A retrospective study on titanium sensitivity: Patch test materials and manifestations

Background Titanium is being increasingly used. Although it is considered to be a non‐allergenic material, allergic reactions to it have been reported. Titanium dioxide has been found to be an unreliable patch test material. Few studies to date have profiled titanium allergy, and it therefore remain...

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Bibliographic Details
Published in:Contact dermatitis 2018-08, Vol.79 (2), p.85-90
Main Authors: de Graaf, Niels P. J., Feilzer, Albert J., Kleverlaan, Cees J., Bontkes, Hetty, Gibbs, Sue, Rustemeyer, Thomas
Format: Article
Language:English
Subjects:
Adult
Aged
Allergens - adverse effects
Allergies
contact allergy
Dermatitis
Dermatitis, Allergic Contact - diagnosis
Dermatitis, Allergic Contact - etiology
Erythema
Female
Humans
implants
Male
medical device
Middle Aged
Original
Oxalic acid
patch test
Patch Tests - methods
Retrospective Studies
Risk factors
Salts
Titanium
Titanium - adverse effects
Titanium dioxide
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Summary:Background Titanium is being increasingly used. Although it is considered to be a non‐allergenic material, allergic reactions to it have been reported. Titanium dioxide has been found to be an unreliable patch test material. Few studies to date have profiled titanium allergy, and it therefore remains difficult to distinguish its manifestations. Objectives To evaluate alternatives for titanium dioxide as a patch test preparation, and to profile titanium reactions and manifestations. Methods A retrospective chart review was conducted with 458 patients who underwent patch testing with at least 1 of 5 different titanium salts. Results At least 1 positive result was noted in 5.7% of the patients. The frequency of positive results for the tested salts ranged from 0.9% to 7.9%. Titanium(IV) oxalate hydrate had the highest yield and titanium dioxide the lowest. Erythema, dermatitis and local swelling were the most common objective complaints. In 16 (61.5%) patients, the test result had partial or full clinical relevance. Conclusions No titanium‐specific risk factors and clinical picture could be identified. Titanium dioxide is not adequately sensitive for identifying titanium allergy. The titanium salts seem to be possible superior patch test preparations, but appear to be unsuitable if used singly. The patient's medical history and clinical picture remain crucial in the diagnostic work‐up.
ISSN:0105-1873
1600-0536
DOI:10.1111/cod.13010