What is Gold Allergy?
Gold Allergy: Metallic gold is known for its electrochemical nobility and consequent lack of reactivity. For this reason, it is generally considered to be a non-allergenic metal.
Therefore, gold-related contact dermatitis is rare and difficult to prove. Kligman was the first to discover that gold chloride can cause sensitization.
Fowler then began using 0.5% w/w gold sodium thiosulfate (GSTS) in petroleum jelly as a test preparation to determine the presence of a gold contact allergy. Currently, varying concentrations of GSTS are used in petrolatum.
Gold Allergy symptoms
Patients allergic to gold often present with contact dermatitis, contact stomatitis, or oral lichen planus.
Skin manifestations such as a papular itchy rash are most commonly found on the ears, eyelids or around the eyes, fingers, and neck.
Reactions in remote areas away from contact are also possible. Gold allergy is more common in women.
It was found that one in ten patients with eczema had a positive reaction when standard patch tests included the gold patch test (as GSTS). Therefore, gold is a potent sensitizer, second only to nickel sulfate.
Gold-filled dental patients or people with a gold allergy show a higher-than-normal incidence of allergies, meaning that gold in fillings may be the primary cause of gold allergy.
At the same time, patients with a contact allergy to gold have a higher chance of sensitivity to nickel and cobalt, as well as to other monovalent gold salts such as gold sodium thiomalate.
Diagnosis and treatment
The presence of a gold contact allergy is confirmed by a positive patch test to GSTS, which consists of a persistent papular reaction.
The test reaction can often persist for months after patch application. Patch size should be measured at 3 days, 1 week or even 3 weeks because many reactions take longer than expected to occur when using patch testing.
However, with the intracutaneous test, all reactions occur within the first week and dermal nodules are often formed.
Percutaneous absorption of ionized gold is necessary for positive reaction formation.
An in vitro test for gold allergy looks for the appearance of blast transformation caused by gold salts.
Treatment of gold allergy includes the use of topical emollients and corticosteroids to suppress local allergic manifestations, as well as treating any secondary bacterial infections.
Exposure to gold salts should be minimized to prevent future allergic reactions.