title: Contact sensitivity to menthol and peppermint in patients with intra-oral symptoms.
abstract: We report 12 cases of contact sensitivity to the flavouring agents menthol and peppermint oil in patients presenting with intra-oral symptoms in association with burning mouth syndrome, recurrent oral ulceration or a lichenoid reaction. The patients were referred from the Glasgow Dental Hospital over a 4-year period for assessment of the possible contribution of contact sensitivity to their complaints. 5 patients with burning mouth syndrome demonstrated contact sensitivity to menthol and/or peppermint, with 1 patient sensitive to both agents, 3 positive to menthol only and 1 to peppermint only. 4 cases with recurrent intra-oral ulceration were sensitive to both menthol and peppermint. 3 patients with an oral lichenoid reaction were positive to menthol on patch testing, with 2 also sensitive to peppermint. 9 of the 12 cases demonstrated additional positive patch test results. After a mean follow-up of 32.7 months (range 9-48 months), of the 9 patients that could be contacted, 6 patients described clearance or improvement of their symptoms as a consequence of avoidance of menthol/peppermint.
authors.affiliation: Contact Dermatitis Investigation Unit, Glasgow Royal Infirmary, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Morton
authors.forename: J
authors.initials: J
authors.lastname: Garioch
authors.forename: P
authors.initials: P
authors.lastname: Todd
authors.forename: P J
authors.initials: PJ
authors.lastname: Lamey
authors.forename: A
authors.initials: A
authors.lastname: Forsyth
mesh_terms: D000328:Adult; D000368:Aged; D002054:Burning Mouth Syndrome / Q000139:chemically induced; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D036142:Mentha piperita; D008610:Menthol / Q000009:adverse effects*; D008875:Middle Aged; D009059:Mouth Diseases / Q000139:chemically induced* / Q000503:physiopathology; D010328:Patch Tests; D010938:Plant Oils / Q000009:adverse effects*; D014456:Ulcer / Q000139:chemically induced
chemical_list: D010938:Plant Oils; D008610:Menthol; C015424:peppermint oil