Sensitization to palladium

Contact dermatitis in athletes

“…87 Another report suggested that weightlifters may develop an ACD to nickel and palladium contained in the weights or bars. 88 There are a few other reports of contact dermatitis in athletes in the literature that should be included for comprehensiveness. Trapshooter stigma presents as a lichenified plaque or atrophic scar and results from repeated friction of the wood stock of a gun against the shooter's face.…”

Palladium in dental alloys – the dermatologists’responsibility to warn?

“…If "dentists have the legal and ethical responsibility for selection of alloys used for cast restorations, and should not delegate this to the dental laboratory technician" (36), we as dermatologists have the responsibility to point out potential problems and to inform our collagues of our observations; better to do this at a time when they are still "obscure" (22,25) than to leave it too late. According to Fisher (37), "unexpected positive patch test reactions that are not relevant to the presenting dermatitis ... may be significant in the future and the patient should be informed of the test result.…”

“…Headlines such as "palladium ceramic alloys: possible health hazards" (41,42) versus "dental alloys: unanswerable charlatanism" (43) dominate the news (not necessarily in a fair manner), and probably nobody can yet foresee the final outcome. However, awareness seems essential, and the currently "obscure sources of palladium sensitization" (22,25) and their clinical relevance might soon become evident. We consider that it is our responsibility to point out this potential problem in the scientific literature, even if we cannot yet assess its significance.…”

“…In the past decade, however, several reports have been published on contact allergy to Pd (reviewed in (13,25)), either in cases associated with oral symptoms (14)(15)(16)(17)(18) or non-mucosal dermatitis (19)(20)(21); frequently, the clinical significance has remained undetectable (22)(23)(24)(25)(26). Encouraged by positive patch tests in some patients suffering from burning mouth syndrome, we routinely started testing for Pd allergy in 1990.…”

Palladium alloys for biomedical devices

“…Concerns about allergy to Pd alloys emerged several years after the introduction of Pd-based alloys to dentists in the early 1970s [41]; this topic has been reviewed by several authors [1,4,5,42,43]. Many reports of allergy to Pd alloys were case studies where oral mucositis, urticaria, swelling, redness, burning or other symptoms were observed post-insertion of Pd alloys for dental prostheses [41,[44][45][46][47][48]. Patients often tested positive for hypersensitivity to Pd or Ni (see discussion later) and often experienced resolution of symptoms after the prostheses were removed and replaced with non-metallic alternatives.…”