ABSTRACT
Background@#Oral lichen planus is an idiopathic autoimmune inflammatory condition and oral lichenoid reactions are lesions that resemble oral lichen planus clinically and histopathologically, but develop secondary to various underlying causes. Oral lichenoid reactions have been reported to be caused by contact allergy to dental materials. This study aims to describe the characteristics of patients with a clinical and/or histopathological diagnosis of oral lichen planus who underwent patch testing in Hospital Kuala Lumpur, Malaysia.@*Methods@#This is a 5-year retrospective study of patients who had oral lichen planus and had undergone patch testing at the Department of Dermatology, Hospital Kuala Lumpur, Malaysia between January 2015 and Cecember 2019. Patch tests were performed with European Baseline Series and relevant extended series, which include dental and metal series as well as patients’ own products. Patch test results were recorded according to the International Contact Dermatitis Research Group recommendation.@*Results@#There were 41 patients with oral lichen planus who underwent patch test. The median age was 56 (range 21 to 73) with 70.7% of patients being female. There were 29 (70.7%) patients who developed at least one positive reaction. The most frequent sensitizing allergens were nickel sulfate (34.1%), gold(I)sodium thiosulphate dihydrate (22.0%), fragrance mix I (19.5%), cobalt chloride (14.6%), Peru balsam (12.2%) and sodium tetrachloropalladate (II) hydrate (12.2%). Current relevance was recorded in 16 patients (39.0%) and of these patients, 12 of them had positive patch test reactions to allergens found in dental materials such as dental fillings, dental implants, orthodontic braces, dentures and dental crowns.@*Conclusion@#Contact sensitization was detected in about 70% of our patients with oral lichen planus. The most common sensitizing allergen was nickel sulfate. Current relevance was found mainly towards dental materials.
Subject(s)
Dermatitis, Allergic ContactABSTRACT
@#Amalgam has been widely used in dentistry and its components may cause some oral mucosal changes (OMC), commonly presenting as oral lichenoid lesions (OLLs), acute or generalized sensitivity reaction or amalgam tattoo. Our objective was to determine the demographic and clinical profile of patients with and without OMC adjacent to their amalgam restorations (AR) and to evaluate the prevalence and types of AR-related OMC and associated clinical parameters.Materials and methods: In this retrospective cross-sectional study, 83 outpatients attending the Primary Dental Care Unit at the Faculty of Dentistry, University Malaya wereexamined for the presence of AR-related OMC. The studyperiod was from early to mid July 2016. Firstly, patients’ personal details (age, gender, medical status, social habits) were analyzed and history of AR (the age, condition and number of restorations) was determined. Clinical examination of patient’s oral cavity was carried out to detect any AR-related OMC. The data collected was analyzed using SPSS 12.0.1 Result: Approximately 14.6 % patients had OMC. OLLs and amalgam tattoo made up 1.2% and 13.4% respectively. Females (8.4%) had higher predilection and Chinese were more commonly affected (8.4%). Social habits were not associated with OMC. Certain systemic diseases, age (p=0.005) and duration of amalgam (p=0.007) in the oral cavity were significant risk factors for OMC. Conclusions: Present findings suggest that AR-related OMC is uncommon. Three key parameters namely systemic diseases, patient’s age and duration of AR were identified as significant risk factors predisposing to the development of OMCs.
ABSTRACT
Background: Most of the clinical, epidemiological, and etiogenic studies on oral lichenoid reactions (OLRs) have been undertaken in the United States, UK, Scandinavia, and other European countries. So far, very few cohort studies on a small population have been documented from South Asian region to implicate the role of various causative agents in the precipitation of OLR. Objectives: To implicate the role of various allopathic, alternate medicinal drugs, dental materials, etc., in the precipitation OLRs; to evaluate the pattern of remission; and to estimate the time period for the remission of lesions following the discontinuance of the suspected agents in the population of Tamil Nadu. Materials and Methods: A total of 102 patients were included, of whom 51 (mean age 43.3 years, SD 14.59) formed the study group, who possessed a positive drug history to the intake of either potential allopathic or alternate drugs or had recent dental metallic fillings/restorations, and 51 were (mean age 47.86 years, SD14.67) in the control group possessing oral lichen planus (OLP). The patients were followed up at a monthly interval period for a period of 18 months. Results: Complete remission of signs and symptoms was noticed in 41 patients, partial remission in 6, no change in 2, newer lesions in 1, and flaredup lesions were observed in 1 participant in the study group. The mean onset time for lichenoid eruptions was found to be 2.5 months (SD 58.82) and the mean remission time after discontinuing the drug was 9.1 months (SD 4.7). Conclusion: OLR could be implicated to documented lichenoid agents like calcium channel blockers, ACE inhibitors, atarvastatin, metformin, glibenclamide, dapsone, carbimazole, silver amalgam fillings, etc.in southSouth Indian population. Furthermore, the drugs like oflaxacin, arsenical album, and yellow orpimentumwere also found to have strong implication in the precipitation of OLR. Discontinuance of the suspected agents resulted in healing in the majority of cases.