ALLERGIC CONTACT DERMATITIS TO DENTAL METALS
By Gary M. White, MD
Rarely, allergic contact dermatitis to mercury or other metals (e.g. gold or palladium) in the mouth can induce oral lichenoid lesions.
Oral lichenoid lesions adjacent to the metal-containing product is typical. The buccal mucosa is most frequently involved. Other potential changes include erythema, erosion, frank ulceration and leukoplakia-like lesions. Patch testing with these metals can induce lichenoid changes [Cont Derm 1995;33;323] and confirms the diagnosis.
The appropriate treatment is replacement of dental work, but this should only be done if it is certain that metal allergy is the cause [Semin Cutan Med Surg 1997;16;314].
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