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Wang D, Woo SB. Histopathologic Spectrum of Intraoral Irritant and Contact Hypersensitivity Reactions: A Series of 12 cases. Head Neck Pathol. 2021;15(4):1172-1184doi: 10.1007/s12105-021-01330-8.
Wang, D., & Woo, S. B. (2021). Histopathologic Spectrum of Intraoral Irritant and Contact Hypersensitivity Reactions: A Series of 12 cases. Head and neck pathology, 15(4), 1172-1184. https://doi.org/10.1007/s12105-021-01330-8
Wang, Diana, and Woo, Sook-Bin. "Histopathologic Spectrum of Intraoral Irritant and Contact Hypersensitivity Reactions: A Series of 12 cases." Head and neck pathology vol. 15,4 (2021): 1172-1184. doi: https://doi.org/10.1007/s12105-021-01330-8
Wang D, Woo SB. Histopathologic Spectrum of Intraoral Irritant and Contact Hypersensitivity Reactions: A Series of 12 cases. Head Neck Pathol. 2021 Dec;15(4):1172-1184. doi: 10.1007/s12105-021-01330-8. Epub 2021 Apr 26. PMID: 33904012; PMCID: PMC8633165.
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Head Neck Pathol. 2021 Dec;15(4):1172-1184. doi: 10.1007/s12105-021-01330-8. Epub 2021 Apr 26.

Histopathologic Spectrum of Intraoral Irritant and Contact Hypersensitivity Reactions: A Series of 12 cases.

Head and neck pathology

Diana Wang, Sook-Bin Woo

Affiliations

  1. Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA. [email protected].
  2. Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. [email protected].
  3. Department of Oral Medicine Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA, 02115, USA.
  4. Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
  5. Center of Oral Pathology, StrataDx, Lexington, MA, USA.

PMID: 33904012 PMCID: PMC8633165 DOI: 10.1007/s12105-021-01330-8

Abstract

BACKGROUND: Irritant contact stomatitis (ICS) and contact hypersensitivity stomatitis (CHS) are often caused by alcohol, flavoring agents and additives in dentifrices and foods, and contactants with high or low pH. A well-recognized contactant for ICS is Listerine™ mouthwash, while that for CHS is cinnamic aldehyde. However, many other flavoring agents and even smokeless tobacco are contactants that cause mucosal lesions that are entirely reversible. The objective of this study is to 1) present cases of ICS and CHS with a clear history of a contactant at the site and the histopathologic features of the resulting lesion and 2) define the histopathologic features that characterize such lesions.

METHODS: 12 cases of ICS and CHS with known contactants that exhibited distinct histopathologic patterns were identified.

RESULTS: ICS are characterized by three patterns in increasing order of severity namely: 1) superficial desquamation, 2) superficial keratinocyte edema, and 3) keratinocyte coagulative necrosis with/out spongiosis and microabscesses. CHS is characterized by two patterns namely plasma cell stomatitis with an intense plasma cell infiltrate and a lymphohistiocytic infiltrate with or without non-necrotizing granulomatous inflammation. Three patterns of the latter are recognized: (1) lymphohistiocytic infiltrate at the interface with well-formed or loosely aggregated non-necrotizing granulomas; (2) lymphohistiocytic infiltrate at the interface with peri- and para-vascular lymphohistiocytic nodules; and (3) lymphohistiocytic infiltrate at the interface with peri- and para-vascular lymphohistiocytic nodules containing non-necrotizing granulomas. The same contactant may elicit ICS and CHS, while one histopathologic pattern may be brought on by various contactants.

CONCLUSION: ICS and CHS have distinct histologic patterns. Recognizing that these patterns are caused by contactants would help clinicians manage such mucosal lesions.

© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.

Keywords: Cinnamic aldehyde; Contact hypersensitivity stomatitis; Contact stomatitis; Irritant contact stomatitis; Non-necrotizing granuloma; Smokeless tobacco lesion

References

  1. Nat Rev Immunol. 2012 Jan 13;12(2):114-24 - PubMed
  2. Arch Belg Dermatol Syphiligr. 1973 Jan-Mar;29(1):83-92 - PubMed
  3. Am J Dent. 2004 Feb;17(1):23-6 - PubMed
  4. Int Dent J. 2005 Dec;55(6):365-9 - PubMed
  5. J Dent Hyg. 2013 Feb;87(1):10-8 - PubMed
  6. J Dent. 2005 Apr;33(4):313-24 - PubMed
  7. Dermatol Clin. 2020 Oct;38(4):467-476 - PubMed
  8. J Oral Pathol Med. 2019 Oct;48(9):846-854 - PubMed
  9. Rev Environ Health. 2014;29(3):195-206 - PubMed
  10. Ann Dermatol. 2017 Oct;29(5):536-542 - PubMed
  11. Med Oral. 2002 Mar-Apr;7(2):103-7 - PubMed
  12. Head Neck Pathol. 2019 Mar;13(1):16-24 - PubMed
  13. J Oral Pathol Med. 2006 Apr;35(4):233-40 - PubMed
  14. J Nihon Univ Sch Dent. 1997 Dec;39(4):202-10 - PubMed
  15. Quintessence Int. 2008 Jun;39(6):491-4 - PubMed
  16. J Oral Pathol Med. 2016 Jan;45(1):48-57 - PubMed
  17. Arch Dermatol. 2005 Nov;141(11):1466-7 - PubMed
  18. Contact Dermatitis. 2005 Mar;52(3):160-1 - PubMed
  19. Clin Toxicol. 1978;13(3):333-46 - PubMed
  20. J Periodontol. 1997 May;68(5):485-8 - PubMed
  21. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 May;123(5):559-565 - PubMed
  22. Oral Surg Oral Med Oral Pathol. 1980 Feb;49(2):139-47 - PubMed
  23. Oral Surg Oral Med Oral Pathol. 1990 Oct;70(4):529-36 - PubMed
  24. Int J Dermatol. 2000 Feb;39(2):126-33 - PubMed
  25. Histopathology. 2010 Jan;56(1):3-23 - PubMed
  26. J Periodontol. 2004 May;75(5):762-9 - PubMed
  27. Clin Mol Allergy. 2016 Sep 01;14(1):10 - PubMed
  28. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Dec;106(6):853-60 - PubMed
  29. Contact Dermatitis. 2006 Oct;55(4):216-8 - PubMed
  30. J Dermatol. 2017 Mar;44(3):297-303 - PubMed
  31. J Clin Periodontol. 1996 Dec;23(12):1100-3 - PubMed
  32. J Am Dent Assoc. 1998 Oct;129(10):1435-41 - PubMed
  33. Clin Case Rep. 2018 Jul 17;6(9):1761-1764 - PubMed
  34. Oral Surg Oral Med Oral Pathol. 1977 Feb;43(2):211-7 - PubMed
  35. J Am Dent Assoc. 1988 May;116(6):664-7 - PubMed
  36. Indian J Sex Transm Dis AIDS. 2015 Jul-Dec;36(2):185-7 - PubMed
  37. Case Rep Dent. 2015;2015:196292 - PubMed
  38. Crit Rev Oral Biol Med. 2004 Sep 01;15(5):252-63 - PubMed
  39. Indian J Med Res. 2018 Jul;148(1):14-24 - PubMed
  40. J Periodontol. 1998 Jun;69(6):620-31 - PubMed
  41. Crit Rev Oral Biol Med. 2002;13(4):350-65 - PubMed
  42. Clin Dermatol. 2017 Sep - Oct;35(5):435-440 - PubMed
  43. Med Oral Patol Oral Cir Bucal. 2019 Jul 1;24(4):e452-e460 - PubMed
  44. J Oral Pathol Med. 2006 May;35(5):262-7 - PubMed
  45. Allergy. 2010 Feb;65(2):276-7 - PubMed
  46. Dermatol Clin. 2016 Jul;34(3):263-7 - PubMed

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