTROL;

LACERATIONS.

cerumen A soft waxy secretion, commonly

called EARwax, that the glands in the auditory

(ear) canal produce to help remove debris from

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