Burning Mouth Syndrome Due to Sodium Metabisulfite

Case Report

Austin J Dermatolog. 2016; 3(4): 1065.

Burning Mouth Syndrome due to Sodium Metabisulfite

Aguiar R¹* and Correia TE²

¹Department of Immunoallergology, Hospital Santa Maria, Portugal

²Department of Dermatology and Venereology, Hospital Santa Maria, Portugal

*Corresponding author: Aguiar R, Department of Immunoallergology, Hospital de Santa Maria-Centro Hospitalar Lisboa Norte, AV. Prof. Egas Moniz, 1649-035 Lisboa, Portugal

Received: November 02, 2016; Accepted: November 28, 2016; Published: November 29, 2016

Abstract

Burning mouth syndrome is characterized by an idiopathic burning pain affecting the oral mucosa, with no clinically apparent changes. It can present to a variety of health professionals including allergologists and dermatologists. This article summarizes the important aspects of the condition, including diagnosis and management.

Keywords: Burning mouth syndrome; Sodium metabisulfite; Patch test

Introduction

The International Headache Society has defined the Burning Mouth Syndrome (BMS) as an intraoral burning sensation for which no medical or dental cause can be found [1]. Patients usually describe it as a painful burning sensation of the oral cavity, in the absence of clinically apparent mucosal alterations, more commonly occurring in middle-aged and elderly women [2]. It’s possible cause has not been yet well established, and diagnosis and therapy are controversial [3]. Primary patients’ treatment has been based on the avoidance of possible causes of oral irritation and the provision of psychological support [3]. The condition responds poorly to commonly used treatments and it may become very disabling [4].

The etiological factors involved in BMS have been extensively studied and differentiated into three subgroups: Type 1 patients have no burning on waking but the burning develops as the day goes on and worse in the evening; Type 2 the burning is present on waking and persists throughout the day. On both, the sensation is present every day and this is a different from Type 3 patients in whom the burning is intermittent, atypical and related to food allergy sensitization [5].

Case Presentation

The authors report a 50-year-old woman, referring a painful and burning sensation of the oral cavity (dorsum of the tongue, soft palate and lips) for more than 2 years. The burning occurred intermittently with asymptomatic periods lasting for days or weeks, correlating with some foods. The oral mucous membrane had no inflammatory signs, teeth were in good repair and she wore an artificial denture of chromium-cobalt alloy. The burning did not respond to corticosteroids and/or antifungals. She had no evidence of atopy and was otherwise healthy.

Incisional biopsy was performed to the anterior third of the right edge of the tongue with no abnormal findings (Figure 1). Skin prick tests with commercial extracts of fruits that she related to worsening were negative. Prick-to-prick tests with fresh food were positive for grape, mango, tomatoes, kiwi, peach and apricot. Specific IgE for these fruits were negative.

Citation: Aguiar R and Correia TE. Burning Mouth Syndrome Due to Sodium Metabisulfite. Austin J Dermatolog. 2016; 3(5): 1065. ISSN:2381-9197