Exposure to metallic gold in patients with contact allergy to gold sodium thiosulfate

Gold allergy is common, with approximately 10% of patients patch tested bec ause of eczematous disease being positive to gold sodium thiosulfate (GSTS) . However, clinical relevance seems to be rare. The aim of this prospective double-blind study was to demonstrate the effects of exposure to metallic gold, in this case earrings, in gold-positive patients. 60 female patients with pierced earlobes test-positive to GSTS were included in the study. The patients were randomized into 2 groups, 30 patients receiving earrings wit h a surface layer consisting of 24-carat gold and 30 patients earrings with a surface layer of titanium nitride, virtually indistinguishable from gold . The patients wore the earrings for 8 weeks. During the study, any dermati tis on the earlobes, as well as on other body sites, was registered. The sk in reactions observed were weak but, in total, 17 of the 60 patients had a skin reaction (local or remote) during the study, 12 of whom had received g old earrings and 5 titanium (p<0.05). II patients had a reaction on the ear lobes, 7 of whom had received gold earrings and 4 titanium (NS). With these facts it is hard to exclude that exposure to gold jewelry can be clinicall y relevant in persons hypersensitive to gold.