Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Oct;29(7):2614-2623.
doi: 10.1111/odi.14480. Epub 2023 Feb 5.

Diagnostic delay in autoimmune oral diseases

Massimo Petruzzi  1   2 , Fedora Della Vella  1 , Nicola Squicciarini  1 , Davide Lilli  1 , Guglielmo Campus  2   3   4 , Giuseppina Piazzolla  5 , Alberta Lucchese  6 , Isaac van der Waal  7
Affiliations
Free article
Review

Diagnostic delay in autoimmune oral diseases

Massimo Petruzzi et al. Oral Dis. 2023 Oct.
Free article

Abstract

Autoimmune diseases (ADs) affect about 5% of the general population, causing various systemic and/or topical clinical manifestations. The oral mucosa is often affected, sometimes as the only involved site. The misdiagnosis of oral ADs is an underreported issue. This narrative review focuses on diagnostic delay (DD) in oral ADs (oral lichen planus [OLP], oral Pemphigus Vulgaris, mucous membrane pemphigoid, oral lupus erythematosus, orofacial granulomatosis, oral erythema multiforme [EM], and Sjogren syndrome). Extensive literature research was conducted via MEDLINE, Embase and Google Scholar databases for articles reporting the time spent to achieve the correct diagnosis of oral ADs. Only 16 studies reported DD in oral ADs. Oral autoimmune vesiculobullous diseases are usually diagnosed after 8 months from the initial signs/symptoms, the Sjogren Syndrome diagnosis usually requires about 73 months. No data exist about the DD in OLP, oral lupus erythematosus, orofacial granulomatosis, and oral EM. The diagnosis of oral ADs can be difficult due to the non-specificity of their manifestations and the unawareness of dentists, physicians, and dental and medical specialists about these diseases. This can lead to a professional DD and a consequential treatment delay. The delay can be attributed to the physicians or/and the healthcare system (Professional Delay) or the patient (Patient's Delay).

Keywords: diagnostic delay; oral autoimmune diseases; patient's delay; professional delay; vesciculo-bullous diseases.

PubMed Disclaimer

References

REFERENCES

    1. Allen, K., & Farah, C. S. (2015). Patient perspectives of diagnostic delay for suspicious oral mucosal lesions. Australian Dental Journal, 60(3), 397-403. https://doi.org/10.1111/adj.12246
    1. American Autoimmune Related Diseases Association, Inc. 2013. Avoid Autoimmune Diagnosis Delay. Available online: https://www.aarda.org/autoimmune-disease-diagnosis-delay-tips/. Accessed 14 June 2022.
    1. Arduino, P. G., Broccoletti, R., Carbone, M., Gambino, A., Sciannameo, V., Conrotto, D., Cabras, M., Sciascia, S., Ricceri, F., Baldovino, S., & Carrozzo, M. (2019). Long-term evaluation of pemphigus vulgaris: A retrospective consideration of 98 patients treated in an oral medicine unit in north-West Italy. Journal of Oral Pathology & Medicine: Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 48(5), 406-412. https://doi.org/10.1111/jop.12847
    1. Bansal, M., Singh, N., Patne, S., & Singh, S. K. (2015). Orofacial granulomatosis affecting lip and gingiva in a 15-year-old patient: A rare case report. Contemporary clinical dentistry, 6(Suppl. 1), S94-S96. https://doi.org/10.4103/0976-237X.152958
    1. Bascones-Martínez, A., García-García, V., Meurman, J. H., & Requena-Caballero, L. (2015). Immune-mediated diseases: What can be found in the oral cavity? International Journal of Dermatology, 54(3), 258-270. https://doi.org/10.1111/ijd.12681