ORAL LICHENOID LESIONS, MERCURY HYPERSENSITIVITY AND COMBINED HYPERSENSITIVITY TO MERCURY AND OTHER METALS - HISTOLOGICALLY-PROVEN REPRODUCTION OF THE REACTION BY PATCH TESTING WITH METAL-SALTS

We report 11 patients seen between 1991 and 1994 with oral lichenoid l esions (OLL). In 10 cases, there was contact with dental amalgam filli ngs, and in patient no. 10 with both amalgam restorations and a gold c rown. The last patient had, in addition to her OLL, lichen planus of t he skin and genital mucosa. In 5 cases, combined sensitization to merc ury and other metal salts, particularly gold sodium thiosulfate (GST) and palladium chloride (PDC), was observed. In 10 patients, the lesion s considerably improved or totally cleared within 1 to 9 months of rep lacement of restoration materials. Histological examination of biopsie s from the test sites of amalgam, mercuric chloride, GST and PDC, take n 10 or 17 days after application of patch tests, showed lichenoid cha nges in 7 patients with at least 1 of the allergens. As at least 2 pat ients had inflammatory lesions of the oral mucosa related to both amal gam and gold restorations, combined sensitization to inorganic and org anic mercury derivatives, GST and, in 1 case, PDC, a ''dental restorat ion metal intolerance syndrome'' is proposed. (C) Munksgaard, 1995.