Metal Allergy pp 107-124 | Cite as

Assessment for Metal Allergy: Patch Testing

Chapter

Abstract

The method of choice and gold standard in the diagnosis of delayed-type hypersensitivity is patch testing; therefore, patch testing for metal allergy has become routine. Most national and international baseline series for patch testing contain nickel, chromium and cobalt. There are numerous metals of increasing medical importance that are not on routine patch test programmes. With advances of metallurgy and biotechnology, such metals become increasingly widely present in medical devices, e.g. artificial joints, dental implants, vascular stents, clips and pacemakers. These metals are not routinely tested, as some are not yet commercially available as preparations for patch testing, while others may not be well known to many dermatologists and allergists. This chapter outlines current recommendations and common pitfalls when patch testing to metals. Assessing the clinical relevance of a positive patch test reaction is as important as the execution of patch testing. Several illustrative cases will be provided.

References

  1. 1.
    Johansen JD, Aalto-Korte K, Agner T, et al. European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations on best practice. Contact Dermatitis. 2015;73:195–221.CrossRefGoogle Scholar
  2. 2.
    Spiewak R. Patch testing for contact allergy and allergic contact dermatitis. Open Allergy J. 2008;1:42–51.CrossRefGoogle Scholar
  3. 3.
    Bourke J, Coulson I, English J. Guidelines for care of contact dermatitis. Br J Dermatol. 2001;145:877–85.CrossRefGoogle Scholar
  4. 4.
    Bruynzeel DP, Ferguson J, Andersen K, et al. Photopatch testing: a consensus methodology for Europe. J Eur Acad Dermatol Venereol. 2004;18:679–82.CrossRefGoogle Scholar
  5. 5.
    Jensen CD, Paulsen E, Andersen KE. Retrospective evaluation of the consequence of alleged patch test sensitization. Contact Dermatitis. 2006;55:30–5.CrossRefGoogle Scholar
  6. 6.
    Fransway AF, Zug KA, Belsito DV, et al. North American Contact Dermatitis Group patch test results for 2007-2008. Dermatitis. 2013;24:10–21.CrossRefGoogle Scholar
  7. 7.
    Fischer T, Rystedt I. False-positive, follicular and irritant patch test reactions to metal salts. Contact Dermatitis. 1985;12:93–8.CrossRefGoogle Scholar
  8. 8.
    Storrs FJ, White CR Jr. False-positive “poral” cobalt patch test reactions reside in the eccrine acrosyringium. Cutis. 2000;65:49–53.PubMedGoogle Scholar
  9. 9.
    Marcussen PV. Primary irritant patch-test reactions in children. Arch Dermatol. 1963;87:378–82.CrossRefGoogle Scholar
  10. 10.
    Czarnobilska E, Obtulowicz K, Dyga W, Spiewak R. The most important contact sensitizers in Polish children and adolescents with atopy and chronic recurrent eczema as detected with the extended European Baseline Series. Pediatr Allergy Immunol. 2011;22:252–6.CrossRefGoogle Scholar
  11. 11.
    Mortz CG, Kjaer HF, Eller E, et al. Positive nickel patch tests in infants are of low clinical relevance and rarely reproducible. Pediatr Allergy Immunol. 2013;24:84–7.CrossRefGoogle Scholar
  12. 12.
    Mortz CG, Lauritsen JM, Bindslev-Jensen C, Andersen KE. Prevalence of atopic dermatitis, asthma, allergic rhinitis, and hand and contact dermatitis in adolescents. The odense adolescence cohort study on atopic diseases and dermatitis. Br J Dermatol. 2001;144:523–32.CrossRefGoogle Scholar
  13. 13.
    Brandao MH, Gontijo B, Girundi MA, de Castro MC. Ear piercing as a risk factor for contact allergy to nickel. J Pediatr. 2010;86:149–54.CrossRefGoogle Scholar
  14. 14.
    de Groot AC. Patch testing. Test concentrations and vehicles for 4350 chemicals. Wapserveen: Acdegroot Publishing; 2008. p. 1–1257. (update 2008–2015 available as PDF from the publisher)Google Scholar
  15. 15.
    Fowler JF Jr. Gold remains an important allergen. Dermatitis. 2015;26:67–8.CrossRefGoogle Scholar
  16. 16.
    Bruze M, Hedman H, Bjorkner B, Moller H. The development and course of test reactions to gold sodium thiosulfate. Contact Dermatitis. 1995;33:386–91.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Experimental Dermatology and Cosmetology, Faculty of PharmacyJagiellonian University Medical CollegeKrakowPoland
  2. 2.Dermatology and Allergy Consultancy ‘dermatolog.eu’KrakowPoland

Personalised recommendations