Many cases of immunoglobulin G4-related disease (IgG4-RD) involve swelling of the salivary glands, often affecting the parotid and submandibular glands in the head and neck region, in addition to the lacrimal glands. Cases of IgG4-RD characterized by swelling of the palatal glands, however, are extremely rare. Here, we describe a case of IgG4-RD involving bilateral swelling of the palatal glands. An 83-year-old man presented at our hospital with bilateral swelling of the lacrimal and submandibular glands. A solid bilateral swelling of normal colour and unclear boundaries was observed in the hard palate. The lesion was diagnosed as IgG4-RD and steroid therapy initiated. A subsequent decrease in swelling of the palatal, lacrimal, and submandibular glands was confirmed by magnetic resonance imaging. These results indicate that dentists should suspect IgG4-RD in patients presenting with bilateral swelling of the palatal glands.
Abstract:We report a case of perioral dermatitis due to gold in dental metal. A 67-year-old woman had a dental prosthesis attached by a family dentist six months before visiting our hospital for first medical examination. A few days later, she had erythema around the lips. Patch testing of metal series and lymphocyte stimulation test showed positive results to gold chloride. Her condition resolved three months after removal of the dental prosthesis containing gold.The clinical course and the results of tests suggest the cause of this case is the allergy to gold in a newly attached dental prosthesis. We discuss possible mechanisms of perioral dermatitis due to dental metal with reference to the literature, although the pathomechanism was still unclear.
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