metal allergy

What is Metal Allergy?

Metal allergy, also known as metal hypersensitivity or contact dermatitis, is a condition in which the skin reacts to certain metals, such as nickel, cobalt, and chromium. This reaction can cause an itchy rash, blisters, and other symptoms on the skin.

• Causes: Metal allergy occurs when the body's immune system reacts to the metal as if it were a harmful substance [1]. This reaction can happen after exposure to metals through contact with jewelry, clothing, cosmetics, or medical devices [2].
• Symptoms: The symptoms of metal allergy can range from mild to severe and may include:
  • Red skin
  • Itching or burning sensations
  • Blisters
  • Cracked skin
  • Dry patches of skin
  • Swelling of the skin
  • Joint pain, swelling, and joint discoloration (in some cases) [3]
• Treatment: The first step in treating metal

Common Signs and Symptoms of Metal Allergy

Metal allergy can manifest in various ways, depending on the individual and the specific metal they are allergic to. Here are some common signs and symptoms:

• Skin Reactions: Redness, itching, swelling, blisters, cracked skin, and eczematous reactions are common symptoms of metal allergy.
• Rashes and Discoloration: Skin rash, itching, and discoloration can occur in the area where the metal comes into contact with the skin.
• Joint Pain and Swelling: In some cases, metal allergy can cause joint pain, swelling, and inflammation, particularly around artificial joints.
• Hair Loss: Hair loss has been reported as a symptom of metal allergy in some individuals.

These symptoms can range from mild to severe and may be triggered by exposure to specific metals, such as nickel, which is one of the most common metals that people are allergic to [7][8].

References:

[1] Symptoms include: rashes, redness, swelling and pain. [2] The symptoms of nickel allergy can be mild, or severe enough to be disabling. They include red skin, itching or burning sensations, blisters, cracked skin and... [3] Common symptoms of metal allergy include. Eczema; Dermatitis; Psoriasis; Itchy skin; Hair loss. [4] The symptoms may include skin rash, itching and discoloration in the area around the artificial joint. [5] It can produce a variety of symptoms, including rashes, swelling, or pain due to contact with certain metals (see the symptoms and complications section, below) [6] Metal allergies can trigger uncomfortable symptoms where your skin touches certain substances, leading to skin blistering, swelling, itching, or a rash.

Metal Allergy Diagnostic Tests

There are several diagnostic tests available to determine if someone has a metal allergy. These tests can help identify which metals trigger an allergic reaction and confirm the presence of a metal allergy.

• Patch Test: A patch test is a common method used to diagnose metal allergies. It involves applying small amounts of potential allergens (including nickel) to the skin, covered with small patches. The patches remain on the skin for two days before being removed by a doctor [4][7]. This test can help identify which metals cause an allergic reaction.
• Lymphocyte Transformation Test (LTT): LTT is a blood test that measures immune cell responses to different metals. It can identify which people are susceptible to metal allergies and which metals trigger an allergic reaction [3][11].
• MELISA Blood Test: MELISA is a blood test used to aid in the diagnosis of metal allergies. It tests for immune cell responses to various metals, including nickel, chromium, and cobalt [2].
• Nickel Lymphocyte Proliferation Test (NiLPT): NiLPT is a simple blood test that measures the proliferation of lymphocytes (white blood cells) when presented with a challenge agent. It can diagnose nickel allergy if patch testing is unavailable [5].
• Metal Hypersensitivity Testing: This blood test tests immune cell responses to different metals and can identify which people may be more susceptible to metal allergies [8][13].

These diagnostic tests are essential in identifying metal allergies, especially for individuals who have undergone joint replacement surgery or have a history of metal-related health issues. It's crucial to consult with an allergist or immunologist to determine the best course of action and testing method.

References: [1] - Not provided [2] - Context 2 [3] - Context 3 [4] - Context 4 [5] - Context 5 [7] - Context 7 [8] - Context 8 [11] - Context 11 [13] - Context 13

Treatment Options for Metal Allergy

Metal allergy, also known as contact dermatitis, can be treated with various medications to reduce symptoms and improve skin condition.

• Topical corticosteroids: These creams or ointments are commonly prescribed to decrease inflammation and itching. Examples include clobetasol (Clobex, Cormax) and betamethasone dipropionate (Diprolene) [1].
• Nonsteroidal creams: These creams can also be used to reduce inflammation and itching [2].
• Oral corticosteroids: In some cases, oral steroids like prednisone may be prescribed in a single morning dose of 40-60 mg for 2-3 weeks, as symptoms resolve [5].
• Antihistamines: These medications can help relieve itching and reduce the allergic response.
• Immunotherapy: This treatment method aims to desensitize the body to the metal allergen.

Prescription Medications

Your doctor may prescribe one of the following medications to treat metal allergy:

• Corticosteroid cream
• Nonsteroidal cream
• Oral corticosteroid (e.g., prednisone)
• Oral antihistamine

In severe cases, a prescription steroid cream or oral steroids may be necessary to manage symptoms [7].

Alternative Treatments

Some alternative treatments have shown promise in treating metal allergy infections, such as Teracyte, which can improve wound condition within 24 hours of application and reduce surrounding skin inflammation [8].

The differential diagnosis of metal allergy involves considering various conditions that may present similarly to metal allergy, in order to rule out other potential causes of symptoms.

According to [3], the diagnosis of implant-induced reactions can only be made if they are considered in the differential diagnosis of an adverse reaction occurring in a patient with a medical device. This highlights the importance of considering multiple possible explanations for symptoms when diagnosing metal allergy.

Some conditions that may be considered in the differential diagnosis of metal allergy include:

• Eczema, impaired wound and fracture healing, infection-mimicking reactions [1]
• Local or systemic allergic dermatitis, such as eczema, urticaria, bullous eruption, erythema multiforme, and others [6]

To accurately diagnose metal allergy, a healthcare professional may consider the patient's clinical history, as well as special allergy tests, patch tests [9]. The diagnostic tool most commonly used to confirm or rule out a metal allergy is the patch test [10].

It's worth noting that differentiating between joint failure due to infection versus joint failure due to metal sensitization can be challenging, and several articles have attempted to address this issue [5].

In summary, the differential diagnosis of metal allergy involves considering multiple possible explanations for symptoms, including other conditions that may present similarly. A thorough clinical history and special allergy tests are essential in making an accurate diagnosis.

References: [1] P Thomas (2014) [3] IP Warmuth (1997) [5] KA Pacheco (2015) [6] W Bao (2018) [9] Nickel allergy [10] J Wawrzynski (2017)