Metal Allergy: Chromium

Cases of allergic contact dermatitis due to chromium caused by chromium-tanned leather articles such as shoes and gloves are wellknown. 1,2 In the European Union, hexavalent chromium in new leather articles on the market is restricted to 3 mg/kg since 2015. 3 A recent use-test study showed that also trivalent chromium, the dominating form of chromium released from new leather articles, 4 can elicit allergic reactions in chromium-allergic individuals. 5 For leather articles that are used for a prolonged period, data on the released chromium form are scarce, but one long-term study indicates that the fraction of hexavalent chromium increases with duration of use. 6 CASE REPORTA 36-year-old male patient working as a boat carpenter with a previous history of psoriasis and smoking, but no other known skin disease or allergy, presented with severe eczema showing papules and vesicles at both hands and feet with unknown cause for about half ayear. Due to exposure to various occupational allergens an extensive patch test investigation (Swedish baseline series, extended series, rubber complementary series, epoxy series, and formaldehyde releaser series) was conducted. Patch testing showed a strong (++) reaction to potassium dichromate 0.5% pet. and a positive (+) reaction to cobalt(II) chloride hexahydrate 1% pet.; no other occupational allergens were revealed. The patient stopped wearing leather shoes and gloves, and the eczema improved significantly already after some days. About 80% of the inflammation was reduced within 14 days.The patient described that he was wearing sailing leather shoes without socks during summer and that his work shoes and some gloves were made of leather. A diphenylcarbazide spot test showed a positive result for hexavalent chromium for one pair of the shoes and a doubtful result for the other shoes, and therefore, chemical analysis was conducted for all shoes.HEDBERG ET AL. 179

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confidence: 99%

High release of hexavalent chromium into artificial sweat in a case of leather shoe–induced contact dermatitis

2019

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“…Chemically, the binding of a molecule to a protein is a common prerequisite for successful tanning, for skin allergy, and for one type of allergic asthma. Allergic asthma to chromium is relatively scarcely reported [7][8][9][10][11][12]. Respiratory illness, coupled with high immunoglobulin E (IgE) and chromium levels in the blood have been reported for tannery workers [13,14], although it is not possible to rule out from these studies whether this was due to allergic asthma caused by chromium.…”

Section: Chromium Allergy and Allergic Contact Dermatitis (Acd)mentioning

confidence: 99%

“…The antigen is then processed and presented to T-cells by cutaneous dendritic cells (Langerhans cells) [18] during the sensitization step or recognized by circulating haptenspecific T-cells during the elicitation step [17][18][19][20]. Several common skin proteins, such as albumin and heparin, have been found to be able to be the carriers for the chromium antigen, and chromium binding as well as structural changes of these proteins have been confirmed [7,[21][22][23][24][25][26][27][28][29].…”

Section: Chromium Allergy and Allergic Contact Dermatitis (Acd)mentioning

confidence: 99%

“…Since hexavalent chromium forms exclusively negatively charged mono-or dichromates under the conditions of relevance for skin exposure and since these negatively charged chromates are not able to bind to proteins, it is only trivalent chromium that binds to proteins and forms the antigen [7,[30][31][32]. This means that hexavalent chromium first needs to be reduced prior to forming the antigen.…”

Section: Relevant Chemical Speciation Of Chromium For Acdmentioning

confidence: 99%

“…This means that hexavalent chromium first needs to be reduced prior to forming the antigen. Still, hexavalent chromium is considered to be the more potent skin sensitizer as compared to trivalent chromium species, since it i) penetrates the skin much more efficiently [7], ii) penetrates cell membranes at much higher rates [30,32,33], and iii) seems able, due to its oxidative properties, to induce some immunological responses that trivalent chromium is unable to cause [34,35].…”

Section: Relevant Chemical Speciation Of Chromium For Acdmentioning

confidence: 99%

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Chromium and leather: a review on the chemistry of relevance for allergic contact dermatitis to chromium

Hedberg

2020

J Leather Sci Eng

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As other causes decline in importance, chromium-tanned leather has become a more important source for chromium allergy, which affects around 1% of the general population. The aim of this review is to give suggestions on how to minimize the risk of leather-related allergic contact dermatitis, which can be elicited in chromiumallergic persons by hexavalent and trivalent chromium released from leather. Hexavalent chromium is the more potent chromium form and requires a lower skin dose to elicit allergic reactions. It is formed on the surface of some, antioxidant-free, leathers at dry conditions (< 35% relative humidity) and is influenced by the tanning process and other conditions, such as UV irradiation, contact with alkaline solutions, and leather age. Trivalent chromium is the dominant form released from chromium-tanned leather and its released amount is sufficient to elicit allergic reactions in some chromium-allergic individuals when they are exposed repetitively and over longer time (daysmonths). A low initial test result (< 3 mg/kg) for hexavalent chromium with the current standard test (ISO 17075) does not guarantee a low release of chromium from the leather or a low release of hexavalent chromium under typical exposure conditions during the service life of the leather. Information, labels, and certificates regarding leather products are often insufficient to protect chromium-allergic individuals. Correct labelling and information on the possible content of different allergens, as well as different tanning alternatives for certain leather products, are crucial.

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