Fractal Dimension Assessment of Recurrent Aphthous Stomatitis Remission: A Case of Concomitant Gilbert’s Syndrome

Gilbert’s Syndrome (GS) is a genetic disorder marked by reduced bilirubin conjugation due to enzymatic deficiency, resulting in unconjugated hyperbilirubinemia. While GS is typically asymptomatic, this report presents a rare case of recurrent aphthous stomatitis (RAS) as a possible oral manifestation. A 21-year-old male with GS experienced multiple episodes of painful oral ulcers. Conventional therapy using tetracycline mouth rinse provided limited relief. A novel approach employing self- formulated 2% tetracycline mucoadhesive gel demonstrated superior symptomatic improvement. Clinical outcomes were objectively assessed using fractal analysis, which showed greater remission rates with gel therapy compared to rinse.