ABSENCE OF SKIN SENSITIVITY TO OXIDES OF ALUMINUM, SILICON, TITANIUM OR ZIRCONIUM IN PATIENTS WITH CROHNS-DISEASE

Background-Some metallic compounds, especially of zirconium, can cause cell mediated granulomatous inflammation of the skin. Pigment granule s containing compounds of aluminium, silicon, and titanium have been o bserved within macrophages in the wall of the small intestine in healt h and in Crohn's disease. Zirconium compounds can be ingested in tooth paste. Aim-To determine in a pilot study if granulomatous sensitivity can be detected to compounds of these metals or silicon after injectio n into the skin of patients with Crohn's disease. Subjects-Eight patie nts with Crohn's disease known to have had granulomata in the intestin e and not currently treated with corticosteroids, and two healthy cont rols. Method-Two intradermal injections each of 0.1 ml of a 0.02% susp ension of one of the compounds made in the abdominal wall of each subj ect. The site was marked and full thickness skin biopsy performed six weeks later. Result-A foreign body granuloma was observed on histologi cal examination of two biopsy specimens but no evidence of a cell medi ated response in any subject.Conclusion-No support was found for the h ypothesis that Crohn's disease is due to a specific sensitivity to ing ested metallic or silicon compounds.