[The value of allergy survey in a retrospective series of 40 patients with burning-mouth syndrome (stomatodynia)].
BACKGROUND
By definition, stomatodynia or burning-mouth syndrome involves oral pain with no causes being found on history taking or examination. An allergic origin is often suspected by doctors and patients alike. In this study, we attempted to assess the value of epicutaneous tests in demonstrating allergic causes for patients presenting stomatodynia.


METHODS
This was a single-centre retrospective study of patients undergoing epicutaneous tests between 1996 and 2003 to screen for allergic causes of mouth pain not accounted for by any abnormalities seen during examination performed at consultations for mouth disease.


RESULTS
Forty patients were included (11 male, 29 female; mean age: 58 years), and 39 were excluded. Sixteen patients presented at least one positive test, with a total of 35 positive tests in all. In decreasing order of frequency, the causes were metals, mercury derivatives (nickel salts: n=5; chrome salts: n=3; palladium salts: n=2; phenylmercuric acetate: n=2; thiomersal: n=2; cobalt salts: n=1; gold salts: n=1; mercury: n=1) and resins (acrylates: n=4). The relevance of these test results was considered probable in three cases and possible in five cases, associated with the existence of metals or resins in patients' mouths. The Peru balm test was positive in four cases but was not relevant. Tests for personal products were negative in all cases, with the exception of one case of resin from a prosthesis and one case of tixocortol pivalate.


CONCLUSIONS
Type I stomatodynia (daily occurrence with gradually increase in discomfort throughout the day) and type II stomatodynia (permanent) are not normally attributable to allergies. However, for type III stomatodynia (non-permanent, with acute episodes followed by remission), an allergy survey guided by questioning may be undertaken to determine the cause, primarily prostheses or diet. The relevance of positive test results must be interpreted with caution in view of the incidence of positive epicutaneous tests for metals and Peru balm among the general population studied.
Machet
L
L
Unité fonctionnelle transversale d'allergologie, service de dermatologie, CHRU, université François-Rabelais, 37044 Tours, France. machet@med.univ-tours.fr
Le Dû
S
S
Bernez
A
A
Pillette-Delarue
M
M
Lelièvre
G
G
Hoarau
C
C
Hüttenberger
B
B
Vaillant
L
L
D000180:Acrylic Resins / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000009:adverse effects; D002054:Burning Mouth Syndrome / Q000145:classification / Q000276:immunology*; D002857:Chromium / Q000009:adverse effects; D003035:Cobalt / Q000009:adverse effects; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis*; D008297:Male; D008628:Mercury / Q000009:adverse effects; D008670:Metals / Q000009:adverse effects; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects; D010165:Palladium / Q000009:adverse effects; D010662:Phenylmercuric Acetate / Q000009:adverse effects; D011310:Preservatives, Pharmaceutical / Q000009:adverse effects; D012189:Retrospective Studies; D012882:Skin Tests; D013849:Thimerosal / Q000009:adverse effects
D000180:Acrylic Resins; D000485:Allergens; D008670:Metals; D011310:Preservatives, Pharmaceutical; D002857:Chromium; D013849:Thimerosal; D003035:Cobalt; D010165:Palladium; D009532:Nickel; D008628:Mercury; D010662:Phenylmercuric Acetate