Oral lichenoid lesions caused by allergy to mercury in amalgam fillings

Authors

  • Bryan K. Pang,

    1. Contact & Occupational Dermatitis Clinic, Skin & Cancer Foundation, NSW 2010, Australia
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  • Susi Freeman

    Corresponding author
    1. Contact & Occupational Dermatitis Clinic, Skin & Cancer Foundation, NSW 2010, Australia
    • Susi Freeman, Skin & Cancer Foundation, Australia 277 Bourke Street Darlinghurst, NSW 2010 Australia

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Abstract

Oral lichenoid lesions (OLL) or lichen-planus-like lesions arc often idiopathic. Our aim was to determine whether OLL can he caused by allergy to mercury in amalgam fillings, and whether resolution of OLL occurs after replacement of amalgam with other denial fillings. Patients with only OLL (except for 1 case with cutaneous lichen planus referred for patch testing during 1985– 1994 to the Contact and Occupational Dermatitis Clinic of the Skin & Cancer Foundation, Darlinghurst, were reviewed. Patch tests were performed with 1% mercury, ammoniated mercury, 0.1% thimerosal, 0.1% mercuric chloride, 0.05% phenylmercuric nitrate and an amalgam disc, using Finn Chambers occluded for 2 days. 19 patients (17 women and 2 men; age range: 28–72 years) had OLL in close contact with amalgam fillings and showed positive patch lest reactions to mercury compounds. 16 out of 19 patients had their amalgam fillings replaced. In 13 patients, the OLL healed. 1 patient and marked improvement. 1 patient had no improvement and developed multiple oral squamous cell carcinoma. In conclusion. OLL can be caused by allergy to mercury in amalgam fillings. Replacement of amalgam with other denial fillings usually results in resolution of OLL and is recommended for cases with positive patch test reactions to mercury compounds.

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