Sakitamiwa Classification Jun 2026
This stage represents the acute phase of the ulcer where the mucosal defect is most prominent.
The ulcer is deep with a thick, white or yellowish-gray coating (slough) at the base. The margins are sharp and often swollen with edema. sakitamiwa classification
The Sakita-Miwa system divides ulcer lifecycle development into three progressive macro-stages, with each stage split into two distinct sub-categories ( This stage represents the acute phase of the
| Stage | Phase | Endoscopic Appearance | | :--- | :--- | :--- | | | Active | The surrounding mucosa is edematously swollen and red. No regenerating epithelium is seen. | | A2 | Active | Surrounding edema has decreased. A clear ulcer margin with a slight amount of regenerating epithelium is visible. | | H1 | Healing | The white fibrin coating is becoming thin. Regenerating epithelium is extending into the ulcer base. | | H2 | Healing | The mucosal defect is smaller than in H1. Regenerating epithelium covers most of the ulcer floor. | | S1 | Scarring | Regenerating epithelium completely covers the ulcer floor. The area is markedly red ( red scar ). | | S2 | Scarring | Over several months, the redness fades to match the color of the surrounding mucosa ( white scar ). | A clear ulcer margin with a slight amount
The classification of Sakitamiwa is not universally agreed upon, and different cultural contexts have their own understanding of the condition. However, based on available literature and research, Sakitamiwa can be broadly classified into the following categories:
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