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Abstract

Contact dermatitis to gold has rarely been reported. This precious metal is generally considered as inert, insoluble and resistant to corrosion. Nevertheless, gold salts have a strong potential for sensitization. This condition can occur after contact with gold jewellery and dental alloys, after systemic therapy with gold salts and after occupational contact. The lesions may be expressed as contact dermatitis on the face, ear, neck and/or fingers, and as lichen planus and/or lichenoid stomatitis. The dermatitis is usually not very irritating and the lesions are rarely persistent. Diagnosis is based on the clinical history and examination, on the nature of the exposure sources, and on the results of patch tests with gold sodium thiosulfate (GSTS) at 0.5% in petrolatum. The patch test is read on days 2 and 3 and again after 1 and 3 weeks. Allergen avoidance can be expensive and tiresome, and improvement is not guaranteed. We report the case of a female patient who came to us complaining of burning in her mouth. She had polymetallism and lichenoid lesions facing gold tooth crowns. Patch tests were positive to GSTS at 72 h and at 1 week. Replacement of the gold crowns led to total disappearance of her symptoms within 1 year. Local factors, including humidity, temperature, acid pH, abrasion and contact with substance such as amino acids, bring about the liberation of the sensitizing metallic salts, which may be enhanced by galvanic corrosion secondary to the polymetallism.