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1863454 
Journal Article 
PATCH TESTING WITH PURE PALLADIUM METAL IN PATIENTS WITH SENSITIVITY TO PALLADIUM-CHLORIDE 
Todd, DJ; Burrows, D 
1992 
Yes 
Contact Dermatitis
ISSN: 0105-1873
EISSN: 1600-0536 
NIOSH/00208243 
26 
5 
327-331 
eng 
1395596 
WOS:A1992HW42700009 
A study of the association of palladium (7440053) sensitivity with nickel (7440020) sensitivity was conducted. The study group consisted of 536 consecutive patients, 357 females, who were evaluated for suspected contact dermatitis over a 15 month period. They were patch tested with the European standard allergen series supplemented by 1% palladium-chloride (7647101) in petrolatum. Thirteen patients, 11 females, gave positive responses to palladium-chloride. All were also positive for 5% nickel-sulfate (7786814) in the standard allergen series. The reaction to nickel was stronger than the reaction to palladium in 12 subjects. Twelve subjects were tested with discs of pure palladium foil. None showed a positive response. Since it was known that the palladium-chloride patch test material was contaminated with traces of nickel, the palladium foil discs were analyzed for nickel by X-ray energy dispersive analysis. No nickel was detected; the detection limit for nickel was 250 parts per million. Twelve of the patients with suspected palladium allergy reported having problems with cheap metal jewelry and metal worn on clothing. One of the two males had chronic hand dermatitis due to occupational exposure. None of patients reported any palladium exposures. The authors conclude that the patients with positive patch test reactions to palladium-chloride may be truly allergic to palladium as well as nickel. The negative response to pure palladium reflects a sub threshold effect. When patch testing is performed with palladium-chloride containing trace amounts of nickel, the threshold for each allergen is reduced and an additive effect of both responses occurs to produce a positive palladium patch test response. 
PALLADIUM; NICKEL; CROSS-REACTIVITY; CONTAMINATION; ADDITIVE EFFECTS