Clinically relevant patch test results in patients with burning mouth syndrome.
BACKGROUND
Patients with a sore or burning mouth associated with clinically normal oral mucosa present a difficult diagnostic challenge.


OBJECTIVE
The objective of this study was to assess the value of patch testing in patients with burning mouth syndrome.


METHODS
We retrospectively reviewed the results of patch testing to an oral series in patients with burning mouth syndrome seen at Mayo Clinic, Rochester, Minnesota, between January 2000 and April 2006.


RESULTS
Of 195 consecutive patients with a burning or sore mouth, 75 had patch testing to an oral series, and 28 of these patients (37.3%) had allergic patch test reactions. The most common allergens were nickel sulfate hexahydrate 2.5%, balsam of Peru, and gold sodium thiosulfate 0.5%. On follow-up, 15 patients reported improvement, 4 removed or avoided the offending dental metal, and 6 avoided the dietary allergen. Thirteen patients did not improve; 6 avoided identified allergens, but without improvement; 1 removed dental metals without symptom change; and 5 avoided test-positive dietary allergens but without improvement. The remaining 7 nonresponders had nonrelevant patch test results or did not avoid allergens.


CONCLUSIONS
Patch testing can identify patients who may be allergic to dental metals or dietary additives and who may benefit from removal or avoidance of these.
Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA.
John C
JC
Steele
Alison J
AJ
Bruce
Mark D P
MD
Davis
Rochelle R
RR
Torgerson
Lisa A
LA
Drage
Roy S
RS
Rogers
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000009:adverse effects*; D001453:Balsams / Q000009:adverse effects; D002054:Burning Mouth Syndrome / Q000139:chemically induced / Q000175:diagnosis*; D003722:Dental Alloys / Q000009:adverse effects*; D005260:Female; D005503:Food Additives / Q000009:adverse effects*; D006052:Gold Sodium Thiomalate / Q000009:adverse effects; D006801:Humans; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D008910:Minnesota; D009532:Nickel / Q000009:adverse effects; D010328:Patch Tests / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies
D000485:Allergens; D001453:Balsams; D003722:Dental Alloys; D005503:Food Additives; D008670:Metals; D006052:Gold Sodium Thiomalate; C029938:nickel sulfate; D009532:Nickel; C025080:Peruvian balsam