Tsushima Fumihiko, Sakurai Jinkyo, Shimizu Risa, Kayamori Kou, Harada Hiroyuki
Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Oral Pathology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
J Dent Sci. 2022 Jul;17(3):1300-1306. doi: 10.1016/j.jds.2021.11.008. Epub 2021 Dec 3.
BACKGROUND/ PURPOSE: Distinguishing oral lichenoid contact lesions (OLCLs) from oral lichen planus (OLP) is challenging. This study aimed to identify clinicopathological findings to distinguish OLCLs from OLP, and to evaluate the effectiveness of removing metal allergens in the treatment of OLCLs.
This study retrospectively evaluated 30 patients diagnosed with OLCLs, and 30 age- and sex-matched OLP patients. We also evaluated the effectiveness of removing dental metal containing positive metal allergen, confirmed by skin patch test and metal component analysis in patients with OLCLs.
Palladium and gold were the most common patch test-positive metals observed in the oral cavity of patients with OLCLs. The patients with OLCLs were more likely to present with white type lesions in the buccal mucosa and gingiva than were the patients with OLP (p = 0.030, 0.009, respectively). Overall, 50.0% of patients with OLCLs failed to meet the histopathological diagnostic criteria of OLP. Twenty-three of 24 (95.8%) patients with OLCLs showed a complete or partial improvement after the removal of dental metal.
The present findings suggest the importance of a skin patch test and metal component analysis to confirm suspected OLCLs related to dental metal allergy, as these lesions may improve with the removal of the allergy-inducing metal.
背景/目的：区分口腔苔藓样接触性病变（OLCLs）和口腔扁平苔藓（OLP）具有挑战性。本研究旨在确定区分OLCLs和OLP的临床病理特征，并评估去除金属过敏原在OLCLs治疗中的有效性。
本研究回顾性评估了30例诊断为OLCLs的患者以及30例年龄和性别匹配的OLP患者。我们还评估了在OLCLs患者中去除含阳性金属过敏原的牙科金属的有效性，该过敏原通过皮肤斑贴试验和金属成分分析得以确认。
钯和金是在OLCLs患者口腔中观察到的最常见的斑贴试验阳性金属。与OLP患者相比，OLCLs患者更有可能在颊黏膜和牙龈出现白色型病变（分别为p = 0.030、0.009）。总体而言，50.0%的OLCLs患者不符合OLP的组织病理学诊断标准。24例OLCLs患者中有23例（95.8%）在去除牙科金属后显示出完全或部分改善。
目前的研究结果表明，皮肤斑贴试验和金属成分分析对于确认与牙科金属过敏相关的疑似OLCLs很重要，因为去除诱发过敏的金属后这些病变可能会改善。
