Dental patch testing in patients with undifferentiated oral lichen planus

Area of Science:

• Oral medicine
• Dermatology
• Allergology

Background:

• Distinguishing oral lichen planus (LP) from lichenoid reactions to dental restorations is clinically and histopathologically challenging.
• Epicutaneous patch testing offers a potential diagnostic aid for managing dental restoration decisions.

Purpose of the Study:

• To evaluate the efficacy of epicutaneous patch testing using a dental allergen battery in patients diagnosed with oral LP.
• To determine the correlation between patch test results and clinical outcomes after dental restoration management.

Main Methods:

• Retrospective review of 68 patients with biopsy-proven oral LP undergoing dental epicutaneous patch testing between 2009 and 2016.
• Analysis of patch test results for common dental allergens and association with clinical factors and outcomes.

Main Results:

• A high proportion of patients (79%) exhibited positive patch tests to dental allergens, with gold, mercury, and nickel being most common.
• Positive patch tests were associated with subsequent dental restoration removal and clinical improvement.
• Hypothyroidism and NSAID use were linked to negative patch tests.

Conclusions:

• Epicutaneous patch testing is a valuable tool for identifying relevant allergens in oral LP.
• Patch testing results effectively guided clinical decisions regarding dental restorations, resulting in a high rate of patient improvement.