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LETTER TO EDITOR
Year : 1996  |  Volume : 62  |  Issue : 2  |  Page : 127-128

Oral lichen planus caused by dental amalgam




Correspondence Address:
A Sandra


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Source of Support: None, Conflict of Interest: None


PMID: 20948005

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How to cite this article:
Sandra A, Srinivas C R, Pai S, Pai K. Oral lichen planus caused by dental amalgam. Indian J Dermatol Venereol Leprol 1996;62:127-8

How to cite this URL:
Sandra A, Srinivas C R, Pai S, Pai K. Oral lichen planus caused by dental amalgam. Indian J Dermatol Venereol Leprol [serial online] 1996 [cited 2019 Oct 18];62:127-8. Available from: http://www.ijdvl.com/text.asp?1996/62/2/127/4344



  To the Editor, Top


Lichen planus and lichenoid lesions are known to be provoked by many chemicals and drugs. Dental metals like mercury and silver have been implicated in the aetiopathogenesis, probably due to contact allergy[1],[2] although an electrogalvanic effect has also been postulated.[3],[4] We report a patient who developed oral lichen planus following dental fillings with amalgam containing mercury. A 19-year-old male presented with reticulate bluish white lesions on both buccal mucosa of 2 years duration, in relation to teeth filled with amalgam 4 years ago. Patch testing with dental series (Chemotech AB, Sweden) using Van der Bend chambers showed a positive reaction to elemental mercury (1%) in petrolatum.

Histopathology showed features of LP with basal cell degeneration and band of inflammatory infiltrate in upper dermis. A standard direct immunofluorescence showed a ragged fibrin basement membrane zone band. Fibrin band on immunofluorescence has been reported in LP.[5]

The amalgam fillings were replaced with an inert posterior composite. Two months later the lesions had subsided and patient is asymptomatic.

A diagnosis of oral LP was made based on clinical features, histopathology and immunofluorescence. As the patient was sensitive to mercury and as the lesions appeared following the amalgam filling and subsided following its removal we further feel that in this case mercury in the dental amalgam could have been the precipitating or provoking factor. In a case of oral LP with dental fillings we therefore recommend patch testing with relevant metals, removal of amalgam filling if found positive and replacement with an alternative material.

 
  References Top

1.Conklin R, Blasberg B. Oral lichen planus. Dermatol Clinics 1987;5:663-73.  Back to cited text no. 1    
2.Ostman PO, Anneroth G, Skoglund A. Oral lichen planus lesions in contact with amalgam fillings; a clinical, histologic and immunohistochemical study. Scand J Dent Res 1994;102:172-9.  Back to cited text no. 2  [PUBMED]  
3.Banoczy J, Roed Petersen B, Pindborg J, et al. Clinical and histologic studies on electrogalvanically induced oral white lesions. Int J Oral Surg 1979;48:319-23.  Back to cited text no. 3    
4.Lind P, Hurlen B, Stromme Kappang H. Electrogalvanically induced contact allergy of the oral mucosa. Int J Oral Surg 1984;13:339-45.  Back to cited text no. 4    
5.Abell E, Presbury DG, Marks R, et al. The diagnostic significance of immunoglobulin and fibrin deposition in lichen planus. Br J Dermatol 1975;93:19.  Back to cited text no. 5    




 

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