Allergic contact gingivostomatitis due to gold.

The sixth case of an allergic contact gingivostomatitis to gold crowns previously misdiagnosed as erosive lichen planus is reported. Patch tests to gold chloride (0.5%) and 0.05 cm3 intradermal gold sodium thiomalate (Myochrysine 50 mg/cm3) were positive at 48-72 h. Histopathology of the allergic contact gingivitis revealed a pseudolymphomatous inflammatory dermal reaction with a dense lymphohistiocytic and plasma cell infiltrate. Removal of the gold crowns resulted in a gradual resolution of the gingivostomatitis in 4-6 months, and the patient has remained free of clinical disease for over 3 years. A review of the reported cases of allergic gingivostomatitis to gold crowns revealed that each patient clinically presented with an erosive and ulcerative inflammatory response was usually associated with a clinical history of gold jewelry intolerance.