Screening for gold sensitization in consecutive eczema patients: Prevalence, relevance, and sources of exposure

Background Since the 1990s, gold has been recognized as an important contact allergen. Objectives Based on our results with gold sodium thiosulfate (GST) in the TRUE Test patch test system in the baseline series, the aims of the study were to evaluate baseline testing with gold salts worldwide and to discuss relevance. Methods Patients with positive patch test reactions to GST were questioned on exposure at day 7 reading. Results In a 1-year period, 89 (18.5%) of 480 patients tested positive to GST, making this the most frequent contact allergy. The 89 patients comprised 18 males and 71 females. The reaction was considered relevant in 21%; this is a minimum figure because 2 patients were withdrawn because of unknown relevance and because clinical features suggestive of gold contact allergy at distant sites, such as the face, were not taken into account. Altogether, 88% had been exposed. Worldwide, the prevalence of gold sensitization ranges between 0.78% and 30.7%, and relevance, in larger studies, has been between 15% and 20% of patients. The use of earrings and the presence of dental gold were important sources of exposure. Conclusions Because it may be difficult to diagnose gold allergy, screening may be recommended when history taken suggests gold exposure.