Pang B K, Freeman S
Contact & Occupational Dermatitis Clinic, Skin & Cancer Foundation, NSW, Australia.
Contact Dermatitis. 1995 Dec;33(6):423-7. doi: 10.1111/j.1600-0536.1995.tb02079.x.
Oral lichenoid lesions (OLL) or lichen-planus-like lesions are often idiopathic. Our aim was to determine whether OLL can be caused by allergy to mercury in amalgam fillings, and whether resolution of OLL occurs after replacement of amalgam with other dental fillings. Patients with only OLL (except for 1 case with cutaneous lichen planus) referred for patch testing during 1985-1994 to the Contact and Occupational Dermatitis Clinic of the Skin & Cancer Foundation, Darlinghurst, were reviewed. Patch tests were performed with 1% mercury, 1% ammoniated mercury, 0.1% thimerosal, 0.1% mercuric chloride, 0.05% phenylmercuric nitrate and an amalgam disc, using Finn Chambers occluded for 2 days, 19 patients (17 women and 2 men; age range: 28-72 years) had OLL in close contact with amalgam fillings and showed positive patch test reactions to mercury compounds, 16 out of 19 patients had their amalgam fillings replaced. In 13 patients, the OLL healed. 1 patient had marked improvement. 1 patient had no improvement and developed multiple oral squamous cell carcinoma. In conclusion, OLL can be caused by allergy to mercury in amalgam fillings. Replacement of amalgam with other dental fillings usually results in resolution of OLL and is recommended for cases with positive patch test reactions to mercury compounds.
口腔苔藓样病变（OLL）或苔藓样扁平苔藓病变通常是特发性的。我们的目的是确定OLL是否由对汞合金填充物中的汞过敏引起，以及在用其他牙科填充物替换汞合金后OLL是否会消退。回顾了1985年至1994年间转诊至达令赫斯特皮肤与癌症基金会接触性和职业性皮炎诊所进行斑贴试验的仅患有OLL的患者（1例皮肤扁平苔藓患者除外）。使用Finn Chambers进行斑贴试验，分别用1%汞、1%氯化氨基汞、0.1%硫柳汞、0.1%氯化汞、0.05%硝酸苯汞和一个汞合金盘，封闭2天。19名患者（17名女性和2名男性；年龄范围：28至72岁）的OLL与汞合金填充物密切接触，对汞化合物的斑贴试验反应呈阳性，19名患者中有16名更换了汞合金填充物。13名患者的OLL愈合。1名患者有明显改善。1名患者无改善并发展为多发性口腔鳞状细胞癌。总之，OLL可由对汞合金填充物中的汞过敏引起。用其他牙科填充物替换汞合金通常会使OLL消退，对于对汞化合物斑贴试验反应呈阳性的病例建议这样做。
