Metals Are Important Contact Sensitizers: An Experience from Lithuania

Abstract

Background. Metals are very frequent sensitizers causing contact allergy and allergic contact dermatitis worldwide; up-to-date data based on patch test results has proved useful for the identification of a problem. Objectives. In this retrospective study prevalence of contact allergy to metals (nickel, chromium, palladium, gold, cobalt, and titanium) in Lithuania is analysed. Patients/Methods. Clinical and patch test data of 546 patients patch tested in 2014–2016, in Vilnius University Hospital Santariskiu Klinikos, was analysed and compared with previously published data. Results. Almost third of tested patients (29.56%) were sensitized to nickel. Younger women were more often sensitized to nickel than older ones (36% versus 22.8%, p = 0.0011). Women were significantly more often sensitized to nickel than men (33% versus 6.1%, p < 0.0001). Younger patients were more often sensitized to cobalt (11.6% versus 5.7%, p = 0.0183). Sensitization to cobalt was related to sensitization to nickel (p < 0.0001). Face dermatitis and oral discomfort were related to gold allergy (28% versus 6.9% dermatitis of other parts, p < 0.0001). Older patients were patch test positive to gold(I) sodium thiosulfate statistically significantly more often than younger ones (44.44% versus 21.21%, p = 0.0281). Conclusions. Nickel, gold, cobalt, and chromium are leading metal sensitizers in Lithuania. Cobalt sensitization is often accompanied by sensitization to nickel. Sensitivity rate to palladium and nickel indicates possible cross-reactivity. No sensitization to titanium was found.

A retrospective study on titanium sensitivity: Patch test materials and manifestations

“…A study in Lithuania reported no positive patch test reaction to any of the 5 Ti salts present in their metal series. 17 23,24 This is similar to our experience, in which 8 patients who reacted positively to Ti oxalate were also tested with TiO 2 ; none of the tests gave a positive result. However, the difference in frequency of positive Ti oxalate reactions between patients suspected of having Ti allergy and the control group was non-significant (P = .74).…”

“…However, in these studies, only TiO 2 was used, which might account for the difference in sensitization occurrence from that in our study. A study in Lithuania reported no positive patch test reaction to any of the 5 Ti salts present in their metal series . However, only a relatively small number of patients were tested.…”

Common Allergies and Allergens in Oral and Perioral Diseases

“…Metal salts in dental alloys, for example, have weak interactions with skin proteins and form complexes that make strong allergens that initiate hypersensitivity reactions 14 . Allergic reactions to dental alloys that contain nickel, cobalt and dental amalgam are especially frequent since dentists use them for prosthetic and dental restorations 1,4,15 .…”

“…Although there are many scientific papers on this issue, their results are ambiguous. Various substances can cause both immediate (type I) and delayed (type IV) allergic reactions, of which type IV allergic reactions are more common 1,4,5 .…”

A Nonsteroidal Novel Formulation Targeting Inflammatory and Pruritus-Related Mediators Modulates Experimental Allergic Contact Dermatitis

“…Allergic contact dermatitis (ACD), on the other hand [ 7 ], represents 5–10% of consultations, including those related to irritation, and periodic treatment. Sensitizing allergens are diverse, can include metals such as nickel and gold, components of perfumes and soaps, or organic compounds, and once sensitized, the presence of the allergen will induce the characteristics of ACD [ 8 – 10 ]. Removal of the allergen results in loss of symptoms, but recovery can take weeks, during which treatment of symptoms is desirable [ 10 ].…”