Comment on “Cinnamon‐Induced Contact Stomatitis: A Retrospective Study of 74 Cases and Literature Review”

We read with great interest the retrospective series and literature review by Kalogirou et al., which assembles the largest cohort to date of cinnamon-induced contact stomatitis (CCS) and sharply characterizes its occlusal-plane predilection, mixed erythematous/white phenotype, and rapid remission after withdrawal of the offending product (Kalogirou et al. 2025). The manuscript is clearly written and clinically useful; nevertheless, we believe several practice-oriented refinements could further increase its translational impact. Building on the authors' observation that diagnosis rests on history plus resolution after cessation—and that biopsy and patch testing are often unnecessary—CCS management could be operationalized as a brief chairside pathway for dentists and oral-medicine clinicians: elicit targeted exposure history (chewing gum/candy/mints; brand/flavor), inspect the occlusal line and lateral tongue, trial immediate avoidance, and offer a short topical corticosteroid course only for significant pain (Feller et al. 2017; Zhang and Yan 2020; Kalogirou et al. 2025; Zang et al. 2022). Such steps are consistent with classic case series showing gum-related reactions and quick recovery after discontinuation, as well as reviews emphasizing the limited diagnostic yield of cutaneous patch testing for oral mucosa (Feller et al. 2017; Zhang and Yan 2020; Zang et al. 2022). Because the cohort predominantly shows band-like lesions at the occlusal plane and combined white-red changes, an alternative—but compatible—explanatory lens is synergism between delayed-type hypersensitivity to cinnamaldehyde and local irritancy from co-formulants plus mastication-related friction. This interaction can blur the clinical picture (e.g., angioedema-like swelling), risking misclassification if exposure history is incomplete (Kind et al. 2010). Broader toxicovigilance literature on cinnamon constituents and flavoring additives also supports multi-ingredient contribution to adverse oral events, reinforcing the need to document exact products and excipients in clinical notes (Hajimonfarednejad et al. 2019). Finally, while the authors report complete remission within a week and sensibly reserve biopsy for non-resolving lesions, we suggest codifying a safety-net review at 2–4 weeks with standardized photographs. This helps exclude mimickers (e.g., candidiasis, lichenoid disorders) and very rare coincidental pathology. When lesions persist despite confirmed avoidance, histopathologic evaluation should be performed, mindful of the recognized (but non-specific) spectrum of CCS findings (Wang and Woo 2021). A historical case report of tongue squamous cell carcinoma in a habitual cinnamon-gum user underscores that persistence merits work-up, without implying causality (Westra et al. 1998). In sum, we commend the authors for an exemplary synthesis and propose a concise, exposure-anchored pathway, a mechanistic perspective on irritant–allergen synergy, and structured follow-up to reduce diagnostic delay while preventing unnecessary procedures. Our intent is to help make an already fine paper even more actionable for clinicians and to accelerate accurate recognition and management of CCS. Shiye Huang: writing – original draft. Ziye Zhuang: writing – original draft. Xuezheng Zhu: writing – original draft. Daquan Liao: writing – original draft. Yubin Feng: writing – review and editing. The authors have nothing to report. The authors have nothing to report. The authors declare no conflicts of interest. The authors have nothing to report.