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Suzuki K, Matsunaga K, Ito A, Yagami A, Ito T, Miyazawa H, Sugiura M, Adachi A, Kubota Y, Watanabe Y, Kato A, Nishioka K, Fukunaga A, Mochizuki M, Ikezawa Y, Tsunoda T, Takayama K, Washizaki K, Yokozeki H, Ishihara T, Asada H, Kanto H. Multicenter 1-month follow-up study of the patch-test reaction to the gold sodium thiosulfate of the TRUE Test and its association with piercings and dental metal history. Contact Dermatitis 2021; 85:154-163. [PMID: 33660302 DOI: 10.1111/cod.13827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is controversy over late and long-lasting reactions to gold sodium thiosulfate (GST). OBJECTIVES To study the GST patch-test reaction by observing the application site after 1 month, and to clarify the relevance of GST sensitization by piercings and dental metals. PATIENTS A retrospective analysis was performed on 746 patients (143 male; 603 female) who were patch tested using GST of the TRUE Test. We conducted a questionnaire on the presence of piercings or dental metals in these patients. RESULTS The GST positive rate was 27.9% at day (D)3 and/or D7 and 40.3% up to the 1-month reading. The positive rate was significantly higher in female patients and increased with age. Sixty-two percent of cases with a positive reaction at D7 continued to show a positive reaction after 1 month. Eleven percent of cases with a negative reaction at D3 and D7 showed a late reaction. Both piercings and dental metals were related to gold sensitization. CONCLUSIONS The GST of the TRUE Test had a high positive and low false-negative rate. The 1-month reading after the patch test was important for identifying late reactions. Piercing history and dental metal were associated with gold sensitization.
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Affiliation(s)
- Kayoko Suzuki
- Department of Allergology, Fujita Health University School of Medicine, Nagoya, Japan
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
| | - Kayoko Matsunaga
- Department of Allergology, Fujita Health University School of Medicine, Nagoya, Japan
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
| | - Akiko Ito
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Nagoya, Japan
- Department of Dermatology, Nagata Clinic, Niigata, Japan
| | - Akiko Yagami
- Department of Allergology, Fujita Health University School of Medicine, Nagoya, Japan
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
| | - Takashi Ito
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Toho University Omori Medical Center, Tokyo, Japan
| | - Hitoshi Miyazawa
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Nishi-Sapporo Skin and Allergy Clinic, Sapporo, Japan
| | - Mariko Sugiura
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Environmental Dermatology & Allergology, Daiichi Clinic, Nagoya, Japan
| | - Atsuko Adachi
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, Japan
| | - Yumiko Kubota
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Yuko Watanabe
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Watanabe Skin and Plastic Surgery Clinic, Matsuyama, Japan
| | - Atsuko Kato
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Gokeikai Osaka Kaisei Hospital, Osaka, Japan
| | - Kazue Nishioka
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Joy Dermatological Clinic, Sanyo-Onoda, Japan
| | - Atsushi Fukunaga
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Division of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masako Mochizuki
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Mochizuki Dermatological Clinic, Nagano, Japan
| | - Yuko Ikezawa
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Chigasaki Municipal Hospital, Chigasaki, Japan
| | - Takahiko Tsunoda
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Yamagata City Hospital SAISEIKAN, Yamagata, Japan
| | - Kaoru Takayama
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kumiko Washizaki
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Omorimachi Dermatology, Tokyo, Japan
| | - Hiroo Yokozeki
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Hideo Asada
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Nara Medical University Hospital, Kashihara, Japan
| | - Hiromi Kanto
- Japanese Contact Dermatitis Research Group, Nagoya, Japan
- Department of Dermatology, Toho University Omori Medical Center, Tokyo, Japan
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Brown A, Mandelberg NJ, Munoz-Mendoza D, Palys V, Schalock PC, Mogilner A, North R, A Petersen E. Allergy Considerations in Implanted Neuromodulation Devices. Neuromodulation 2021; 24:1307-1316. [PMID: 33428821 DOI: 10.1111/ner.13332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Allergic reactions are rare and poorly understood complications of neuromodulation device implantation. There are currently no guidelines for management of allergic reactions to these devices and their components. Here we review the published cases of allergic reactions to implanted neuromodulatory devices and leverage the experiences of other specialties that deal with similar complications to formulate recommendations for prevention and management. MATERIALS AND METHODS A review and assessment of the literature. RESULTS Allergic reactions to a number of implantable devices have been observed and published. In dentistry and orthopedics, metals such as nickel are the most frequent cause of allergic reactions. In interventional cardiology, where devices closely resemble neuromodulatory devices, titanium, silicone, and polyurethanes are the most common causes of allergic reactions. In neurosurgery, allergic reactions to implantable neuromodulatory devices are rare, and we summarize 13 cases published to date. Such allergic reactions generally present as local dermatitis, erythema, and pruritus, which can be difficult to distinguish from surgical site infection. In one published case, symptoms resolved with corticosteroid treatment, but all other cases required explantation. The successful reimplantation with a modified device was reported in some cases. CONCLUSIONS Patients should be screened for a personal history of contact allergy before implantation procedures. A multidisciplinary approach to suspected cases of postoperative allergic reactions involving collaboration between neurosurgeons and other implanting physicians, dermatologists or allergists, and device manufacturers is recommended. In cases where an allergic reaction is suspected, an infectious etiology should be ruled out first. Clinical suspicion can then be supported with the use of patch testing, interpreted by an experienced dermatologist or allergist. If patch testing supports an allergic etiology, the implanting physician and the device manufacturer can work together to modify the device for safe reimplantation.
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Affiliation(s)
- Austin Brown
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Diana Munoz-Mendoza
- Division of Pediatric Allergy, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, USA
| | - Viktoras Palys
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Peter C Schalock
- Department of Dermatology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Alon Mogilner
- Department of Neurosurgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Richard North
- The Institute of Neuromodulation, Chicago, IL, USA.,The Neuromodulation Foundation, Baltimore, MD, USA.,The Johns Hopkins University School of Medicine (ret.), Baltimore, MD, USA
| | - Erika A Petersen
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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