Predisposition of allergy in patients with benign migratory glossitis Mustafa Goregen, DDS, PhD, a Mehmet Melikoglu, MD, b Ozkan Miloglu, DDS, PhD, c and Teoman Erdem, MD, d Erzurum, Turkey ATATURK UNIVERSITY AND ERZURUM REGIONAL RESEARCH AND TRAINING HOSPITAL Objective. The purpose of this study was to investigate the presence of allergy in patients with benign migratory glossitis (BMG) using patch and prick tests. Patients and methods. Eighty patients (40 BMG and 40 healthy controls) received patch and prick tests. If at least one test result was positive, patients were considered to be allergic. Results. The prick test was positive in 10 patients (25.0%) of the study group and in 4 patients (10.0%) of the control group. The patch test was positive in 12 patients (30.0%) of the study group and in 6 patients (15.0%) of the control group. When results of both tests were evaluated together, the study group showed a positive rate of 47.5% (n = 19), whereas the control group showed a positive rate of 22.5% (n = 9) (P = .02). Conclusion. Our results revealed that a combination of prick and patch tests can significantly enhance the diagnostic accuracy of predisposition of allergy in patients with BMG. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:470-474) Benign migratory glossitis (BMG) is a recurrent con- dition characterized by loss of epithelium particularly of the filiform papillae on the dorsum of the tongue. The appearance is of multifocal, circinate, irregular erythematous patches bounded by a slightly elevated, white or cream-colored keratotic band or line. The central erythematous patch represents atrophy of the filiform papillae. The white border is composed of regenerating filiform papillae and a mixture of keratin and neutrophils. 1,2 The etiology of BMG remains unknown. Several related etiologic factors have been proposed; however, none of the suggested causes provide clear-cut evidence of a causal relationship. One of them is allergy or atopy. 1-21 It is difficult to diagnose allergy using a single criterion. This condition is mostly detected by the existence of abnormalities—such as asthma, ec- zema, or hay fever—personal or familial history, raised levels of serum immunoglobulin E (IgE), the presence of IgE against specific antigens, like tissue mast cells, and positive patch or prick tests. In the literature, a relationship between BMG and allergy has been shown by history of patients in some studies, 1,3-7,10,11,13 total serum IgE levels, 14 HLA antigen, 20 and prick tests. 2,12 More recently, the role of cellular immunity in aller- gic diseases has been emphasized. For instance, the pathogenesis of atopic dermatitis formerly highlighted the role of type 1 reactions and IgE; however, more recent evidence also suggests cellular immunity (par- ticularly T-cell) involvement. 22,23 To evaluate these distinct arms of immunity, the prick test is a method that measures the coexistence of type 1 allergic reac- tion, atopy, and IgE, whereas the patch contact test is a method for measuring delayed cellular hypersensitivity (type 4 reaction). As there is lack of information in the literature on BMG and these immunological mecha- nisms, we sought to investigate the role of contact allergens in BMG by using both the prick and patch tests. PATIENTS AND METHODS The study began with 107 patients. Excluded were patients who used any medication (mainly steroid, an- tihistamine, and antidepressant), patients with atopic dermatitis or any diagnosed allergic problems (such as allergic rhinitis, asthma, and hay fever), children younger than 5 years, pregnant patients, and patients who did not take into account warnings about the applying al- lergen. The final sample study group was 40 dental patients (25 female and 15 male; mean age: 25.6  11.2) diagnosed with BMG. Another 40 dental patients without BMG lesions (25 female and 15 male; mean a Research Assistant, Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey. b Research Assistant, Department of Dermatology, Health Ministry, Erzurum Regional Research and Training Hospital, Erzurum, Turkey. c Assistant Professor, Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey. d Professor, Department of Dermatology, Faculty of Medicine, Ataturk University, Erzurum, Turkey. Received for publication Jan 9, 2010; returned for revision Apr 12, 2010; accepted for publication Apr 21, 2010. 1079-2104/$ - see front matter © 2010 Mosby, Inc. All rights reserved. doi:10.1016/j.tripleo.2010.04.036 470