Susuma Oshimura has graduated from Aichi Gakuin University School of Dentistry in 1978. He has obtained his PhD from Aichi Gakuin University School of Dentistry in 1997 and has worked as a Visiting Lecturer of Fujita Health University Dermatology. He has several articles published to his credit.

The number of patients that visit our clinic with metal allergy as chief complaint have ncreased over the years. This is increase is in The number of patients that visit our clinic with metal allergy as chief complaint have increased over the years. This is increase is in part due to the number of recent reports from the media that have sensationally been released. Owing to this, dental professionals now focus more on metal allergy and their relation to dermal symptoms and recommend patients to be patch tested for metal allergy. In some cases, the dermal symptoms have significantly improved after the metal free dental restorations, however, in other cases, it is not that simple. For example, some patients diagnosed with Pustulosis palmoplantaris (PPP) do not show an improvement of the situation even if metallic fillings are replaced with non-metals. Moreover, some other patients with PPP do not even respond to the patch testing with a large series of metal allergens. In this kind of situation, metal allergy may not be the direct cause for dermal symptoms. We have experienced that in some of these cases, endodontically treating the periapical lesions improve the refractory dermal symptoms, which is in accordance to the literature. This suggests that dental focal infection is associated to some dermal symptoms such as the PPP. Although clinically, we suspect that dental focal infection is the primary reason for the PPP, there is a lack of concrete evidence in the literature. In this lecture, chronic dermal diseases showing metal allergy-like symptoms that improved after endodontic treatment will be presented and discussed based on our long-term experience.