• Marléne IsakssonEmail author
Reference work entry


Gold was considered to be an inert material not being able to give contact allergy or allergic contact dermatitis. However, gold allergy is common among dental patients as well as dermatitis patients. The relevance, however, is usually uncertain except in dental patients and in stented patients having received a gold stent. Gold should be tested in dental cases and in cases of eyelid and/or facial dermatitis or when jewelry allergy is suspected. Testing should also be considered when there is dermatitis of the ears, hands, or neck. Gold should also be tested in potential occupational exposure.


Gold allergy Dental gold Patch testing Patch test readings Gold sodium thiosulfate Gold jewelry Stent material Oral lichenoid lesions Gold trichloride Gold sodium thiomalate Chrysotherapy Facial dermatitis Eyelid dermatitis 


  1. Adams R (1983) Occupational skin disease. Grune and Stratton, New YorkGoogle Scholar
  2. Adams R (1990) Occupational skin disease. 2nd edn. WB Saunders Company, PhiladelphiaGoogle Scholar
  3. Admani S, Jacob SE (2014) Allergic contact dermatitis in children: review of the past decade. Curr Allergy Asthma Rep 14:421PubMedCrossRefGoogle Scholar
  4. Ahlgren C, Ahnlide I, Björkner B et al (2002) Contact allergy to gold is correlated to dental gold. Acta Derm Venereol 82:41–44PubMedCrossRefGoogle Scholar
  5. Ahlgren C, Bruze M, Möller H et al (2012) Contact allergy to gold in patients with oral lichen lesions. Acta Derm Venereol 92:138–143PubMedCrossRefGoogle Scholar
  6. Ahnlide I, Björkner B, Bruze M et al (2000) Exposure to metallic gold in patients with contact allergy to gold sodium thiosulfate. Contact Dermatitis 43:344–350PubMedCrossRefGoogle Scholar
  7. Ahnlide I, Ahlgren C, Björkner B et al (2002) Gold concentrations in blood in relation to the number of gold restorations and contact allergy to gold. Acta Odontol Scand 60:301–305PubMedCrossRefGoogle Scholar
  8. Armstrong DKB, Walsh MY, Dawson JF (1997) Granulomatous contact dermatitis due to gold earrings. Br J Dermatol 136:776–778PubMedCrossRefGoogle Scholar
  9. Aro T, Kanerva L, Häyrinen-Immonen R, Silvennoinen-Kassinen S, Konttinen YT, Jolanki R, Estlander T (1993) Long-lasting allergic patch test reaction caused by gold. Contact Dermatitis 28:276–281PubMedCrossRefGoogle Scholar
  10. Asthner B (1990) Textbook of electrolytic and chemical finishing (in Swedish). Ytforum Förlags AB, LinköpingGoogle Scholar
  11. Björkman L, Ekstrand J, Lind BB (1998) Determination of gold released from dental alloys in saliva (abstract). J Dent Res 77:765Google Scholar
  12. Björkner B, Bruze M, Möller H (1994) High frequency of contact allergy to gold sodium thiosulfate. An indication of gold allergy? Contact Dermatitis 30:144–151PubMedCrossRefGoogle Scholar
  13. Björkner B, Bruze M, Möller H et al (2008) Allergic contact dermatitis as a complication of lid loading with gold implants. Dermatitis 19:148–153PubMedCrossRefGoogle Scholar
  14. Bowyer A (1967) Epidermal reactions and prolonged dermal reactions to patch testing with gold salts. Acta Derm Venereol 47:9–14Google Scholar
  15. Brown DH, Smith WE, Fox P, Sturrock RD (1982) The reactions of gold (0) with amino acids and the significance of these reactions in the biochemistry of gold. Inorg Chim Acta 67:27–30CrossRefGoogle Scholar
  16. Bruze M, Björkner B, Möller H (1995a) Skin testing with gold sodium thiomalate and gold sodium thiosulfate. Contact Dermatitis 32:5–8PubMedCrossRefGoogle Scholar
  17. Bruze M, Hedman H, Björkner B, Möller H (1995b) The development and course of test reactions to gold sodium thiosulfate. Contact Dermatitis 33:386–391PubMedCrossRefGoogle Scholar
  18. Bruze M, Björkner B (1996) Patch testing with gold sodium thio-sulfate. Abstract 49, Jadassohn Centenary Congress, LondonGoogle Scholar
  19. Budden MG, Wilkinson DS (1978) Skin and nail lesions from gold potassium cyanide. Contact Dermatitis 4:172–173PubMedCrossRefGoogle Scholar
  20. Cavelier C, Foussereau J (1995) Kontaktallergie gegen Metalle and deren Salze. Dermatosen Occup Environ 43:100–112Google Scholar
  21. Chen JK, Lampel HP (2015) Gold contact allergy: clues and controversies. Dermatitis 26:69–77PubMedCrossRefPubMedCentralGoogle Scholar
  22. Collet E, Lacroix M, Dalac S (1994) Allergie de contact á l’or métal et á ses alliages. Ann Derm Syph 121:21–24Google Scholar
  23. Comaish S (1969) A case of contact hypersensitivity to metallic gold. Arch Dermatol 99:720–723PubMedCrossRefPubMedCentralGoogle Scholar
  24. Cowan MA (1960) Contact dermatitis due to gold. Br J Dermatol 72:348–349PubMedCrossRefGoogle Scholar
  25. Cronin E (1980) Contact dermatitis. Churchill Livingstone, EdinburghGoogle Scholar
  26. Danesh M, Murase JE (2015) Titanium dioxide induces eyelid dermatitis in patients allergic to gold. J Am Acad Dermatol 73:e21PubMedCrossRefGoogle Scholar
  27. Doyle E, Mavrikakis I, Lee EJ et al (2005) Type IV hypersensitivity reactions to upper lid gold weight implants-is patch testing necessary? Orbit 24:205–210PubMedCrossRefGoogle Scholar
  28. Ekqvist S, Svedman C, Möller H et al (2007) High frequency of contact allergy to gold in patients with endovascular coronary stents. Br J Dermatol 157:730–738PubMedCrossRefGoogle Scholar
  29. Ekqvist S, Svedman C, Lundh T et al (2008) A correlation found between gold concentration in blood and patch test reactions in patients with coronary stents. Contact Dermatitis 59:137–142PubMedCrossRefGoogle Scholar
  30. Elgart M (1972) Allergic contact dermatitis to gold. Arch Dermatol 106:254Google Scholar
  31. Elgart ML, Higdon RS (1971) Allergic contact dermatitis to gold. Arch Dermatol 103:649–653PubMedCrossRefPubMedCentralGoogle Scholar
  32. Estlander T, Kari O, Jolanki R et al (1998) Occupational allergic contact dermatitis and blepharoconjunctivitis caused by gold. Contact Dermatitis 38:40–41PubMedCrossRefGoogle Scholar
  33. Felix B, Ducombs G (1993) Allergie professionelle á l’or. Lettre du GERDA 10:44–45Google Scholar
  34. Fisher AA (1967) Contact dermatitis. Lea & Febiger, PhiladelphiaGoogle Scholar
  35. Fisher AA (1974a) Ear piercing hazard of nickel-gold sensitization. JAMA 228:1226. (letter)PubMedCrossRefGoogle Scholar
  36. Fisher AA (1974b) Allergic reactions due to metals used in dentistry. Cutis 14:797–800Google Scholar
  37. Fisher AA (1974c) Metallic gold: the cause of a persistent allergic ‘dermal’ contact dermatitis. Cutis 14:177–180Google Scholar
  38. Fisher AA (1987) Ear piercing and sensitivity to nickel and gold. J Am Acad Dermatol 17:853PubMedCrossRefGoogle Scholar
  39. Fleming C, Burden D, Fallowfield M, Lever R (1997a) Lymphomatoid contact reaction to gold earrings. Contact Dermatitis 37:298PubMedCrossRefGoogle Scholar
  40. Fleming C, Forsyth A, MacKie R (1997b) Prevalence of gold contact hypersensitivity in the west of Scotland. Contact Dermatitis 36:302–304PubMedCrossRefGoogle Scholar
  41. Fleming C, Porter D, MacKie R (1998) Absence of gold sodium thiosulfate contact hypersensitivity in rheumatoid arthritis. Contact Dermatitis 38:55–56PubMedCrossRefGoogle Scholar
  42. Forestier JM (1929) L’aurothérapie dans les rheumatismes chroniques. Bull Soc Med Hop Paris 53:323–327Google Scholar
  43. Forster HW Jr, Dickey RF (1949) A case of sensitivity to gold-ball orbital implant. Eczematous contact-type dermatitis due to 14-karat gold. Am J Ophthalmol 32:659–662PubMedCrossRefGoogle Scholar
  44. Fowler JF Jr (1987) Selection of patch test materials for gold allergy. Contact Dermatitis 17:23–25PubMedCrossRefGoogle Scholar
  45. Fowler JF Jr (1988) Allergic contact dermatitis to gold. Arch Dermatol 124:181–182PubMedCrossRefGoogle Scholar
  46. Fowler JF Jr (1990) Allergic contact dermatitis to metals. Am J Contact Dermat 1:212–223CrossRefGoogle Scholar
  47. Fox JM, Kennedy R, Rostenberg A Jr (1961) Eczematous contact-sensitivity to gold. Arch Dermatol 83:956–959PubMedCrossRefGoogle Scholar
  48. Fregert S, Kollander M, Poulsen J (1979) Allergic contact stomatitis from gold dentures. Contact Dermatitis 5:63–64PubMedCrossRefGoogle Scholar
  49. Gaul LE (1954) Incidence of sensitivity to chromium, nickel, gold, silver, and copper compared to reactions to their aqueous salts including cobalt sulfate. Ann Allergy 12:429–444PubMedGoogle Scholar
  50. Giorgini S, Tognetti L, Zanieri F et al (2010) Occupational airborne allergic contact dermatitis caused by gold. Dermatitis 21:284–287PubMedCrossRefGoogle Scholar
  51. Goh CL (1988) Occupational dermatitis from gold plating. Contact Dermatitis 18:122–123PubMedCrossRefGoogle Scholar
  52. Heise H, Beyer H, Rauschenbach D (1997) Ergebnisse der Epikutantestung auf Goldsalze versus Amalgam. Z Dermatol 183:68–72Google Scholar
  53. Helm KF, Marks JG Jr, Leyden JJ et al (1995) Topical auranofin ointment for the treatment of plaque psoriasis. J Am Acad Dermatol 33:517–519PubMedCrossRefGoogle Scholar
  54. Holland RI (1980) Galvanic currents between gold and amalgam. Scand J Dent Res 88:269–272PubMedGoogle Scholar
  55. Iwatsuki K, Tagami H, Moriguchi T, Yamada M (1982) Lymphadenoid structure induced by gold hypersensitivity. Arch Dermatol 118:608–611PubMedPubMedCentralCrossRefGoogle Scholar
  56. Kanerva L, Rantanen T, Aalto-Korte K et al (2001) A multicenter study of patch test reactions with dental screening series. Am J Contact Dermat 12:83–87PubMedGoogle Scholar
  57. Kaur S, Eisen M, Leiger K et al (2006) Screening for gold allergy among dental clinic employees and patch test population. Contact Dermatitis 54:172–173PubMedCrossRefGoogle Scholar
  58. Kawahara D, Oshima H, Kosugi H et al (1993) Further epidemiologic study of occupational contact dermatitis in the dental clinic. Contact Dermatitis 28:114PubMedCrossRefGoogle Scholar
  59. Khamaysi Z, Bergman R, Weltfriend S (2006) Positive patch test reactions to allergens of the dental series and the relation to the clinical presentations. Contact Dermatitis 55:216–218PubMedCrossRefGoogle Scholar
  60. Kim TW, Kim WI, Mun JH et al (2015) Patch testing with dental screening series in oral disease. Ann Dermatol 27:389–393PubMedPubMedCentralCrossRefGoogle Scholar
  61. Klaschka F (1975) Contact allergy to gold. Contact Dermatitis 1:264–265PubMedCrossRefGoogle Scholar
  62. Kligman AM (1966) The identification of contact allergens by human assay. III. The maximization test, a procedure for screening and rating contact sensitizers. J Invest Dermatol 47:393–409PubMedCrossRefGoogle Scholar
  63. Kobayashi Y, Nanko H, Nakamura J, Mizoguchi M (1992) Lymphocytoma cutis induced by gold pierced earrings. J Am Acad Dermatol 27:457–458PubMedCrossRefGoogle Scholar
  64. Koch P, Bahmer FA (1995) Oral lichenoid lesions, mercury hypersensitivity and combined hypersensitivity to mercury and other metals: histologically-proven reproduction of the reaction by patch testing with metal salts. Contact Dermatitis 33:323–328PubMedCrossRefGoogle Scholar
  65. Koch P, Kiehn M, Frosch PJ (1997) Epikutane Testung mit Goldsalzen. Hautarzt 48:812–816PubMedCrossRefGoogle Scholar
  66. Larsen W, Adams RM, Maibach HI (1992) Color text of contact dermatitis. WB Saunders, PhiladelphiaGoogle Scholar
  67. Larsson Å, Möller H, Björkner B et al (1997) Morphology of endogenous flare-up reactions in contact allergy to gold. Acta Derm Venereol 77:474–479PubMedGoogle Scholar
  68. Leow Y-H, Ng S-K, Goh C-L (1998) A preliminary study of gold sensitization in Singapore. Contact Dermatitis 38:69–170CrossRefGoogle Scholar
  69. Malinauskiene L, Isaksson M, Bruze M (2013) Systemic contact dermatitis in a gold-allergic patient after treatment with an oral homeopathic drug. J Am Acad Dermatol 68:e58PubMedCrossRefGoogle Scholar
  70. Marks JG Jr, Helm KF, Kreuger GG et al (1995) Contact dermatitis from topical auranofin. J Am Acad Dermatol 32:813–814PubMedCrossRefGoogle Scholar
  71. Martin MD, Broughton S, Drangsholt M (2003) Oral lichen planus and dental materials: a case-control study. Contact Dermatitis 48:331–336PubMedCrossRefGoogle Scholar
  72. McDaniel LM, Couch SM (2017) Allergic eyelid dermatitis as the sole manifestation of gold hypersensitivity. Ophthal Plast Reconstr Surg 33:e80-e82PubMedCrossRefGoogle Scholar
  73. Mc Kenna KE, Dolan O, Walsh MY, Burrows D (1995) Contact allergy to gold sodium thiosulfate. Contact Dermatitis 32:143–146CrossRefGoogle Scholar
  74. Merck Index (1983) In: Windholz M (ed) Merck index, 10th edn. Merck & Co Inc, RahwayGoogle Scholar
  75. Minang JT, Areström I, Troye-Blomberg M et al (2006) Nickel, cobalt, chromium, palladium and gold induce a mixed Th1- and Th2-type cytokine response in vitro in subjects with contact allergy to the respective metals. Clin Exp Immunol 146:417–426PubMedPubMedCentralCrossRefGoogle Scholar
  76. Monti M, Berti E, Cavicchini S, Sala F (1983) Unusual cutaneous reaction after a gold chloride patch test. Contact Dermatitis 9:150–151PubMedPubMedCentralCrossRefGoogle Scholar
  77. Möller H, Björkner B, Bruze M (1996) Clinical reactions to systemic provocation with gold sodium thiomalate in patients with contact allergy to gold. Br J Dermatol 135:423–427PubMedCrossRefGoogle Scholar
  78. Möller H, Svensson Å, Björkner B et al (1997) Contact allergy to gold and gold therapy in patients with rheumatoid arthritis. Acta Derm Venereol (Stockh) 77:370–373Google Scholar
  79. Möller H, Ohlsson K, Linder C et al (1998) Cytokines and acute phase reactants during flare-up of contact allergy to gold. Am J Contact Dermat 9:15–22PubMedGoogle Scholar
  80. Möller H, Ohlsson K, Linder C et al (1999) The flare-up reactions after systemic provocation in contact allergy to nickel and gold. Contact Dermatitis 40:200PubMedCrossRefGoogle Scholar
  81. Nakada T, Iijima M, Nakayama H, Maibach HI (1997) Rôle of ear piercing in metal allergic contact dermatitis. Contact Dermatitis 36:233–236PubMedCrossRefGoogle Scholar
  82. Nedorost S, Wagman A (2005) Positive patch-test reactions to gold: patients’perception of relevance and the role of titanium dioxide in cosmetics. Dermatitis 16:67–70PubMedGoogle Scholar
  83. Nonaka H, Nakada T, Iijima M (2003) Contact Dermatitis 48:112PubMedCrossRefGoogle Scholar
  84. Park SJ, Lee CW, Hong MK et al (2002) Comparison of gold-coated Nir stents with uncoated Nir stents in patients with coronary artery disease. Am J Cardiol 89:872–875PubMedCrossRefGoogle Scholar
  85. Petros H, Macmillan AL (1973) Allergic contact sensitivity to gold with unusual features. Br J Dermatol 88:505–508PubMedPubMedCentralCrossRefGoogle Scholar
  86. Rapson WS (1985) Skin contact with gold and gold alloys. Contact Dermatitis 13:56–65PubMedCrossRefGoogle Scholar
  87. Räsänen LR, Kalimo K, Laine J et al (1996) Contact allergy to gold in dental patients. Br J Dermatol 134:673–677PubMedCrossRefGoogle Scholar
  88. Räsänen L, Kaipiainson-Seppanon O, Thyllykangas-Ludswarvi R et al (1999) Hypersensitivity to gold in gold sodium thiosulfate induced dermatitis. Br J Dermatol 141:683–688PubMedCrossRefGoogle Scholar
  89. Roenigk HR Jr, Handel D (1974) Gold vasculitis. Arch Dermatol 109:253–255PubMedCrossRefGoogle Scholar
  90. Russel MA, Langley M, Truett APIII et al (1999) Lichenoid dermatitis after consumption of gold-containing liquor. J Am Acad Dermatol 36:841–844CrossRefGoogle Scholar
  91. Sabroe RA, Sharp LA, Peachey RDG (1996) Contact allergy to gold sodium thiosulfate. Contact Dermatitis 34:345–348PubMedCrossRefGoogle Scholar
  92. Schaffran RM, Storrs FJ, Schalock P (1999) Prevalence of gold sensitivity in asymptomatic individuals with gold dental restorations. Am J Contact Dermat 10:201–206PubMedGoogle Scholar
  93. Schmollack E (1971) Berufliche Kontaktekzeme durch Kaliumgoldzyanid. Dermatol Monatsschr 157:821–824PubMedGoogle Scholar
  94. Schöpf E, Wex O, Schulz KH (1970) Allergische Kontaktstomatitis mit spezifischer Lymphocytenstimulation durch Gold. Hautarzt 21:422–424PubMedGoogle Scholar
  95. Shelley WB, Epstein E (1963) Contact sensitivity to gold as a chronic papular eruption. Arch Dermatol 87:388–391PubMedCrossRefGoogle Scholar
  96. Sidi E, Hincky M (1965) Problèmes d’actualité concernant les dermatoses professionelles. Rev Fr Allergol 5:198–209PubMedGoogle Scholar
  97. Silva R, Pereira F, Bordalo O et al (1997) Contact allergy to gold sodium thiosulfate. A comparative study. Contact Dermatitis 37:78–81PubMedCrossRefGoogle Scholar
  98. Silvennoinen-Kassinen S, Niinimäki A (1984) Gold sensitivity blast transformation. Contact Dermatitis 11:156–158PubMedCrossRefGoogle Scholar
  99. Somov BA, Khaimovsky GD (1964) Allergic dermatitis caused by aurum compounds in watch industry. Vestn Dermatol Venerol 10:33Google Scholar
  100. Sperber BR, Allee J, Elenitsas R et al (2003) Papular dermatitis and a persistent patch test reaction to gold sodium thiosulfate. Contact Dermatitis 48:204–208PubMedCrossRefGoogle Scholar
  101. Suzuki H (1998) Nickel and gold in skin lesions of pierced earlobes with contact dermatitis. A study using scanning electron microscopy and x-ray microanalysis. Arch Dermatol Res 290:523–527PubMedCrossRefGoogle Scholar
  102. Svedman C, Tillman C, Gustavsson CG et al (2005) Contact allergy to gold in patients with gold-plated intracoronary stents. Contact Dermatitis 52:192–196PubMedCrossRefGoogle Scholar
  103. Svedman C, Dunér K, Kehler M et al (2006) Lichenoid reactions to gold from dental restorations and exposure to gold through intracoronary implant of a gold-plated stent. Clin Res Cardiol 95:689–691PubMedCrossRefGoogle Scholar
  104. Svedman C, Ekqvist S, Möller H et al (2009) A correlation found between contact allergy to stent material and restenosis of the coronary arteries. Contact Dermatitis 60:158–164PubMedCrossRefGoogle Scholar
  105. Svedman C, Gruvberger B, Dahlin J et al (2013) Evaluation of a method for detecting metal release from gold; cysteine enhances release. Acta Derm Venereol 93:577–578PubMedCrossRefGoogle Scholar
  106. Svedman C, Möller H, Gruvberger B et al (2014) Implants and contact allergy: are sensitizing metals released as haptens from coronary stents? Contact Dermatitis 71:92–97PubMedCrossRefGoogle Scholar
  107. Svensson Å, Theander J (1992) Skin rashes and stomatitis due to parenteral treatment of rheumatoid arthritis with sodium aurothiomalate. Ann Rheum Dis 51:326–329PubMedPubMedCentralCrossRefGoogle Scholar
  108. Tammaro A, Tuchinda P, Persechino S, Gaspari A (2011) Contact allergic dermatitis to gold in a tattoo: a case report. Int J Immunopathol Pharmacol 24:1111–1113PubMedCrossRefPubMedCentralGoogle Scholar
  109. Tan E, Delaney TA (1996) Occupational contact dermatitis to gold. Australas J Dermatol 37:218–219PubMedCrossRefGoogle Scholar
  110. Thomas I (1987) Gold therapy and its indications in dermatology. J Am Acad Dermatol 16:845–854PubMedCrossRefGoogle Scholar
  111. Trathen WT, Stanley RJ (1985) Allergic reaction to Hulka clips. Obstet Gynecol 66:743–744PubMedGoogle Scholar
  112. van Gestel A, Koopman R, Wijnands M et al (1994) Mucocutaneous reactions to gold: a prospective study of 74 patients with rheumatoid arthritis. J Rheumatol 21:1814–1819PubMedGoogle Scholar
  113. Vassilopoulou A, Bertazzoni M (1997) Dermatite da contatto negli orafi. Bollettino di Dermatologia Allergologica e Professionale 12:9–14Google Scholar
  114. Wiesenfeld D, Ferguson MM, Forsyth A, MacDonald DG (1984) Allergy to dental gold. Oral Surg 57:158–160PubMedCrossRefGoogle Scholar
  115. Wiesner M, Pambor M (1998) Allergic contact dermatitis from gold. Contact Dermatitis 38:52–53PubMedCrossRefGoogle Scholar
  116. Young E (1974) Contact hypersensitivity to metallic gold. Dermatologica 149:294–298PubMedCrossRefGoogle Scholar

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Authors and Affiliations

  1. 1.Department of Occupational and Environmental Dermatology, Department of Clinical Sciences Malmö Lund UniversitySkåne University HospitalMalmöSweden

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