Burning mouth syndrome: a possible etiologic role for local contact hypersensitivity.

BACKGROUND: The pathogenesis of the burning mouth syndrome (BMS) is not yet understood. Apart from psychologic factors, several etiologic "somatic" factors have been reported. OBJECTIVE: In 22 patients (19 women, 3 men, mean age 56 years) classified with BMS, clinical and laboratory investigations were performed, with particular emphasis on the role of contact hypersensitivity. Twenty of the 22 patients wore a complete or partial denture. METHODS: Besides clinical and laboratory investigations patch testing was performed with a standard routine series and a standardized denture-dental (acrylate and metal) series. RESULTS: Folate, iron, pyridoxine deficiency, and Candida infections were found, but correction of the deficiency or treatment of the infection was of no benefit. Contact allergy to allergens used in the production of acrylate-based dentures was observed in six (27%) of the cases (all wore a denture); positive reactions were seen to N,N,-dimethyl-4-toluidine (3 cases), to 4-tolyldiethanolamine (2 cases), to benzoylperoxide (2 cases), and to oligotriacrylate (1 case). In six cases (27%) a possible relevant sensitization was seen to dental metals and in particular to gold chloride (four cases). CONCLUSION: The possible role of local hypersensitivity reactions to denture or dental components as etiologic factors in BMS must be considered.

Psychologic characteristics of men with alopecia androgenetica and their modification.

Psychologic characteristics were studied in a sample of 168 men with alopecia androgenetica who participated in a clinical trial on the efficacy of minoxidil gel. In general, no evidence of psychologic malfunctioning was found. Instead, a slightly more adequate psychologic state was indicated. However, specific problems associated with hair loss were reported by a substantial number of men. Responders with cosmetic improvement in the group over 35 years of age improved more regarding general psychologic maladjustment, inadequacy, and self-evaluation than those who did not respond. A reverse trend was, however, found in the group younger than 35 years of age, where the nonresponders improved more. An explanation for these findings is derived from the theory of cognitive dissonance.

Why men with hair loss go to the doctor.

Consultations, motives, experience, and attitudes were explored in 201 men with alopecia androgenetica who had two years before shown interest in hair treatment using minoxidil. During the past two years, one-third consulted a professional on account of hair loss. General practitioners were consulted by 60% and other professionals by about 75%. The main motive for the consultation was hair treatment, which was offered to half of the consulting subjects. Medical professionals were generally considered to be more suitable than other professionals for consultation on minoxidil treatment. The perceived chance of the treatment being successful and the amount of hair problems experienced seemed more important factors for consulting than the views on the suitability of a professional or the extent of baldness. There were indications that subjects who consulted both general practitioners and other professionals had also more general problems.