Background: Contact allergy to palladium emerges as a relevant concern for public health due to the increasing environmental exposure (nickel-free jewellery gold alloys, electronic devices including mobile phones, computers and LED television sets, palladium release from car exhaust converters). Until now, patch test with palladium chloride was the common way of diagnosing palladium allergy, however, newer data suggest that sensitivity of this test may be too low. With this regard, sodium tetrachloropalladate seems a better option.
This study was aimed at comparing results of patch tests to palladium chloride and sodium tetrachloropalladate in a large population of eczema patients.
Methods: In phase 2 of the KRAK study, patients with chronic/recurrent eczema were patch tested to both palladium(II)chloride 2% pet. (Chemotechnique Diagnostics; cat.-No. P-001) and sodium tetrachloropalladate(II) hydrate 3% pet. (S-017). The test substances w ere applied on the patient's back for 2 days in IQ Ultra chambers (Chemotechnique), with subsequent readings on days 3, 5 and 8.
Results: 1026 patients were tested: 730 females and 296 males, aged 1-90 (median 40) years. Positive reaction to at least one of the compared substances was recorded in 223 patients, including 81 who reacted to both formulations, 123 who reacted to S-017 only, and 19 who reacted to P-001 only (chi2: p < 0.001). The overall detection rate was 19.9% for S-017 (204 positive reactions, including 50 rated as clinically relevant, and 48 as cross reactions), and 9.7% for P-001 (100 positive reactions, including 24 clinically relevant and 30 cross reactions). Testing to P-001 only would have missed 29 clinically relevant reactions detected w ith S-017 (2.8% of all patients), while testing to S-017 only would have missed 4 relevant reactions to P-001 (0.4%).
Conclusion: Sodium tetrachloropalladate(II) hydrate 3% pet. is more effective than palladium chloride 2% pet. in the detection of contact allergy to palladium.
Patch testing in Krakow (Cracow), Poland
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Document created: 29 May 2017, last updated: 30 May 2017.