Patch testing with pure palladium metal in patients with sensitivity to palladium chloride

Abstract

During a 15‐month period. 536 patients being investigated for suspected contact dermatitis were paid) tested with the European standard series and palladium chloride 1% pet, 13 patients (2.4%) had a positive allergic response to palladium chloride and all 13 were also allergic to nickel. 12 of these 13 patients consented to further patch testing with discs of pure palladium metal Toil, mid none reacted. We have shown previously that palladium chloride patch test material contains traces of nickel, and propose an explanation for these results in terms of the additive effect of allergens when tested in combination.

Palladium Patch Reactivity

“…Thirty-nine were female and 39 also reacted to nickel. Very similar results were seen in other European studies [4,5]. Our results show a higher prevalence of positive patch tests, although about only one half of our patients had a 2 or 3+ reaction.…”

Novel sensor to investigate microstructural contributions to corrosion of high‐palladium dental alloys

“…Pure Pd has been previously reported to be nontoxic from local and systemic toxicity evaluations (Bessing & Kallus, ; Murdoch & Pepys, ). The reported contact hypersensitivity to palladium (Camarasa, Burrows, Menné, Wilkinson, & Shaw, ; Todd & Burrows, ) may be caused by corroded Pd ions, but it should be noted that such case reports of Pd allergy lack information about the specific dental alloys found to be problematic; other corroded ions from the dental alloy could potentially be the source of allergic reaction. Nevertheless, concerns have been expressed in the dental literature about the clinical use of dental alloys containing Pd (Wataha & Hanks, ).…”

Palladium alloys for biomedical devices

“…Controversy persists and, to date, no prospective, randomized, appropriately controlled studies have been performed to establish the prevalence of allergic responses to Pd dental alloys. However, several reports have concluded that even in patients with documented Pd allergy, the risk of allergic reaction to Pd alloy is relatively low because of the low corrosion rate of Pd from these alloys [1,42,[49][50][51].…”

“…Palladium alloys for biomedical devices to nickel [41,50,51,[56][57][58][59]. The incidence appears to range from 93 to 100% [1].…”

“…However, prevalence of allergy in the general population is unclear because most studies have evaluated populations that had some other immunological sign or symptom. For example, patients who have eczema [41], a history of allergic reaction [49], Ni allergy or allergy to other metals [50,52] or who work in metal refineries [51,53] have been used as cohorts for assessing allergy to Pd ions. A more recent retrospective study used a cohort of dental patients who had received a metallic prosthesis, and found the prevalence of PdCl 2 sensitivity to be 3.8%, based on a patch test [54].…”