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Metal Allergy: Other Metals

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Abstract

In the periodic system, metals represent up to 75% of the elements in the principal groups and all the elements in the accessory groups, the lanthanides and the actinides. Metallic elements are typically hard, shiny, and nontransparent and have a good electrical and thermal conductivity and a high density. Apart from the common sensitizing metals, nickel, cobalt, and chromium, there are many more commonly occurring metals present in the environment, in food, cosmetics, and drugs, to which humans can be exposed. Contact allergy to them has been rarely reported, most often from occupational exposure, and from medical implants and particularly dental alloys. Clinical manifestations include allergic contact dermatitis and stomatitis, but systemic contact dermatitis has also been observed. Although so-called metal test series with rarely sensitizing metals for patch testing exist, most of these metals have not been systematically evaluated regarding the compounds, the concentrations, and the vehicles that are used for patch testing. Therefore, a lack of standardization and validation is currently present. In this chapter, we give an overview of metal compounds, concentrations, and vehicles (if indicated) as reported in the literature. This information should, however, be used with caution. Because metals may have an irritant potential and some metals are even toxic to the human organism, it is mandatory that the utmost reservation be exercised with the testing of nonstandardized metal compounds. Finally, the reading, interpretation, and establishment of relevance require a careful analysis by experienced dermatologists.

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References

  1. Stieger P, Bircher AJ. Sensibilisation aux métaux rarement impliqués dans l'allergie de contact. In: Le Coz C, editor. Progrès en Dermato-Allergologie - Strasbourg 2010. Montrouge: John Libbey Eurotext Ltd.; 2010. p. 165–92.

    Google Scholar 

  2. Bircher AJ. Allergy and hypersensitivity to implant materials. In: Hirschmann MT, Becker R, editors. The unhappy total knee replacement. Cham: Springer International Publishing; 2015. p. 243–55.

    Chapter  Google Scholar 

  3. Flint GN. A metallurgical approach to metal contact dermatitis. Contact Dermatitis. 1998;39:213–21.

    Article  CAS  Google Scholar 

  4. Shallcross L, Ritchie S, Harberts E, Tammaro A, Gaitens J, Gaspari A. Manganese oxidation state as a cause of irritant patch test reactions. Dermatitis. 2014;25:66–71.

    Article  CAS  Google Scholar 

  5. Koch P. Metalle und Metallsalze. In: Fuchs T, Aberer W, editors. Kontaktekzem. München-Deisenhofen: Dustri-Verlag Dr. Karl Feistle; 2007. p. 481–516.

    Google Scholar 

  6. Cavelier J, Foussereau J. Kontaktallergien gegen Metalle und deren Salze. Derm Beruf Umwelt. 1995;43:202–9.

    Google Scholar 

  7. De Groot AC. Patch testing, test concentrations and vehicles for 4350 chemicals. Wapserveen: acdegroot publishing; 2008.

    Google Scholar 

  8. Nakayama H. New aspects of metal allergy. Acta Dermatovenerol Croat. 2002;10:207–19.

    PubMed  Google Scholar 

  9. Motolese A, Truzzi M, Giannini A, Seidenari S. Contact dermatitis and contact sensitization among enamellers and decorators in the ceramics industry. Contact Dermatitis. 1993;28:59–62.

    Article  CAS  Google Scholar 

  10. Rietschel RL, Fowler JF. Fishers contact dermatitis. Baltimore, MD: Williams and Wilkins; 1995.

    Google Scholar 

  11. Holmqvist I. Occupational arsenical dermatitis; a study among employees at a copper ore smelting work including investigations of skin reactions to contact with arsenic compounds. Acta Derm Venereol Suppl (Stockh). 1951;26:1–214.

    CAS  Google Scholar 

  12. Wahlberg JE, Boman A. Contact sensitivity to arsenical compounds. Clinical and experimental studies. Derm Beruf Umwelt. 1986;34:10–2.

    CAS  PubMed  Google Scholar 

  13. Mohamed KB. Occupational contact dermatitis from arsenic in a tin-smelting factory. Contact Dermatitis. 1998;38:224–5.

    Article  CAS  Google Scholar 

  14. Sainio EL, Jolanki R, Hakala E, Kanerva L. Metals and arsenic in eye shadows. Contact Dermatitis. 2000;41:5–10.

    Article  Google Scholar 

  15. Geier J, Vieluf D, Fuchs T. Patch testing with cadmium chloride. Contact Dermatitis. 1996;34:73–4.

    Article  CAS  Google Scholar 

  16. Hamann D, Thyssen JP, Hamann CR, Hamann C, Menné T, Johansen JD, Spiewak R, Maibach H, Lundgren L, Lidén C. Jewellery: alloy composition and release of nickel, cobalt and lead assessed with the EU synthetic sweat method. Contact Dermatitis. 2015;73:231–8.

    Article  CAS  Google Scholar 

  17. Nourmoradi H, Foroghi M, Farhadkhani M, Vahid Dastjerdi M. Assessment of lead and cadmium levels in frequently used cosmetic products in Iran. J Environ Public Health. 2013;2013:962727.

    Article  CAS  Google Scholar 

  18. Van Loon LA, Van Elsas PW, Van Joost T, Davidson CL. Test battery for metal allergy in dentistry. Contact Dermatitis. 1986;14:158–61.

    Article  Google Scholar 

  19. Cristani M, Santoro G, Cimino F, Pellegrino A, Galati P, Isola S, Saija A, Gangemi S. The importance of the patch test (as a preventive method) before an orthopaedic prosthesis implantation: a case report. Ital J Allergy Clin Immunol. 2007;17:124–5.

    Google Scholar 

  20. Commandeur C, Richard M, Renzi PM. Severe hypersensitivity reaction to injectable gallium 67 in a worker exposed to silica. Allergy. 1992;47:337–9.

    Article  CAS  Google Scholar 

  21. Komamura H, Kozuka T, Fumjimoto K, Hashimoto S, Kataoka Y, Tashiro M, Yoshikawa K. Patch testing with 20 metals in dental appliances. Skin Res. 1989;31:268–72.

    Google Scholar 

  22. Scherer K, Simon D, Ballmer-Weber B, Pelloni F, Plaza T, Von Schulthess A, Kohler E, Drzimalla K, Bircher AJ. Prevalence of contact sensitization to metals - first results of the SCDRG study. Contact Dermatitis. 2010;63:95.

    Google Scholar 

  23. Marcusson JA, Cederbrant K, Heilborn J. Indium and iridium allergy in patients exposed to dental alloys. Contact Dermatitis. 1998;38:297–8.

    Article  CAS  Google Scholar 

  24. Stingeni L, Brunelli L, Lisi P. Contact sensitivity to rhodium and iridium in consecutively patch tested subjects. Contact Dermatitis. 2004;51:316–7.

    Article  CAS  Google Scholar 

  25. Bergman A, Svedberg U, Nilsson E. Contact urticaria with anaphylactic reactions caused by occupational exposure to iridium salt. Contact Dermatitis. 1995;32:14–7.

    Article  CAS  Google Scholar 

  26. Morales Mateluna CA, Scherer Hofmeier K, Bircher AJ. Approach to hypersensitivity reactions from intravenous iron preparations. Allergy. 2017;72:827–30.

    Article  CAS  Google Scholar 

  27. Castelain M, Raison-Peyron N. Allergies "rares" aux métaux. In: Cleenewerk MB, Frimat P, editors. Progrès en Dermato-Allergologie - Lille 2004. Paris: John Libbey Eurotext; 2004. p. 357–72.

    Google Scholar 

  28. Haedicke H. Metallische Leiter. (1998) http://www.vienet.de/vienete/grundlagen/metall.htm.

  29. Thyssen JP, Menné T. Metal allergy - a review on exposures, penetration, genetics, prevalence, and clinical implications. Chem Res Toxicol. 2010;23:309–18.

    Article  CAS  Google Scholar 

  30. Baer RL. Allergic contact sensitization to iron. J Allergy Clin Immunol. 1973;51:35–8.

    Article  CAS  Google Scholar 

  31. Nater JP. Epidermale Überempfindlichkeit gegen Eisen. Hautarzt. 1960;11:223–4.

    CAS  PubMed  Google Scholar 

  32. Hemmer W, Focke M, Wantke F, Gotz M, Jarisch R. Contact hypersensitivity to iron. Contact Dermatitis. 1996;34:219–20.

    Article  CAS  Google Scholar 

  33. Saxena M, Warshaw E, Ahmed DD. Eyelid allergic contact dermatitis to black iron oxide. Am J Contact Dermat. 2001;12:38–9.

    CAS  PubMed  Google Scholar 

  34. Zugerman C. Contact dermatitis to yellow iron oxide. Contact Dermatitis. 1985;13:107–9.

    Article  CAS  Google Scholar 

  35. Gustafson K, Jakobsen S, Lorenzen N, Thyssen J, Johansen J, Bonefeld C, Stilling M, Baad Hansen T, Søballe K. Metal release and metal allergy after total hip replacement with resurfacing versus conventional hybrid prosthesis. Acta Orthop. 2014;85:348–54.

    Article  Google Scholar 

  36. Greiner J, Diezel W. [Inflammation-inhibiting effect of magnesium ions in contact eczema reactions]/Entzündungshemmende Wirkung von magnesium-Ionen bei der Kontaktekzem-Reaktion. Hautarzt. 1990;41:602–5.

    CAS  PubMed  Google Scholar 

  37. Witte F, Abeln I, Switzer E, Kaese V, Meyer Lindenberg A, Windhagen H. Evaluation of the skin sensitizing potential of biodegradable magnesium alloys. J Biomed Mater Res A. 2008;86:1041–7.

    Article  Google Scholar 

  38. Blumenthal G, Linke D, Vieth S. Die 1. Reihe der Übergangselemente Titan Ti, Vanadium V, Chrom Cr, Mangan Mn, Eisen FE, Cobalt Co, Nickel Ni. In:Chemie - Grundwissen für Ingenieure. Wiesbaden: Vieweg+Teubner Verlag/Springer Fachmedien Wiesbaden GmbH; 2006a. p. 319–33.

    Google Scholar 

  39. Blumenthal G, Linke D, Vieth S. Die 2. und 3. Reihe der Übergangselemente Zirconium Zr, Hafnium Hf, Niobium Nb, Tantal Ta, Molybdän Mo, Wolfram W, Technetium Tc, Rhenium Re. In:Chemie - Grundwissen für Ingenieure. Wiesbaden: Vieweg+Teubner Verlag/Springer Fachmedien Wiesbaden GmbH; 2006b. p. 335–40.

    Google Scholar 

  40. Köster R, Vieluf D, Kiehn M, Sommerauer M, Kähler J, Baldus S, Meinertz T, Hamm CW. Nickel and molybdenum contact allergies in patients with coronary in-stent restenosis. Lancet. 2000;356:1895–7.

    Article  Google Scholar 

  41. Leis Dosil VM, Cabeza Martinez R, Suarez Fernandez RM, Lazaro Ochaita P. Allergic contact dermatitis due to manganese in an aluminium alloy. Contact Dermatitis. 2006;54:67–8.

    Article  Google Scholar 

  42. Ortiz Ruiz A, Ramírez Espinosa M, López Jornet P. Oral lichen planus and sensitization to manganese in a dental prosthesis. Contact Dermatitis. 2006;54:214–5.

    Article  Google Scholar 

  43. Velásquez D, Zamberk P, Suárez R, Lázaro P. Allergic contact dermatitis to manganese in a prosthodontist with orthodontics. Allergol Immunopathol (Madr). 2010;38:47–8.

    Article  Google Scholar 

  44. Watchmaker J, Collins R, Chaney K. Allergic contact dermatitis to manganese in metallic implant. Dermatitis. 2015;26:149–50.

    Article  Google Scholar 

  45. Eben R, Walk R, Summer B, Maier S, Thomsen M, Thomas P. Implantatallergieregister - ein erster Erfahrungsbericht. Orthopäde. 2009;38:557–62.

    Article  CAS  Google Scholar 

  46. Zabala R, Aguirre A, Eizaguirre X, Diaz Pérez JL. Contact dermatitis from potassium chloride. Contact Dermatitis. 1993;29:218–9.

    Article  CAS  Google Scholar 

  47. Goossens A, Cattaert N, Nemery B, Boey L, De Graef E. Occupational allergic contact dermatitis caused by rhodium solutions. Contact Dermatitis. 2011;64:158–61.

    Article  Google Scholar 

  48. De La Cuadra J, Grau Massanés M. Occupational contact dermatitis from rhodium and cobalt. Contact Dermatitis. 1991;25:182–4.

    Article  Google Scholar 

  49. De La Fuente EG, Alvarez JG, Vicente FJ, Sols M, Naz E, Lopez Estebaranz JL. Occupational contact dermatitis caused by rhodium. Am J Contact Dermat. 2003;14:172–3.

    PubMed  Google Scholar 

  50. Santucci B, Valenzano C, De Rocco M, Cristaudo A. Platinum in the environment: frequency of reactions to platinum-group elements in patients with dermatitis and urticaria. Contact Dermatitis. 2000;43:333–8.

    Article  CAS  Google Scholar 

  51. Cameli N, Bardazzi F, Morelli R, Tosti A. Contact dermatitis from rubidium iodide in eyedrops. Contact Dermatitis. 1990;23:377–8.

    Article  CAS  Google Scholar 

  52. Richter G, Heidelbach U, Heidenbluth I. [Allergic contact eczemas caused by selenite]/Allergische Kontaktekzeme durch Selenit. Derm Beruf Umwelt. 1987;35:162–4.

    CAS  PubMed  Google Scholar 

  53. Senff H, Kuhlwein A, Bothe C, Hausen BM, Tillack J. Allergic contact dermatitis from selenite. Contact Dermatitis. 1988;19:73–4.

    Article  CAS  Google Scholar 

  54. Mitchell DM, Ganpule MT, Beck MH. Contact sensitivity to silicic acid in Unguentum Merck. Contact Dermatitis. 1987;16:178.

    Article  CAS  Google Scholar 

  55. Beyer DJ, Belsito DV. Delayed hypersensitivity to silicon causing gingival hyperplasia. Contact Dermatitis. 1997;37:234.

    Article  CAS  Google Scholar 

  56. Puri S, Dornhoffer JL, North PE. Contact dermatitis to silicone after Cochlear implantation. Laryngoscope. 2005;115:1760–2.

    Article  Google Scholar 

  57. Oprea ML, Schnöring H, Sachweh JS, Ott H, Biertz J, Vazquez-Jimenez JF. Allergy to pacemaker silicone compounds: recognition and surgical management. Ann Thorac Surg. 2009;87:1275–7.

    Article  Google Scholar 

  58. Tanaka T, Miyachi Y, Horio T. Ulcerative contact dermatitis caused by sodium silicate. Coexistence of primary irritant contact dermatitis and contact urticaria. Arch Dermatol. 1982;118:518–20.

    Article  CAS  Google Scholar 

  59. Sterling JP. Silver-resistance, allergy, and blue skin: truth or urban legend? Burns. 2014;40(Suppl 1):S19–23.

    Article  Google Scholar 

  60. White IR, Rycroft RJG. Contact dermatitis from silver fulminate – fulminate itch. Contact Dermatitis. 1982;8:159–63.

    Article  CAS  Google Scholar 

  61. Group A, Lea A. Contact dermatitis with a highlight on silver: a review. Wounds. 2010;22:311–5.

    PubMed  Google Scholar 

  62. Ozkaya E. A rare case of allergic contact dermatitis from silver nitrate in a widely used special patch test marker. Contact Dermatitis. 2009;61:120–2.

    Article  Google Scholar 

  63. García AA, Rodríguez Martín AM, Serra Baldrich E, Manubens Mercade E, Puig Sanz L. Allergic contact dermatitis to silver in a patient treated with silver sulphadiazine after a burn. J Eur Acad Dermatol Venereol. 2016;30:365–6.

    Article  Google Scholar 

  64. Jankićević J, Vesić S, Vukićević J, Gajić M, Adamič M, Pavlović MD. Contact sensitivity in patients with venous leg ulcers in Serbia: comparison with contact dermatitis patients and relationship to ulcer duration. Contact Dermatitis. 2008;58:32–6.

    PubMed  Google Scholar 

  65. Agarwal S, Gawkrodger D. Occupational allergic contact dermatitis to silver and colophonium in a jeweler. Am J Contact Dermat. 2002;13:74.

    PubMed  Google Scholar 

  66. Catsakis LH, Sulica VI. Allergy to silver amalgams. Oral Surg Oral Med Oral Pathol. 1978;46:371–5.

    Article  CAS  Google Scholar 

  67. Menné T, Andersen KE, Kaaber K, Osmundsen PE, Andersen JR, Yding F, Valeur G. Tin: an overlooked contact sensitizer? Contact Dermatitis. 1987;16:9–10.

    Article  Google Scholar 

  68. Shimizu T, Kobayashi S, Tanaka M. Systemic contact dermatitis to zinc in dental fillings. Clin Exp Dermatol. 2003;28:675–6.

    Article  CAS  Google Scholar 

  69. Rystedt I, Fischer T, Lagerholm B. Patch testing with sodium tungstate. Contact Dermatitis. 1983;9:69–73.

    Article  CAS  Google Scholar 

  70. Miyamoto T, Inoue S, Watanabe T. A case of immediate hypersensitivity reaction with tungsten. Allergy. 2005;60:415–6.

    Article  CAS  Google Scholar 

  71. Shvartsbeyn M, Tuchinda P, Gaitens J, Squibb K, Mcdiarmid M, Gaspari A. Patch testing with uranyl acetate in veterans exposed to depleted uranium during the 1991 gulf war and the Iraqi conflict. Dermatitis. 2011;22:33–9.

    PubMed  Google Scholar 

  72. Krecisz B, Kieć Swierczyńska M, Bakowicz Mitura K. Allergy to metals as a cause of orthopedic implant failure. Int J Occup Med Environ Health. 2006;19:178–80.

    Article  Google Scholar 

  73. Yanagi T, Shimizu T, Abe R, Shimizu H. Zinc dental fillings and palmoplantar pustulosis. Lancet. 2005;366:1050.

    Article  Google Scholar 

  74. Ido T, Kumakiri M, Kiyohara T, Sawai T, Hasegawa Y. Oral lichen planus due to zinc in dental restorations. Contact Dermatitis. 2002;47:51. Discussion 51

    Article  Google Scholar 

  75. Sakai T, Hatano Y, Fujiwara S. Systemic contact dermatitis due to zinc successfully treated with a zinc-restricted diet: a case report. Allergol Int. 2013;62:265–7.

    Article  Google Scholar 

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Bircher, A.J. (2018). Metal Allergy: Other Metals. In: Chen, J., Thyssen, J. (eds) Metal Allergy. Springer, Cham. https://doi.org/10.1007/978-3-319-58503-1_35

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  • DOI: https://doi.org/10.1007/978-3-319-58503-1_35

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