ABSTRACT
BACKGROUND: The pathophysiology of primary burning mouth syndrome (BMS) is extensively debated but poorly understood. OBJECTIVE: The aim of the study was to evaluate neuropathic and psychological components of BMS in patients with primary BMS. METHODS: Subjects were recruited through a consultation dedicated to mouth diseases, during which a diagnosis of primary BMS was assessed. Patients answered the abbreviated Douleur Neuropathique 4 questionnaire (DN4i), the Hospital Anxiety and Depression Scale (HADS) and the questionnaire de la douleur de Saint-Antoine (QDSA), the French version of the McGill pain questionnaire. RESULTS: Thirty-five patients with primary BMS were included in the study: 31 % of them had a DN4i score in favour of neuropathic pain and 34.3 % had a HADS overall score in favour of anxiety and depressive disorder. CONCLUSION: Both physiological and psychological aspects of BMS need to be actively investigated by clinicians to successfully manage these patients. The physiological and psychological aspects are not mutually exclusive. The DN4i and the HADS are easy-to-use tools and could be used in an initial assessment of BMS patients.
Subject(s)
Anxiety/physiopathology , Burning Mouth Syndrome/physiopathology , Burning Mouth Syndrome/psychology , Depression/physiopathology , Neuralgia/physiopathology , Aged , Anxiety/epidemiology , Depression/epidemiology , Female , Humans , Male , Middle Aged , Neuralgia/epidemiology , Pain Measurement/methods , Surveys and QuestionnairesABSTRACT
BACKGROUND: Skin psoriasis precedes the onset of psoriatic arthritis (PsA) in 84% of patients with psoriasis. Dermatologists have an important role to screen psoriasis patients for PsA. The efficiency of PsA screening remains unknown. OBJECTIVE: We sought to determine the point prevalence of undiagnosed PsA in patients with psoriasis using a systematic search of the literature and meta-analysis. METHODS: PubMed, Cochrane, and Embase database searches yielded 394 studies for review. No study aimed to determine the prevalence of undiagnosed PsA in patients with psoriasis. We assumed that the prevalence of newly diagnosed PsA in patients with psoriasis at the time they seek medical care could be a sound estimate of this value. Seven epidemiological studies and 5 studies on PsA screening questionnaires allowed us to clearly identify patients with newly diagnosed PsA and were selected for review. RESULTS: The prevalence of undiagnosed PsA was 15.5% when all studies were considered and 10.1% when only epidemiological studies were considered. LIMITATIONS: Data were obtained from studies not designed to address the question at hand. Heterogeneity was high (I(2) = 96.86%), and therefore a random effects model was used. CONCLUSION: The high prevalence of undiagnosed PsA in patients with psoriasis adds to the recommendation that dermatologists need to screen all patients with psoriasis for PsA.
