This volume opens by providing a comprehensive overview of the use and regulation of metals in our society, metal properties, and available testing methodologies. Common and uncommon metal allergens and sources of exposure are then reviewed in depth, detailing allergic responses and paying special consideration to select patient populations. In the general population, the prevalence of metal allergy is high. Environmental sources of metal exposure include jewelry, clothing, electronic devices, coins, leather, diet, and occupational exposure. Metal allergy may result in allergic contact dermatitis and systemic contact dermatitis, as well as several less common manifestations. Further, metal allergy has been associated with device failure and/or dermatitis following implantation of medical devices and dental implants. As metals are ubiquitous, this book will be indispensable for a wide range of clinicians and investigators. This handy reference will meet the needs of all health professionals and investigators who are interested in metal allergy and its diagnosis and management.
Preface.- I Metal: Overview.- 1 Use of metals in our society.- 2 Methods to detect metal composition: XRF, SEM, ICP-MS.- 3 Metal corrosion.- 4 EN1811.- 5 EN ISO 17075.- 6 Regulation of metal exposure to prevent allergy.- II Metals, skin and the immune system.- 7 Deposition of metals on the skin and spot tests.- 8 Penetration of metals through the skin barrier.- 9 Innate immune system response: Toll-like receptors.- 10 Acquired immunity: T cell response.- 11 Tolerance development.- 12 Metal patch testing.-13 Lymphocyte proliferation assays.- III Allergens.- 14 Aluminum.- 15 Berylium.- 16 Chromium.- 17 Cobalt.- 18 Copper.- 19 Gold.- 20 Nickel.- 21 Palladium.- 22 Titanium.- 23 Other metals: iron, platinum, tin, zinc.- IV Common Sources of Metal Exposure.- 24 Metals in every day devices.- 25 Metals in tools and the workplace.- 26 Metals in cosmetics.- 27 Metals in coins.- 28 Metals in the diet.- V Hypersensitivity to Metallic Implants.- 29 Orthopedic Metal Implants.- 30 Cardiovascular Metal Implants.- 31 Dental Metal Implants.- 32 Other Metal Implants: Gynecological, Neurovascular.- 33 Diagnostic work-up of patients with metal implant failure.- VI Metal Allergy in Select Patient Populations.- 34 Metal allergy in children.- 35 Metal allergy in atopic dermatitis.- 36 Metal allergy in Asia.- VII Uncommon Manifestations of Metal Allergy.- 37 Metal allergy in asthma.- 38 Metal allergy in palmoplantar pustulosis.- 39 Metal allergy in endometriosis.- 40 Systemic Nickel Allergy Syndrome.- Future research areas.- Subject Index.