Metal Allergy pp 545-549 | Cite as

Metal Allergy and Palmoplantar Pustulosis

  • Paolo D. Pigatto
  • Gianpaolo Guzzi


There is controversy surrounding the existence of palmoplantar pustulosis (PPP) and psoriasis as separate clinical entities, or as variants of the same clinical entity. PPP is usually defined as a chronic skin disease characterized by crops of sterile pustules with erythema and sometimes scaling on the palms and soles. PPP has in some studies been associated with autoimmune conditions such as thyroid diseases and celiac disease.

Positive patch test reactions to several metals have been documented in patients with PPP, and notably, removal of dental alloys with these metals has been reported in some cases to result in the resolution of skin manifestations, suggesting a causative relationship. PPP is associated with moderate-to-severe discomfort and disability and is difficult to treat, often requiring the use of immunosuppressive agents.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Biomedical, Surgical and Dental Sciences, Unit of DermatologyIRCCS Galeazzi Hospital, University of MilanMilanItaly
  2. 2.Italian Association for Metals and Biocompatibility Research – A.I.R.M.E.BMilanItaly

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