Allergic contact dermatitis caused by copper

Abstract

The patient is a 5-year-old right-handed boy who presented to the dermatology department with a 2-year history of recurrent fingertip dermatitis, which was more pronounced on the first three digits of his right hand. He had a past history of asthma, but not of eczema or hay fever. The symptoms improved when he was away from home and school. Although the fingertip dermatitis responded to clobetasol propionate 0.05% ointment or tacrolimus 0.03% ointment and a bland emollient, it continued to reoccur intermittently. This led us to believe that the cause was exposure at his home or at school.A detailed history showed that the patient enjoyed playing with marbles, a tablet computer, 1p and 2p coins, Lego ® , and, in particular, a collection of > 150 die-cast model cars that he liked to crash together, many of which had lost their paint. He was patch tested with the British Contact Dermatitis Society baseline series and metals series, with allergens and IQ Ultra TM chambers (Chemotechnique, Vellinge, Sweden). On day (D) 2 and D4, he had a strong positive (++) reaction to copper(II) sulfate pentahydrate 2% pet., and a negative reaction to nickel. A more haemorrhagic but less infiltrated response

Contact Allergy in Children

“…Copper dental amalgam has caused problems in children [1], but it can also be a sensitization source in metal toys, such as cars (with nickel being negative) [63].…”

Hidden risks in toys: A systematic review of pediatric toy contact dermatitis

“…The source of the copper allergy was believed to be his model cars, and his dermatitis resolved after avoiding the metal cars. 12 Children were also found to come in contact with allergenic metals by way of costume jewelry. A 9-year-old female who was "addicted" to costume jewelry was found to have lichenified plaques of the hands, antecubital arms, and perioral region.…”

“…A 5‐year‐old boy with recurrent finger dermatitis underwent patch testing and was found to have a strong positive reaction to copper(II) sulfate pentahydrate and a negative reaction to nickel. The source of the copper allergy was believed to be his model cars, and his dermatitis resolved after avoiding the metal cars …”

Contact Allergy: A Review of Current Problems from a Clinical Perspective

“…A 5-year-old boy who loved to play with coins and various toys developed fingertip dermatitis, which was attributed to copper release from some materials, and subsequent sensitisation detected by patch testing with copper(II) sulfate pentahydrate 2% pet. [ 39 ]. A malachite necklace caused eczema in a 63-year-old patient, which could be attributed to sensitisation to copper (copper sulfate 2% pet.…”