title: A composite index for determining the impact of oral ulcer activity in Behcet's disease and recurrent aphthous stomatitis.
abstract: BACKGROUND
  Although number, frequency and healing time of oral ulcers and pain are generally used for clinical practice and studies in Behcet's disease (BD) and recurrent aphthous stomatitis (RAS), no standardized activity index is currently present to monitor clinical manifestations associated with oral ulcers. The aim of this study was to develop a standardized composite index (CI) to assess oral ulcer activity in BD and RAS.
  
  
  METHODS
  In this cross-sectional study, 121 patients with BD and 45 patients with RAS were included. Sixty-five percentage of BD and 68.9% of RAS patients were in active stage during the previous 3 months. The developed CI included the presence of oral ulcers, ulcer-related pain and functional status and was evaluated in patients with both active and inactive disease for content validity.
  
  
  RESULTS
  Composite index score was observed to be higher in active patients with RAS (6.94 + or - 2.19) compared with active BD patients (6.01 + or - 2.04) (P = 0.04). The number of oral ulcers and healing time of oral ulcers were significantly higher in RAS compared with BD (P = 0.018, P = 0.001 respectively). CI score correlated with the number of oral ulcers in both BD and RAS (P = 0.000, P = 0.002 respectively). CI score was '0' for inactive patients without oral ulcer in BD and RAS.
  
  
  CONCLUSIONS
  The presented CI as an oral ulcer activity index seems to be a reliable and suitable tool for evaluating the clinical impact and disease-specific problems in BD and RAS.
authors.affiliation: Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey. goncamumcu@marmara.edu.tr
authors.forename: G
authors.initials: G
authors.lastname: Mumcu
authors.forename: H
authors.initials: H
authors.lastname: Sur
authors.forename: N
authors.initials: N
authors.lastname: Inanc
authors.forename: U
authors.initials: U
authors.lastname: Karacayli
authors.forename: H
authors.initials: H
authors.lastname: Cimilli
authors.forename: N
authors.initials: N
authors.lastname: Sisman
authors.forename: T
authors.initials: T
authors.lastname: Ergun
authors.forename: H
authors.initials: H
authors.lastname: Direskeneli
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000145:classification* / Q000188:drug therapy / Q000503:physiopathology; D016022:Case-Control Studies; D003078:Colchicine / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000145:classification; D004435:Eating / Q000502:physiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008409:Mastication / Q000502:physiology; D019226:Oral Ulcer / Q000145:classification*; D010147:Pain Measurement; D010865:Pilot Projects; D012008:Recurrence; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013064:Speech Disorders / Q000145:classification; D013281:Stomatitis, Aphthous / Q000145:classification* / Q000503:physiopathology; D013651:Taste Disorders / Q000145:classification; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology
chemical_list: D007166:Immunosuppressive Agents; D003078:Colchicine