Gold Dental Implant-Induced Oral Lichen Planus

Lichen planus is a chronic inflammatory cutaneous and mucosal disease mostly affecting middle-aged individuals. The etiology of lichen planus is unknown, but current literature suggests that it is an altered immune response characterized by dysregulated T-cell activation and subsequent inflammation...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-02, Vol.14 (2), p.e21852
Main Authors: Rasul, Taha F, Anderson, Jackson, Bergholz, Daniel R, Faiz, Arfa, Prasad, Rishi R
Format: Article
Language:English
Subjects:
Allergies
Allergy/Immunology
Antihypertensives
Case reports
Dental crowns
Dental implants
Dentists
Dermatitis
Dermatology
Disease
Gold
Heavy metals
Inflammation
Inhibitor drugs
Oral Medicine
Pathology
Patients
Severe acute respiratory syndrome coronavirus 2
Skin
Skin diseases
Toxicity
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Summary:Lichen planus is a chronic inflammatory cutaneous and mucosal disease mostly affecting middle-aged individuals. The etiology of lichen planus is unknown, but current literature suggests that it is an altered immune response characterized by dysregulated T-cell activation and subsequent inflammation which can be associated with conditions like allergic contact dermatitis and hepatitis C. Additionally, heavy metals like lead, tin, arsenic, and bismuth can create inflammatory and allergic reactions that can predispose to the formation of lichen planus. This report examines the case of a 64-year-old female with longstanding oral lichenoid lesions with superimposed Wickham's striae, allergic skin reactions to several medications, and a history of receiving gold-containing dental implants. As a result of her history and subsequent allergy testing, she was found to have a gold allergy. The constant mucosal irritation from her dental implants likely was associated with the development of her oral lesions, which were confirmed to be oral lichen planus. She was recommended to apply triamcinolone 0.1% ointment to her oral lesions and to follow up with her dentist for evaluation of her filings. Further, it was recommended she replaces the dental crowns with compounds lacking gold to decrease the persistent irritation. This case represents the first such instance of gold dental fillings directly having an appreciable role in the development of oral lichen planus.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.21852