Metal allergy: Gold

Gold is today a well-known but still controversial contact sensitizer. The patch test reaction to gold is sometimes difficult to read, and positive reactions typically appear late; therefore, two readings are of utmost importance. Gold is not generally within the baseline series but is recommended in any dental and metal series. Gold can give rise not only to local eczematous reactions, chronic papular reactions, or generalized dermatitis, but also to lichenoid reactions, especially when in contact with the oral mucosa. The sensitizer can also give rise to systemic allergic contact dermatitis when exposure is systemic. Female sex, dental gold restorations and age are factors that are associated with contact allergy to gold.