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Hypersensitivity reactions to metallic implants-diagnostic algorithm and suggested patch test series for clinical use.

Schalock, Peter C; Menné, Torkil; Johansen, Jeanne D; Taylor, James S; Maibach, Howard I; Lidén, Carola; Bruze, Magnus LU and Thyssen, Jacob P (2012) In Contact Dermatitis 66(1). p.4-19
Abstract
Cutaneous and systemic hypersensitivity reactions to implanted metals are challenging to evaluate and treat. Although they are uncommon, they do exist, and require appropriate and complete evaluation. This review summarizes the evidence regarding evaluation tools, especially patch and lymphocyte transformation tests, for hypersensitivity reactions to implanted metal devices. Patch test evaluation is the gold standard for metal hypersensitivity, although the results may be subjective. Regarding pre-implant testing, those patients with a reported history of metal dermatitis should be evaluated by patch testing. Those without a history of dermatitis should not be tested unless considerable concern exists. Regarding post-implant testing, a... (More)
Cutaneous and systemic hypersensitivity reactions to implanted metals are challenging to evaluate and treat. Although they are uncommon, they do exist, and require appropriate and complete evaluation. This review summarizes the evidence regarding evaluation tools, especially patch and lymphocyte transformation tests, for hypersensitivity reactions to implanted metal devices. Patch test evaluation is the gold standard for metal hypersensitivity, although the results may be subjective. Regarding pre-implant testing, those patients with a reported history of metal dermatitis should be evaluated by patch testing. Those without a history of dermatitis should not be tested unless considerable concern exists. Regarding post-implant testing, a subset of patients with metal hypersensitivity may develop cutaneous or systemic reactions to implanted metals following implant. For symptomatic patients, a diagnostic algorithm to guide the selection of screening allergen series for patch testing is provided. At a minimum, an extended baseline screening series and metal screening is necessary. Static and dynamic orthopaedic implants, intravascular stent devices, implanted defibrillators and dental and gynaecological devices are considered. Basic management suggestions are provided. Our goal is to provide a comprehensive reference for use by those evaluating suspected cutaneous and systemic metal hypersensitivity reactions. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Contact Dermatitis
volume
66
issue
1
pages
4 - 19
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • wos:000297926500002
  • pmid:21957996
  • scopus:83455258023
ISSN
0105-1873
DOI
10.1111/j.1600-0536.2011.01971.x
language
English
LU publication?
yes
id
64d7e2ed-c438-474e-b458-d81e9740af61 (old id 2200986)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21957996?dopt=Abstract
date added to LUP
2011-11-01 16:44:48
date last changed
2017-10-22 03:18:33
@article{64d7e2ed-c438-474e-b458-d81e9740af61,
  abstract     = {Cutaneous and systemic hypersensitivity reactions to implanted metals are challenging to evaluate and treat. Although they are uncommon, they do exist, and require appropriate and complete evaluation. This review summarizes the evidence regarding evaluation tools, especially patch and lymphocyte transformation tests, for hypersensitivity reactions to implanted metal devices. Patch test evaluation is the gold standard for metal hypersensitivity, although the results may be subjective. Regarding pre-implant testing, those patients with a reported history of metal dermatitis should be evaluated by patch testing. Those without a history of dermatitis should not be tested unless considerable concern exists. Regarding post-implant testing, a subset of patients with metal hypersensitivity may develop cutaneous or systemic reactions to implanted metals following implant. For symptomatic patients, a diagnostic algorithm to guide the selection of screening allergen series for patch testing is provided. At a minimum, an extended baseline screening series and metal screening is necessary. Static and dynamic orthopaedic implants, intravascular stent devices, implanted defibrillators and dental and gynaecological devices are considered. Basic management suggestions are provided. Our goal is to provide a comprehensive reference for use by those evaluating suspected cutaneous and systemic metal hypersensitivity reactions.},
  author       = {Schalock, Peter C and Menné, Torkil and Johansen, Jeanne D and Taylor, James S and Maibach, Howard I and Lidén, Carola and Bruze, Magnus and Thyssen, Jacob P},
  issn         = {0105-1873},
  language     = {eng},
  number       = {1},
  pages        = {4--19},
  publisher    = {Federation of European Neuroscience Societies and Blackwell Publishing Ltd},
  series       = {Contact Dermatitis},
  title        = {Hypersensitivity reactions to metallic implants-diagnostic algorithm and suggested patch test series for clinical use.},
  url          = {http://dx.doi.org/10.1111/j.1600-0536.2011.01971.x},
  volume       = {66},
  year         = {2012},
}