Allergy and Oral Mucosal Disease

Rees, Shiona Rachel (2001) Allergy and Oral Mucosal Disease. DDS thesis, University of Glasgow.

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Abstract

The purpose of this study was to assess the prevalence of positive results to cutaneous patch testing in patients with oral mucosal diseases and to assess the relevance of exclusion of identified allergens to the disease process. It was also attempted to identify microscopic features that were related to a hypersensitivity aetiology in patients with oral lichenoid eruptions. The analysis was carried out retrospectively in the Departments of Oral Medicine and Oral Pathology in Glasgow Dental Hospital And School and the Contact Dermatitis Investigation Unit in the Royal Infirmary, Glasgow. A total of 1,252 patients with oral mucosal diseases who had been referred to the Contact Dermatitis Unit were assessed, and the prevalence of positive reactions to patch testing and contact urticaria testing in each disease cohort was compared to the prevalence of positive reactions in 100 control volunteers. Sections of specimens from patients with oral lichenoid eruptions were analysed using photographic standards and by counting cells and measuring the sections. The results indicated that patients with oral mucosal diseases were significantly more likely to have demonstrable hypersensitivity to food additives, especially benzoic acid, and perfumes and flavourings, especially cinnamaldehyde, than controls. Dietary avoidance therapy to identified allergens caused improvement in the majority. Patients with oral lichenoid eruptions were significantly more likely to react to mercurial allergens on patch testing than patients with recurrent aphthous stomatitis or orofacial granulomatosis. Microscopic examination revealed that the density of the inflammatory infiltrate was higher in those patients with oral lichenoid eruptions who had one or more positive patch tests or contact urticaria tests. They also had more disruption of the basal cell layer though this was of borderline significance. It was concluded that patch testing and contact urticaria testing, together with the resultant allergen avoidance therapy, are useful adjuncts in the management of oral mucosal diseases. The presence of a florid (in terms of thickness and density) inflammatory infiltrate and disruption of the basal cell layer in cases of oral lichenoid eruptions, suggested that an allergic aetiology was more likely.

Item Type: Thesis (DDS)
Qualification Level: Doctoral
Additional Information: Adviser: David Wray
Keywords: Medicine, Dentistry
Date of Award: 2001
Depositing User: Enlighten Team
Unique ID: glathesis:2001-76253
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Nov 2019 16:14
Last Modified: 19 Nov 2019 16:14
URI: http://theses.gla.ac.uk/id/eprint/76253

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