ABSTRACT
BACKGROUND: The subject of lichen planus (LP) and dental metal allergy long has been debated. An overwhelming majority of the existing literature focuses on mercury and gold salts in relation to oral lichen planus. OBJECTIVE: Our objective was to expand current knowledge regarding LP and lichenoid lesions (LL) and dental metal allergy by investigating more metals and investigating cutaneous and genital disease in addition to oral disease. METHODS: Fifty-one patients with known LP or LL were patch tested to a series of dental metals. Patients chose to replace their dental metals or make no revision. A telephone survey was conducted after 1 year to determine disease state. RESULTS: Thirty-eight of 51 patients (74.5%) had at least 1 positive reaction. Twenty-five of 51 patients (49.0%) showed sensitivity to at least 1 mercurial allergen. Prevalence data for patients patch tested by the North American Contact Dermatitis Group (NACDG) from 1996 to 1998 was available for chromate, cobalt, gold, nickel, and thimerosal. The prevalence of positive reactions was higher in our group than in the NACDG group for all 5 of these allergens, and statistical significance was achieved for chromate (P = .028), gold (P = .041), and thimerosal (P = .005). Of patients who had a positive patch test reaction to 1 or more metals, 100% (9 of 9) reported improvement after metal replacement, whereas 62.5% (15 of 24) reported improvement without metal replacement. CONCLUSION: Sensitization to dental metals is more common among LP and LL patients than in routinely tested patients, and might be an etiologic or triggering factor in the disease.
Subject(s)
Allergens/adverse effects , Dental Alloys/adverse effects , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/etiology , Lichen Planus/complications , Adolescent , Adult , Aged , Aged, 80 and over , Dermatitis, Allergic Contact/complications , Female , Genitalia , Humans , Kentucky/epidemiology , Male , Medical Records , Middle Aged , Mouth , Patch Tests , Prevalence , SkinSubject(s)
Carcinoma, Squamous Cell/classification , Carcinoma, Squamous Cell/pathology , Skin Neoplasms/classification , Skin Neoplasms/pathology , Acantholysis , Bowen's Disease/pathology , Carcinoma/pathology , Carcinoma, Papillary/pathology , Carcinoma, Signet Ring Cell/pathology , Carcinoma, Verrucous/pathology , Humans , Keratoacanthoma/pathologyABSTRACT
We report a case of severe peristomal dermatitis that was refractory to conventional treatments. Patch testing revealed positive allergies to myroxylon perulase (balsam of Peru), propylene glycol, Stomahesive paste, and Gantrez. This is the second reported case of patch-test-positive peristomal allergy to Gantrez.
Subject(s)
Carboxymethylcellulose Sodium/adverse effects , Colostomy , Dermatitis, Allergic Contact/etiology , Dermatologic Agents/adverse effects , Gelatin/adverse effects , Maleates/adverse effects , Pectins/adverse effects , Polyenes/adverse effects , Polyvinyls/adverse effects , Tissue Adhesives/adverse effects , Adolescent , Dermatitis, Allergic Contact/diagnosis , Drug Combinations , Female , Humans , Ointments , Patch TestsABSTRACT
Allergic contact dermatitis of the scalp is relatively uncommon. This is a case report of a patient with chronic scalp dermatitis in the distribution of his continuous positive airway pressure (CPAP) mask neoprene rubber strap. Our objective was to identify any relevant contact allergens. Patch testing to the North American Contact Dermatitis Group (NACDG) Standard Allergens, a series of supplemental rubber allergens, and a sample of the neoprene from the patient's mask strap was performed. Relevant allergies to dialkyl thioureas, and the neoprene rubber portion of the CPAP mask strap were identified. Replacement with a cloth strap resulted in clearing of the dermatitis.