Oral white lesions are quite common clinical conditions in clinical dental practice. They can be an expression of different diseases, so it is crucial to achieve a correct diagnosis to start an adequate treatment. However, differential diagnosis is not always easy because the clinical appearance of oral white lesions is often similar and non-pathognomonic. We report on a 42-year-old Caucasian woman who complained of a chronic white patch on the left border of her tongue. A provisional diagnosis

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... of oral hairy leukoplakia was made, but the patient was HIV-negative and not immunocompromised. A patch test was performed to exclude an allergic reaction, which resulted negative. Two large amalgam fillings were removed, and the lesion regressed after two weeks, suggesting a diagnosis of oral lichenoid lesions. Amalgam-associated oral lichenoid lesions could be mistaken for hairy leukoplakia when located on the lateral border of the tongue. Patch tests for dental metal series are only sometimes helpful for a diagnosis of oral lichenoid lesions. Patients should follow a careful follow-up to monitor any neoplastic derailment of the lichenoid lesions.