Assessment of the prevalence of Behcet's disease in recurrent aphthous ulceration worldwide: a systematic review

Abstract

Background: The aim of this study was to evaluate the prevalence of Behcet's syndrome in patients with recurrent aphthous stomatitis (RAS). Material and Methods: A search was performed in Scopus, Medline/PubMed, The Cochrane Library and Web of Science databases, according to PRISMA. In addition, a search was carried out in the DANS Easy Archive to access gray literature and a manual search in the reference list of included studies was used as an additional resource to refine the search. Cross-sectional studies in patients with recurrent aphthous stomatitis evaluating the diagnosis of Behcet's syndrome were analyzed to identify prevalence. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess the methodological quality of the articles. Results: The study design, sample size, sex, International Study Group (ISG) diagnostic criteria and prevalence of the syndrome were evaluated. After screening and reading the articles in full, 7 met the inclusion criteria. The articles involved a total of 2841 participants with recurrent aphthous ulcerations, with 141 having a diagnosis of Behcet's syndrome. Studies were of good quality as assessed by the JBI Critical Appraisal Checklist for cross-sectional studies. Conclusions: The prevalence of Behcet's syndrome in patients with recurrent aphthous stomatitis (RAS) is generally low, with similar frequency in both sexes and more common in the range of countries that extends from the Mediterranean Basin to the Far East.