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Different types of metals or their synthetics may act as a skin sensitizers.

Some of these are discussed below briefly.

  1. Chromium Dermatitis 
    The chromates are strong skin sensitizers. They may act as a primary irritant or causing delayed type of contact eczema. Chromates sensitization occurs in painters, photographers, diesel engine mechanics, welders, tanners and those who are exposed to different dyes. Dichromates are found in shoes, zippers, leather hat bands, leather camera cases, cement, glues and chrome plated custom jewels.

Patch test.


  1. Avoid contact with the chromate

  2. Active treatment: is the same as that of contact dermatitis

Fig. 193. Acute contact dermatitis (Earrings)

Fig. 192. Contact dermatitis (Watch)

  1. Nickel

  2. Nickel metal can cause dermatitis but other metals dermatitis is due to metal salts that of chromate, mercury, zinc, gold, silver and others. Metal salts are available in earrings, hairpins, rings, braces and spectacle frames.

    Fig. 194a. Contact dermatitis (Necklace)

    Fig. 194b.. Metal dermatitis

    Gold salts and platinum especially when mixed with other metals may cause dermatitis. The most common source of metallic nickel is plated objects. Stainless steel (usually containing 8% Ni and 18% Cr.) seems not to have the same capacity to elicit contact dermatitis as alloys with, for example, copper in coins, but cooking foods with acid pH, such as fruit, in stainless steel saucepans may increase nickel release.

    The nickel salts (nickel sulfate, nickel ammonium sulfate, etc.) are all used in plating processes.

    Eye shadow may contain nickel. Very small amounts of nickel are sufficient to elicit dermatitis.

    Sources of nickel have been detected in medical injectors and cardiac pacemakers.

    Certain foods and beverages contain much higher concentrations of nickel than others, such as domestic water, and exposure to nickel may also be a contaminant for vegetables from fertilizers .

  3. Mercury

    Different types of mercuric salts may cause dermatitis. The different mercuric salts that may cause skin sensitization are:

    Mercuric salts as Mercurochrome used as a common antiseptic may cause dermatitis. Phenyl mercuric salts used in glue or gelatin waving solution, in cosmetic industry as a preservative, in agriculture as insecticide and fungicide. Many salts of aluminum may cause allergy or irritation to the skin surface.

    The metal is used in amalgam (alloy of silver or copper and mercury) for tooth filling and in instruments.

    Generalized exanthemas have been reported in sensitized individuals from amalgam and broken thermometers.

    Metallic mercury is a rare cause of cutaneous granuloma .The inorganic mercury salts are nowadays less used as topical medicaments.

    The organic compounds are used in pesticides and as antimicrobial agents in oils, paints and the textile industry, in water, in the paper industry and in shoe linings, but seldom cause sensitization. Sometimes the organic compounds are used as preservatives in injection solutions, gamma globulin and antigenic extracts, or in expectorants, creams, skin disinfectants, eye drops and contact lens solutions.

    Phenyl mercuric borate (Merfen) is still much used as a disinfectant and fungicide.

    Phenyl mercuric acetate is used in some vaginal spermicides, which may cause allergic reaction.

    Red mercuric sulfide (cinnabar) is used in red tattoos causing granulomatous reactions and in artists paints. It may contain impurity of cadmium sulfide and can thereby cause phototoxic reactions.

    Most cases that are sensitive to mercury , react on patch testing to the metal both the inorganic and organic compounds .

    Aluminum injected as hydroxide in adsorbed vaccine can cause granuloma. It has also been reported as rare contact sensitizers.

    Recycled alumina can cause pruritus.

  4. Arsenic

    Arsenic salts are common cause of dermatitis. Different type are used in the manufacture of chalk, fabrics and domestic articles, disinfectant in agriculture and as a preservative of animal skins .

    Arsenic may be present in medicaments, wood preservatives, pesticides, glass industry, tanning, fireworks, additives, gold in fireproof packaging and animal foodstuff .

  5. Gold

    Gold metal is a common skin sensitizer.

    Gold salts, e.g. gold trichloride (used in photography, gold plating and gilding glass and porcelain) are sensitizers.

    White gold may contain nickel.

    Gold chloride is strong sensitizer.

    Patch tests for these salts can give positive reaction .

  6. Iodine

    Formerly when iodine was widely used as an antiseptic and antimycotic agent the frequency of sensitization was much higher than it is now .

    Povidone-iodine solution has only 1% available iodine and is a rare sensitizers.



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