Electron‐beam treatment of allergic granuloma due to gold pierced earrings

Abstract

A 35-year-old man had a medical history of atopic disease, with rhinitis, asthma and flexural dermatitis since childhood. He had worked as a carpenter since he was 18 years old. After 1 year in this work, he reported more severe relapsing episodes of asthma, rhinitis, conjunctivitis and widespread dermatitis but not urticarial lesions. He improved only on weekends and holidays. Every time he returned to work, he experienced a worsening of symptoms and these were so severe that he occasionally required systemic corticosteroids.

Allergic contact granuloma due to palladium following ear piercing

“…The granulomas were very resistant to repeated intralesional injections with corticosteroids. In the literature, electron beam therapy (4) has been proposed using a dose of 20 Gy. However, this was considered dangerous by the radiotherapist; indeed, at this rather low dose, a delayed sarcomatous degeneration can, indeed, not be excluded.…”

“…The first case of a sarcoidal‐type allergic contact granuloma was published in 1983 (1) and concerned gold in earrings, which was also reported later on (2–4). However, several other metals and their salts have caused allergic granulomatous reactions and concerned varying exposition sources (see Jappe et al (5) and Casper et al (6) for review): beryllium in mining, fluorescent tube production, and beryllium alloy production (7); aluminium as adjuvant in vaccines and hyposensitization extracts, and in antiperspirants and tattoos (also for cosmetic purposes) (8, 9); zirconium in antiperspirants; mercury, chromium, and cobalt as pigments in tattoos and also in orofacial granulomatosis; and titanium in pacemakers (10).…”

Gold und seine anorganischen Verbindungen [MAK Value Documentation in German language, 2006]

“…Wahrscheinliche Ursachen einer nicht-beruflich erworbenen Sensibilisierung waren der Kontakt mit Goldschmuck (Collet et al 1994;Comaish 1969;Cronin 1980;Fowler 1987;Rytter und Schubert 1971;Wiesner und Pambor 1998), vergoldeten Brillengestellen (Guin 1999) oder einer vergoldeten Hörhilfe (O'Donoghue et al 2004). Relativ häufig war die Exposition gegen Ohrringe aus Gold oder aus Goldlegierungen verantwortlich (Aoshima und Oguchi 1988;Armstrong et al 1997;Iwatsuki et al 1987;Kobayashi et al 1992;Koga et al 1993 a, b;Nagashima et al 2004;Osawa et al 1994;Park et al 1999), die in mehreren Fällen zu nodulären, granulomatösen oder lymphomatoiden Hautveränderungen an den Ohrläppchen führte. Bei einer Patientin mit Kontaktekzem der Ohrläppchen wurden mit einer Mikro-Rönt-genanalyse noch vier Monate nach Entfernung der Ohrringe Goldspuren im Gewebe nachgewiesen (Suzuki 1998 Weitere, zumeist ältere Berichte über Sensibilisierung durch Gold bzw.…”