An allergic sensitivity to gold earrings produced a lymphadenoid reaction with germinal centers in the dermis of the pierced earlobes of a 21-year-old woman, However, a patch test for 1% gold sodium thiomalate gave a long-lasting, clinically and histologically eczematous response. Electron microscopic and cytochemical observations showed that non-T lymphocytes and plasma cells were dominant in the dermal infiltrate of the lesions, whereas lymphocytes with convoluted nuclei (which were probably T cells) and monocytes invaded the epidermis in the patch test site. These findings suggest that continuous exposure of the dermis to gold in a sensitized person may induce a lymphadenoid cellular reaction different from the histologic findings seen after contact with the epidermis.