Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham; School of Dentistry, Institute of Medical and Dental Sciences, College of Medical and Dental Sciences, University of Birmingham; and Birmingham Dental Hospital, Birmingham Community Health Foundation Trust, Birmingham, UK.
School of Dentistry, Institute of Medical and Dental Sciences, College of Medical and Dental Sciences, University of Birmingham; Birmingham's NIHR BRC in Inflammation Research, University of Birmingham; and Birmingham Dental Hospital, Birmingham Community Health Foundation Trust, Birmingham, UK.
Clin Exp Rheumatol. 2023 Oct;41(10):2048-2055. doi: 10.55563/clinexprheumatol/joeacu. Epub 2023 Oct 30.
To define the clinical characteristics of oral ulceration (OU) in Behçet's disease (BD), to allow differentiation from other causes of OU, including aphthous ulcers, by an International Delphi consultation. To develop a clinical guideline on how to recognise BD ulcers.
Round 1. 40 clinical images of OU in BD, recurrent aphthous stomatitis (RAS), inflammatory bowel disease (IBD) and mucous membrane pemphigoid (MMP) were shown. Participants answered, independently, which images would be consistent with a BD ulcer. Round 2. The results from marking independently were shown. The panel remarked the questions through iteration process. The images not agreed to be a possible BD ulcer were discarded. Round 3. 10 clinical descriptors that may define BD ulcers were suggested. Participants ranked the level of importance for each descriptor on each image presented. Round 4. Participants re-ranked their level of agreement for each descriptor through iteration process. Whether the clinical pictures would be different from RAS was also explored. A final agreement was reached.
This study has shown clear differentiation between BD, IBD and MMP ulcers when defining them by phenotype through clinical images only. On the other hand, no differentiation between RAS and BD ulcers was found. The most important clinical descriptors that define BD ulcers have been agreed.
New clinical guidance for Health Care Professionals (HCP) on how to recognise a BD ulcer has been proposed. This should elucidate an earlier diagnosis, quicker access to treatment and control of the disease enhancing patient's quality of life.
通过国际德尔菲咨询，定义白塞病（BD）口腔溃疡（OU）的临床特征，以便将其与其他 OU 病因（包括复发性阿弗他溃疡[RAS]）区分开来。制定关于如何识别 BD 溃疡的临床指南。
第 1 轮。展示 40 张 BD、复发性阿弗他口炎（RAS）、炎症性肠病（IBD）和黏膜类天疱疮（MMP）的 OU 临床图像。参与者独立回答哪些图像与 BD 溃疡一致。第 2 轮。显示独立标记的结果。专家组通过迭代过程对问题进行了评论。将不同意可能为 BD 溃疡的图像丢弃。第 3 轮。提出了 10 个可能定义 BD 溃疡的临床描述符。参与者对每个呈现的图像上的每个描述符的重要性进行排名。第 4 轮。参与者通过迭代过程重新对每个描述符的一致性进行排名。还探讨了临床图像是否与 RAS 不同。最终达成一致意见。
本研究通过仅通过临床图像定义表型，显示了 BD、IBD 和 MMP 溃疡之间的明显区别。另一方面，在 RAS 和 BD 溃疡之间未发现差异。已经商定了定义 BD 溃疡的最重要临床描述符。
为医疗保健专业人员（HCP）提出了关于如何识别 BD 溃疡的新临床指导。这将阐明更早的诊断、更快获得治疗和控制疾病，从而提高患者的生活质量。
