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We have read the short communication “Oral vesiculobullous lesions associated with SARS‐CoV‐2 infection” (Martin Carreras‐Presas, Amaro Sanchez, Lopez‐Sanchez, Jane‐Salas, & Somacarrera Perez, 2020) by Dr. Martín Carreras‐Presas et al. with great interest. We congratulate the team for contributing to the knowledge about this devastating infection in such challenging times. However, we raise some concerns that must be addressed.

The numbers of participants over 75 years of age in pre-vious studies of oral health have not been sufficient to permit a full investigation of the influence of age on the mouth. In this study a disproportionate stratified random sample of 255 independent elders was selected from a list of urban voters to provide similar numbers of men and women in three age groups. The subjects were interviewed and examined, and nearly half of them had mucosal disorders. There was a significant (P < 0.05) association between mucosal lesions and the use of dentures and tobacco, whereas stomatitis, denture-related hyperplasia and angular cheilitis in particular were associated significantly with men and with the use of defective dentures. Logistic regression revealed that neither age alone nor the quality of dentures predispose to mucosal lesions, but that the odds of finding stomatitis, denture-related hyperplasia and angular cheilitis in particular increased about three-fold in denture-users, and almost doubled in men.

OBJECTIVES: To analyse the interface stomatitis patterns of oral lichenoid lesions in contact with amalgam and to compare these with the histologic changes in oral lesions clinically associated with porcelain-fused-to-metal (PFM) restorations. To relate these features to the presence of tissue-bound mercury (Hg). DESIGN: A retrospective analysis of tissue biopsies, with clinical data collected via a complementary questionnaire. SUBJECTS AND METHODS: 479 biopsies diagnosed in 1987 as ‘lichenoid reactions’. From these, we retrieved all with amalgam contact and without candida or medication. From 1990–91, all mucosal lesions stated to be associated with PFM restorations were then retrieved for comparative analysis. The biopsies were examined with routine histologic and autometallographic methods. RESULTS: 77 amalgam-associated lesions were found and could be subdivided into five pre-defined interface stomatitis types. We found 22 lesions associated with PFM and 20 showed histopathologic features similar to those associated with amalgam. Hg accumulations were detected in the majority of amalgam-associated but only in part of the PFM-associated lesions. CONCLUSIONS: Amalgam-associated lichenoid lesions present a wide spectrum of histopathologic patterns, corresponding to similar patterns in dermatopathology but with no evidence of association with specific disease. PFM-associated lesions tend to display similar lichenoid features, suggestive of common pathogenetic mechanisms. Hg accumulations may play a role to maintain the chronicity of such oral lichenoid lesions.