What characteristic distinguishes major aphthous ulcers?

Major aphthous ulcers, also known as major canker sores or Sutton's ulcers, are distinguished by their size and healing characteristics. They are larger than minor aphthous ulcers and typically measure more than one centimeter in diameter. These ulcers can take a longer time to heal, often several weeks, and they frequently leave behind scarring upon healing. This scarring can be a significant marker, setting major aphthous ulcers apart from their minor counterparts, which are smaller and generally heal without leaving scars.

The other choices present characteristics that do not apply to major aphthous ulcers. For example, while minor aphthous ulcers tend to be small and temporary, major ulcers are not characterized by this trait. Major aphthous ulcers are not associated with the herpes virus; that connection is more relevant to other conditions like cold sores. Lastly, these ulcers do not appear exclusively on the tongue; they can occur on various mucosal surfaces in the mouth, including the inner cheeks, gums, and soft palate. Thus, the defining feature of major aphthous ulcers is their large size and tendency to heal with scarring.