False‐positive, follicular and irritant patch teat reactions to metal salts

Abstract

853 hard metal workers were patch tested with nickel sulphate 5%, potassium dichromate 0.5% and cobalt chloride 1%, each in petrolatum. Non-allergic reactions appeared in 6.5% of the nickel tests, 13% of the chromium tests and 18.3% of the cobalt tests. Most of the individuals with positive, poral or pustular reactions were retested with serial dilutions of metal salts in pet. and in water. The accuracy of a positive initial nickel reaction was 83%, a chromium reaction 40% and a cobalt reaction 62%. The nonallergic reactions were partly reproducible and correlated with both the type of patch test material and with individual factors. Weak and moderately strong positive patch test reactions to metal salts may be irritant and should be checked with serial dilution tests or at least be retested. A reduction of the cobalt chloride concentration from 1% to 0.5% in the standard test material is discussed.

Patch Test Results with Metals and Meteorological Conditions

“…As Fischer and Rystedt [16] point out in their research, even morphologically ‘positive’ reactions to metal salts may be irritant rather than allergic. The slight increase observed in weak positive reactions under dry/cold or ‘irritating’ weather conditions, the magnitude of which is in between the clear-cut increase in irritant and doubtful reactions and the lack of increased risk in the case of stronger positive reactions, is well in line with this notion.…”

“…However, a number of studies identify dry/cold meteorological conditions to be a risk factor for (experimental) skin irritation [12,13,14,15]. In light of the fact that metal allergens are partly marginal irritants under patch test conditions, potentially yielding false-positive reactions [16], we undertook an examination of the impact of meteorological conditions on patch test reactions to a set of important metal allergens.…”

Heavy Metal Level in Soil, Water, Human Blood Samples and Potential Skin Allergy Risk Near Tanneries From Vellore District, India.

“…For example, ingestion of nickel leads to a decrease in circulating CD8+ CD45RO+ CLA+ blood ©IJRASET (UGC Approved Journal): All Rights are Reserved lymphocytes, which correlates with migration of CD8+ memory T cells into tissues. Ingestion of nickel by nickel-sensitive peoples has also been shown to increase serum levels of interleukin (IL)-5, a Th2 cytokine, and although contact dermatitis is classically thought of as a type IV hypersensitivity (Th1 reaction), IL-5 is known to enhance proliferation of eosinophils and may explain why eosinophils can be seen on biopsy [55].…”

“…Cases of contact dermatitis caused by cutaneous exposure to cosmetics products and jewellery that contain nickel have been reported in the literature. The thinness of the stratum cornea and intermittent exposure to sweat on the eyelids have been associated with increased nickel absorption through the skin from cosmetics, allowing lower nickel concentrations to elicit a reaction [7]. Cobalt is a strong skin sensitizer [8].…”

Estudo da proliferação linfocitária em pacientes sensibilizados ao níquel

“…1 Moreover, applying nickel in petrolatum to the skin may result in follicular lesions and pustules like irritating reactions, as well as doubtful and false-negative results. 4,5 Another diagnostic method mentioned in the literature but with varied and controversial results is the lymphocyte proliferation test -LPT. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Peripheral blood lymphocytes of patients are placed in contact with nickel in LPT.…”