Investigation of Behçet's Disease and Recurrent Aphthous Stomatitis Frequency: The Highest Prevalence in Turkey

Abstract

Background: The Recurrent Aphthous Stomatitis (RAS) is the most frequently observed painful pathology of the oral mucosa in the society. It appears mostly in idiopathic form; however, it may also be related with systemic diseases like Behçet’s Disease (BD). Aims: Determining the prevalence of RAS and BD in the Northern Anatolian Region, which is one of the important routes on the Antique Silk Road. Study Design: Cross-sectional study. Methods: Overall, 85 separate exemplification groups were formed to reflect the population density, and the demographic data of the region they represent. In the first stage, the individuals, who were selected in random order, were invited to a Family Physician Unit at a certain date and time. The dermatological examinations of the volunteering individuals were performed by only 3 dermatology specialists. In the second stage, those individuals who had symptoms of BD were invited to our hospital, and the Pathergy Test and eye examinations were performed. Results: The annual prevalence of RAS was determined as 10.84%. The annual prevalence was determined to be higher in women than in men (p=0.000). It was observed that the prevalence was at the peak level in the 3rd decade, and then decreased proportionally in the following decades (p=0.000). It was also observed that the aphtha recurrence decreased in the following decades (p=0.048). The Behçet’s prevalence was found to be 0.60%. The prevalence in women was found to be higher than in men (0.86% female, 0.14% male; p=0.022). Conclusion: While the RAS prevalence ratio was at an average value when compared with the other societies; the BD prevalence was found as the highest ratio in the world according to the literature.

Keywords

• Behçet’s disease, prevalence, recurrent aphthous stomatitis

References

1. 1. Preeti L, Magesh K, Rajkumar K, Karthik R. Recurrent aphthous stomatitis. J Oral Maxillofac Pathol 2011;15:252-6. [Crossref]
2. 2. Sakane T, Takeno M, Suzuki N, Inaba G. Behçet’s disease. N Engl J Med 1999;341:1284-91. [Crossref]
3. 3. Natah SS, Konttinen YT, Enattah NS, Ashammakhi N, Sharkey KA, Häyrinen-Immonen R. Recurrent aphthous ulcers today: a review of the growing knowledge. Int J Oral Maxillofac Surg 2004;33:221-34. [Crossref]
4. 4. International Study Group for Behçet’s Disease. Criteria for diagnosis of Behçet’s disease. Lancet 1990;335:1078-80.
5. 5. Shulman JD, Beach MM, Rivera-Hidalgo F. The prevalence of oral mucosal lesions in U.S. adults: data from the Third National Health and Nutrition Examination Survey, 1988-1994. J Am Dent Assoc 2004;135:1279-86. [Crossref]
6. 6. Patil S, Reddy SN, Maheshwari S, Khandelwal S, Shruthi D, Doni B. Prevalence of recurrent aphthous ulceration in the Indian Population. J Clin Exp Dent 2014;6:36-40. [Crossref]
7. 7. Pongissawaranum W, Laohapand P. Epidemiologic study on recurrent aphthous stomatitis in a Thai dental patient population. Community Dent Oral Epidemiol 1991;19:52-3. [Crossref]
8. 8. Porter SR, Scully C, Pedersen A. Recurrent aphthous stomatitis. Crit Rev Oral Biol Med 1998;9:306-21. [Crossref]

9. 9. Davatchi F, Tehrani-Banihashemi A, Jamshidi AR, Chams-Davatchi C, Gholami J, Moradi M, et al. The prevalence of oral aphthosis in a normal population in Iran: a WHO-ILAR COPCORD study. Arch Iran Med 2008;11:207-9.
10. 10. Rivera-Hidalgo F, Shulman JD, Beach MM. The association of tobacco and other factors with recurrent aphthous stomatitis in an US adult population. Oral Dis 2004;10:335-45. [Crossref]
11. 11. Zain RB. Oral recurrent aphthous ulcers/stomatitis: prevalence in Malaysia and an epidemiological update. J Oral Sci 2000;42:15-9. [Crossref]
12. 12. Huling LB, Baccaglini L, Choquette L, Feinn RS, Lalla RV. Effect of stressful life events on the onset and duration of recurrent aphthous stomatitis. J Oral Pathol Med 2012;41:149-52. [Crossref]
13. 13. Wray D, Ferguson MM, Mason DK, Hutcheon AW, Dagg JH. Recurrent aphthae: treatment with vitamin B12, folic acid and iron. Br Med J 1975;2:490-3. [Crossref]
14. 14. Scully C, Porter S. Oral mucosal disease: Recurrent aphthous stomatitis. Br J Oral Maxillofac Surg 2008;46:198-206. [Crossref]
15. 15. Aynali G, Ozkan M, Aynali A, Ceyhan B, Armağan H, Yarıktaş M, et al. The evaluation of serum vitamin B12, folic acid and hemoglobin levels in patients with recurrent minor aphthous stomatitis. Kulak Burun Bogaz Ihtis Derg 2013;23:148-52. [Crossref]
16. 16. Thongprasom K, Youngnak P, Aneksuk V. Hematologic abnormalities in recurrent oral ulceration. Southeast Asian J Trop Med Public Health 2002;33:872-7.
17. 17. Olson JA, Feinberg I, Silverman S Jr, Abrams D, Greenspan JS. Serum vitamin B12, folate, and iron levels in recurrent aphthous ulceration. Oral Surg Oral Med Oral Pathol 1982;54:517-20. [Crossref]
18. 18. Bookman R. Relief of Canker Sores on Resumption of Cigarette Smoking. Calif Med 1960;93:235-6.
19. 19. Grady D, Ernster VL, Stillman L, Greenspan J. Smokeless tobacco use prevents aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1992;74:463-5. [Crossref]
20. 20. Scheid P, Bohadana A, Martinet Y. Nicotine patches for aphthous ulcers due to Behcet’s syndrome. N Engl J Med 2000;343:1816- 7. [Crossref]
21. 21. Mahr A, Maldini C. Epidemiology of Behçet’s disease. Rev Med Interne 2014;35:81-9. [Crossref]
22. 22. Demirhindi O, Yazici H, Binyildiz P, Dayioglu N, Tuzun Y, Altac M, et al. The prevalence of Behcet’s disease in Fener village (Silivri, Istanbul) and its sur-roundings. Cerrahpasa journal of med 1981;12:509-14.
23. 23. Idil A, Gurler A, Boyvat A, Caliskan D, Ozdemir O, Isik A, et al. The prevalence of Behcet’s disease above the age of 10 years. The results of a pilot study conducted at the Park Primary Health Care Center in Ankara, Turkey. Ophthalmic Epidemiol 2002;9:325-31. [Crossref]
24. 24. Azizlerli G, Kose AA, Sarica R, Gul A, Tutkun IT, Kulaç M, et al. Prevalence of Behcet’s disease in İstanbul, Turkey. Int J Dermatol 2003;42:803-6. [Crossref]
25. 25. Yurdakul S, Günaydın I, Tüzün Y, Tankurt N, Pazarli H, Ozyazgan Y, et al. The prevalence of Behçet’s syndrome in a rural area in northern Turkey. J Rheumatol 1988;15:820-2.
26. 26. Cakir N, Pamuk ON, Dervis E, Imeryuz N, Uslu H, Benian O, et al. The prevalences of some rheumatic diseases in western Turkey: Havsa study. Rheumatol Int 2012;32:895-908. [Crossref]