[Eugenol in root canal cement:possible cause for urticarial reactions]

Area of Science:

• Allergy and Immunology
• Dermatology
• Dental Materials Science

Background:

• Chronic urticaria presents a diagnostic challenge, with potential environmental triggers requiring thorough investigation.
• Dental materials, particularly those used in root canal treatments, are seldom considered as etiological factors for chronic urticaria.

Observation:

• A patient with chronic urticaria experienced symptom exacerbation correlating with dental procedures.
• Initial investigations suggested a root canal cement as a potential cause of the patient's persistent urticarial symptoms.

Findings:

• Epicutaneous patch tests and intradermal tests were performed in collaboration with Utrecht University Hospital.
• A causal link between eugenol, a constituent of the dental cement, and urticaria was confirmed via oral provocation.
• Eugenol, also found in balsam of Peru, demonstrated allergenic potential in eliciting and sustaining urticaria.

Implications:

• The findings underscore the importance of considering dental materials as potential allergens in chronic urticaria cases.
• Clinicians should exercise caution when managing patients with chronic urticaria, recognizing the risk of anaphylactic reactions to allergens like eugenol.
• This case highlights the allergenic properties of eugenol and its role in prolonged urticarial responses, emphasizing its presence in dental applications.