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Clinically Relevant Patch Test Results in Patients With Burning Mouth Syndrome

Steele, John C. MB, ChB, BDS, MFDS; Bruce, Alison J. MB, ChB; Davis, Mark D.P. MD; Torgerson, Rochelle R. MD, PhD; Drage, Lisa A. MD; Rogers, Roy S. III MD

doi: 10.1097/DER.0b013e31824a625e

Background: Patients with a sore or burning mouth associated with clinically normal oral mucosa present a difficult diagnostic challenge.

Objective: The objective of this study was to assess the value of patch testing in patients with burning mouth syndrome.

Methods: We retrospectively reviewed the results of patch testing to an oral series in patients with burning mouth syndrome seen at Mayo Clinic, Rochester, Minnesota, between January 2000 and April 2006.

Results: Of 195 consecutive patients with a burning or sore mouth, 75 had patch testing to an oral series, and 28 of these patients (37.3%) had allergic patch test reactions. The most common allergens were nickel sulfate hexahydrate 2.5%, balsam of Peru, and gold sodium thiosulfate 0.5%. On follow-up, 15 patients reported improvement, 4 removed or avoided the offending dental metal, and 6 avoided the dietary allergen. Thirteen patients did not improve; 6 avoided identified allergens, but without improvement; 1 removed dental metals without symptom change; and 5 avoided test-positive dietary allergens but without improvement. The remaining 7 nonresponders had nonrelevant patch test results or did not avoid allergens.

Conclusions: Patch testing can identify patients who may be allergic to dental metals or dietary additives and who may benefit from removal or avoidance of these.

Author Information

From the Department of Dermatology, Mayo Clinic, Rochester, MN.

Address reprint requests to Alison J. Bruce, MB, ChB, Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail:

The authors have no funding or conflicts of interest to declare.

©2012American Contact Dermatitis Society, All Right Reserved

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