Urticarial dermatitis caused by dental implant adhesive compounds: A case report

We report a case of dental adhesive-induced urticaria in a patient with prior history of Hashimoto's Thyroiditis. This 65-year-old woman dated the onset of her urticaria to dental implants made of titanium 18 months prior. The patient had seen multiple physicians for her symptoms and was referred to an allergist for management of her chronic urticaria. The patient had been on steroids and antihistamines with poor control of her urticaria. Because of the expense of dental hardware, patient elected to keep the implants and remained on medications. She was patch tested using two panels (T. R. U. E. Test® and Dormer Labs DS-1000 ® Kit) at 48 and 96 hours post application. She had 1-2+ erythema with some micropapules on patch testing to compounds containing acrylate-based adhesives, as well as Gold and Nickel-containing compounds found in her hardware. We confirmed with a dental lab that those compounds were indeed found in her dental adhesive and in her dental hardware. Allergic contact urticaria and dermatitis have been reported in the literature. Many dental bonding products contain 2-HEMA, a common allergen in adhesives. It is important for allergist to take a detailed history and know that acrylates in dental adhesives can be a cause of chronic urticaria. In our case, the patient now had a known cause of chronic urticaria, and remained on medications for her condition.