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Keywords:

  • allergic contact dermatitis;
  • gold chloride;
  • mercuric chloride;
  • metal;
  • nickel sulfate;
  • patch test

Abstract

Although metals are common contact allergens, clinical findings of metal contact dermatitis have varied. Such patients have subsequently become rare in Japan as gold dermatitis caused by ear piercing or baboon syndrome by broken thermometers. To evaluate such clinical findings and to determine the frequency of metal allergy, we analyzed the results of patch testing with 18 metals from 1990–2009. Nine hundred and thirty-one patients (189 men and 742 women, mean age 39.0 years [standard deviation ± 17.8]) were tested. Metals were applied on the back for 2 days, and the results read with the International Contact Dermatitis Research Group (ICDRG) scoring system 3 days after application. Reactions of + to +++ were regarded as positive. Differences of positive rates between men and women, and patients from 1990–1999 and those from 2000–2009 were analyzed with the χ2-test. Differences were considered significant at < 0.05. The metal to which the most patients reacted was 5% nickel sulfate (27.2%), irrespective of sex and phase. Significantly more women reacted to nickel sulfate (< 0.01), mercuric chloride (< 0.05) and gold chloride (< 0.01) than men. Significantly more patients in the 1990s reacted to palladium chloride, mercuric chloride and gold chloride (all < 0.01) than from 2000–2009. Nickel has been the most common metal allergen and mercury-sensitivity has decreased over 19 years in Japan.