Patch test reactions to metal salts in patients with oral mucosal lesions associated with amalgam restorations

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Abstract
Patch testing with various metal salts was performed in patients with oral mucosal lesions associated with amalgam restorations, by using polypropylene-coated aluminium discs. Positive reactions to mercuric chloride were obtained in 5/12 (42%) of these patients, but only in 1/11 patients (9%) with oral mucosal lesions unassociated with amalgam restorations and in 3/36 patients (8%) in a control group without mucosal lesions. The difference between the former group and the control patients is statistically significant (p less than 0.05). In addition, a positive test reaction to copper sulfate was obtained in 2 patients (16%) with amalgam-associated mucosal lesions and negative reactions to mercuric chloride. 2 of the 5 positive test reactions to mercuric chloride, in the patients with lichenoid mucosal lesions associated with amalgam, became lichenoid and persisted for at least 3 weeks. The patients with these reactions were also positive at a concentration of 0.05% mercuric chloride, but were negative to metallic mercury, in contrast to 2 other patients in the same group. This indicates the necessity of including mercuric chloride when patch testing such patients.