Garner Lisa A
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA.
Dermatol Ther. 2004;17(4):321-7. doi: 10.1111/j.1396-0296.2004.04034.x.
Metals are in close contact with skin and mucous membranes on a repeated, if not constant, basis. Nickel and mercury, well-recognized causes of contact dermatitis; gold and palladium, recently gaining acceptance as patch test allergens on standard screening trays; and cobalt are reviewed in this article. Sensitization to nickel, the most frequently identified allergen on patch testing, is associated with ear piercing. Contact with this potential allergen is ubiquitous. Mercury may be encountered as organic mercury in thimerosal, used as an antiseptic and a preservative in topical medications and vaccines, and metallic mercury found in dental amalgam and thermometers. Both forms may cause contact dermatitis. Gold, recognized as a frequent sensitizer, has been implicated in some cases of eyelid, patchy diffuse and oral lichenoid dermatitis. Cobalt allergy, found frequently in patients who are nickel allergic, also has been associated with ear piercing. Palladium sensitivity is often associated with nickel allergy. However, the incidence of clinical relevance is yet to be established.
金属会反复（即便不是持续不断地）与皮肤和黏膜密切接触。镍和汞是公认的接触性皮炎病因；金和钯最近在标准筛查托盘上作为斑贴试验变应原逐渐被认可；本文将对钴进行综述。对镍致敏是斑贴试验中最常发现的变应原，与穿耳洞有关。接触这种潜在变应原的情况很普遍。汞可能以硫柳汞中的有机汞形式存在，硫柳汞在局部用药和疫苗中用作防腐剂，汞还以金属汞的形式存在于牙科汞合金和温度计中。这两种形式都可能引起接触性皮炎。金被认为是一种常见的致敏原，在一些眼睑、斑片状弥漫性和口腔苔藓样皮炎病例中与之有关。钴过敏在对镍过敏的患者中经常发现，也与穿耳洞有关。钯敏感性通常与镍过敏有关。然而，其临床相关性的发生率尚未确定。
