Patch Testing With a Large Series of Metal Allergens

Findings From More Than 1,000 Patients in One Decade at Mayo Clinic

Mark D.P. Davis; Michael Z. Wang; James A. Yiannias; James H. Keeling; Suzanne M. Connolly; Donna M. Richardson; Sara A. Farmer


Dermatitis. 2011;22(05):256-271. 

In This Article


Allergic patch-test reactions to metals may be more prevalent than previously suspected. Although many metals known to be associated with dermatitis are already in the standard allergen series, other important metals still are not included. A specialized series of metals was a useful adjunct to the standard allergen series for the detection of metal allergies. The metal series has evolved over time to include multiple metals in different salts and concentrations. Patients may react to one concentration of a metal and not to another; similarly, patients may react to one preparation of a metal and not to another.

Numerous factors contribute to the difficulty of interpreting patch-test reactions to metals; thus, many questions regarding metal allergy remain unanswered. These questions will be the subject of future studies. Nevertheless, the reaction rates presented here may be a useful reference for those planning to perform patch tests with metals or for those postulating that a metal may be important in causing allergy.


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