Contact dermatitis to metals is still frequent in both Europe and North America and in other parts of the world. Most frequent is allergy to nickel, with prevalence numbers up to 17–25 % in dermatitis patients. Nickel allergy is predominantly affecting women. Chromium allergy is still common among construction and tannery workers, although it seems to be increasing in the general population among women. Cobalt allergy is still very prominent among hard metal workers and is also seen in the general population. Palladium allergy is closely related to nickel allergy due to cross-reactivity, and therefore it is difficult to evaluate the prevalence of solitary palladium allergy. In this chapter a brief description about metal sources and exposures is given. It focuses on new knowledge about surface composition, skin doses of metal and a quick guide to test the patients. The chapter also briefly gives some suggestion of what to tell the patients, and how to use spot tests and screening tools, for identifying nickel and cobalt in everyday items that patients handle at work or during their free time.
KeywordsContact allergy Metals Skin dose Surface area Nickel Cobalt Chromium Palladium Sources of exposure
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