Diagnostic delay in autoimmune oral diseases

Area of Science:

• Oral Medicine
• Immunology
• Dermatology

Background:

• Autoimmune diseases (ADs) affect 5% of the population, frequently manifesting in the oral mucosa.
• Misdiagnosis of oral ADs is a significant, underreported problem.
• Oral ADs include conditions like oral lichen planus, pemphigus vulgaris, and Sjogren syndrome.

Purpose of the Study:

• To review the diagnostic delay (DD) in various oral autoimmune diseases.
• To identify factors contributing to delayed diagnosis in oral ADs.

Main Methods:

• A narrative review of literature was conducted using MEDLINE, Embase, and Google Scholar.
• Searched for studies reporting time to diagnosis for oral ADs.
• Included 16 studies that reported diagnostic delay data.

Main Results:

• Oral autoimmune vesiculobullous diseases typically have an 8-month diagnostic delay.
• Sjogren syndrome diagnosis averages a 73-month delay.
• No diagnostic delay data was found for oral lichen planus, oral lupus erythematosus, orofacial granulomatosis, and oral erythema multiforme.

Conclusions:

• Delayed diagnosis of oral ADs stems from non-specific symptoms and lack of awareness among healthcare professionals.
• Both professional (physician/system) and patient delays contribute to the overall diagnostic delay.
• Addressing diagnostic delay is crucial for timely and effective treatment of oral autoimmune diseases.