Table 1.
Summary of Disease Variants Implicated in Metal Allergy.
| Tissue | Primary Disease Presentation | Disease Variant(s) |
|---|---|---|
|
| ||
| Dermal | Allergic Contact Dermatitis (ACD): | |
| Hypersensitivity | Eczematous ACD | Nummular Dermatitis, Dyshidrotic Eczema, Recurrent Vesicular Hand Eczema Pruritic Papular, Lymphomatous, Lymphomatoid-Eosinophilic, Depigmented |
| Responses | Non-Eczematous ACD | Contact Dermatitis, Palmoplantar Pustulosis |
| Photo-Mediated ACD | ||
| Allergic Granulomatous Skin Reactions | ||
| IgE-Mediated Allergic Skin Responses: | ||
| Atopic Dermatitis/Contact Urticaria | ||
| Photo-Mediated Contact Urticaria | ||
| Oral Mucosal Allergy | Allergic Contact Stomatitis, Oral Lichen Planus, Orofacial Granulomatosis, Burning Mouth Syndrome, Geographic Tongue, Peri-Oral ACD, Allergic Contact Cheilitis | |
| Ocular Allergy | Allergic Conjunctivitis, Eyelid Contact Dermatitis, Atopic Keratoconjunctivitis, Contact Blepharoconjunctivitis | |
| Metal Hypersensitive Alopecia Areata Bullous Autoimmune Dermatoses: | ||
| Pemphigus | ||
| Pemphigoid | ||
| Respiratory | Allergic Asthma | Antibody-Mediated (IgE, IgG), Cell-Mediated; Th2/Eosinophilic, /Th1/17/Neutrophilic |
| Hypersensitivity | Allergic Rhinitis | |
| Responses | Immediate Hypersensitivity Laryngitis | |
| Hypersensitivity Pneumonitis: | ||
| Chronic Beryllium Disease | ||
| Gold Lung | ||
| Hard Metal Lung Disease | ||
| Pulmonary Eosinophilia | Eosinophilic bronchitis, Eosinophilic Pneumonia | |
| GI Hypersensitivity | Contact Allergic Mucositis/Gastritis | |
| Responses | Allergic Esophagitis: | |
| Eosinophilic Esophagitis | ||
| Lymphocytic Esophagitis | ||
| Systemic | Anaphylaxis | Type I, Mixed-Type Anaphylaxis |
| Hypersensitivity | Systemic ACD | Baboon Syndrome |
| Responses | Airborne ACD | |
| Chronic Urticaria Syndrome | ||
| Systemic Nickel Allergy Syndrome | ||
| Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome | ||
| Kounis Syndrome | ||
| Systemic Sensitization | Implant Failure, Metallosis | |
Table 1: A comprehensive list of unique disease variants implicated in metal allergy. An extensive review of the scientific literature was performed and all reports describing metal-induced hypersensitivity responses in human subjects were compiled. All of the unique disease variants implicated in these publications are discussed in this manuscript and summarized in the table above. Responses are grouped according to primary tissue of involvement, as either dermal, respiratory, gastrointestinal, or systemic hypersensitivity reactions. Distinctive clinical manifestations and disease variants associated with specific conditions are listed where applicable.