Cinnamon-induced oral erythema multiformelike sensitivity reaction.
BACKGROUND
Erythema multiforme, or EM, is a hypersensitivity reaction to agents such as herpes virus, drugs or foods. Oral EM-like reactions may be induced by cinnamon. It is important for dentists to recognize this condition.


METHODS
The authors report an unusual case of cinnamon-induced oral EM-like reaction in an older female patient. The disease manifested itself as chronic extensive surface ulcerations and lip swelling. The patient was treated repeatedly with topical and systemic steroids but responded to them only temporarily. The patient was cured when the offending agent--cinnamon--was eliminated from her diet.


CONCLUSIONS
Oral EM or EM-like reactions pose a diagnostic dilemma due to their varied etiologies and clinical manifestations. Correct diagnosis is essential for effective treatment. A negative skin test does not rule out an allergic reaction to food.
University of Nebraska Medical Center, Department of Oral Biology, College of Dentistry, Lincoln 68583-0740, USA. dcohen@unmc.edu
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D000287:Administration, Topical; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002908:Chronic Disease; D002935:Cinnamomum zeylanicum / Q000009:adverse effects*; D004892:Erythema Multiforme / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005447:Fluocinonide / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000188:drug therapy / Q000209:etiology*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008047:Lip Diseases / Q000188:drug therapy / Q000209:etiology; D019226:Oral Ulcer / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D005447:Fluocinonide; D011241:Prednisone