Background: The concept of contact allergy aggravating or inducing oral lic
henoid mucositis diagnosed as oral lichen planus (OLP) is well recognized b
ut somewhat controversial.
Objective: We sought to identify clinically relevant contact allergens that
may be important in the management of patients with OLP.
Methods: We retrospectively reviewed patients with OLP who had patch tests
performed at Mayo Clinic Rochester and Mayo Clinic Scottsdale from 1994 to
1997 and 1988 to 1997, respectively.
Results: Patch tests were performed on 46 patients with a clinical and hist
opathologic diagnosis of OLP. Of these, 25 (54%) had positive patch test re
sults. Eighteen (72%) of the patients with positive results had clinically
relevant reactions. Of the patients;with positive metal reactions, 5 had im
provement after removal of the metal prosthesis or restoration. Six others
noted that their most troublesome areas were adjacent to metal dental resto
rations. Six patients with reactions to flavorings and one patient with an
acrylate dental retainer sensitivity had improvement after avoiding these a
llergens.
Conclusion: Our findings support the concept that contact allergy to metals
, flavorings, and plastics can be important in the pathogenesis and managem
ent of patients with oral lichenoid mucositis diagnosed as OLP .