title: The relevance and effect of amalgam replacement in subjects with oral lichenoid reactions.
abstract: In this study we examined the prevalence of mercury hypersensitivity in patients with oral lichenoid reactions (OLR) and the effect of amalgam replacement in subjects with amalgams adjacent to OLR irrespective of their mercury sensitivity status. One hundred and ninety-seven patients with oral problems were examined: 109 with OLR, 22 with oral and generalized lichen planus, and 66 with other oral diagnoses, including aphthous ulcers and orofacial granulomatosis. Nineteen per cent of patients with OLR reacted to mercury on patch testing, significantly more than in those with generalized lichen planus (0%) and in those with other oral diagnoses (3%). Twenty-two patients with OLR and adjacent amalgams had amalgam replacement and, in 16 of 17 mercury-positive subjects and three of four mercury-negative subjects, the OLR resolved after amalgam removal. In conclusion, we found a significantly increased prevalence of mercury hypersensitivity in patients with localized OLR in comparison to subjects with other oral problems. Amalgam replacement resulted in resolution of OLR in the majority of patients with amalgams adjacent to OLR irrespective of their mercury sensitivity status.
authors.affiliation: Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, U.K.
authors.forename: S H
authors.initials: SH
authors.lastname: Ibbotson
authors.forename: E L
authors.initials: EL
authors.lastname: Speight
authors.forename: R I
authors.initials: RI
authors.lastname: Macleod
authors.forename: E R
authors.initials: ER
authors.lastname: Smart
authors.forename: C M
authors.initials: CM
authors.lastname: Lawrence
mesh_terms: D000328:Adult; D003723:Dental Amalgam / Q000009:adverse effects*; D003875:Drug Eruptions / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017512:Lichenoid Eruptions / Q000139:chemically induced* / Q000628:therapy; D008297:Male; D008628:Mercury / Q000009:adverse effects*; D008875:Middle Aged; D009059:Mouth Diseases / Q000139:chemically induced*
chemical_list: D003723:Dental Amalgam; D008628:Mercury