A 10-year Retrospective Study on Palladium Sensitivity

Olayemi Durosaro; Rokea A. el-Azhary

Disclosures

Dermatitis. 2009;20(4):208-213. 

In This Article

Materials and Methods

This retrospective study was approved by the Mayo Clinic Institutional Review Board. Patients who underwent patch testing for suspected allergic contact dermatitis at Mayo Clinic from October 1, 1997, to December 31, 2006, were identified from an existing clinical database.

Patch testing was conducted in a standardized fashion using the same methods as previously described by our group.[11,12] Testing was performed with Finn Chambers (Epitest Ltd Oy, Tuusula, Finland) on Scanpor tape (Norgesplaster Aksjeselskap, Vennesla, Norway); patches were applied to the upper backs of patients and removed after 48 hours. Most allergens, including palladium in petrolatum, were purchased from Chemotechnique Diagnostics AB (Vellinge, Sweden). The other allergens were compounded by the Mayo Clinic pharmacy. Reactions were evaluated initially at 48 to 72 hours and again at 96 to 168 hours after application of the patch. Final patch-test reading, interpretation of results, and assessment of relevancy were performed by the ordering physician.

Patch-test reactions were interpreted with the following criteria: negative reaction, macular erythema or weak reaction (nonvesicular erythema, infiltration, and possibly papules), strong reaction (edematous or vesicular), and extreme reaction (spreading, bullous, ulcerative lesions). A positive allergic patch-test result was defined as a weak, strong, or extreme reaction at the last reading or as a macular erythema reaction if the result was relevant after irritant reactions had been excluded.

A total of 910 patients were identified who were patch-tested with palladium chloride 2% in petrolatum as part of the stomatitis, oral complete, or metal series. The medical records of these patients were reviewed individually to determine the patient's skin manifestation and dermatologic diagnosis at the time of the patch testing.

The associations between patient characteristics and palladium sensitivity (ie, yes or no) were assessed with the two-sided chi-square test and summarized through calculating odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Analyses were performed with the Statistical Analysis System software package, version 9 (SAS Institute Inc., Cary, NC).

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