[Mercury sensitization in amalgam fillings. Assessment from a dermatologic viewpoint]

Epicutaneous tests were performed on 88 patients (27 men, 61 women; mean age 36.8 [18-68] years) thought to have an allergy against amalgam or mercury. In addition their oral mucosa was assessed clinically. The epicutaneous test was positive for mercury sensitization in seven patients, five of them reporting oral mucosa symptoms. Such symptoms also occurred, although less frequently, in non-sensitized patients (30 of 81). In three sensitized patients there was evidence of perioral dermatitis which in two of them cleared up after removal of the amalgam fillings. Two further patients had no further complaints, such as burning sensation on the oral mucosa, recurrent aphthous ulcers or gingivitis, after removal of amalgam fillings. In one patient each peroral eczema and diarrhoea aggravated after amalgam fillings had been taken out. These observations indicate that responses to mercury allergy are not uniform and show considerable individual variations. There is no reason to advise against or prohibit the use of amalgam fillings. Their substitutions by other materials may well bring about other types of allergy.