TOPLINE

Gold allergy was common among patients with dermatitis — 18.7% tested positive — and was more prevalent in women and in patients older than 40 years, but it was not associated with a higher risk for autoimmune disease.

METHODOLOGY

• Researchers conducted a retrospective cohort study to describe patients who tested positive for gold allergy and assess whether gold allergy was associated with autoimmune disease.
• They analyzed 3436 patients with dermatitis (mean age, 45.73 years; 34.08% men) who underwent consecutive patch testing for gold allergy at a hospital in Denmark between 2015 and 2024.
• Gold allergy was defined as a positive patch test to gold sodium thiosulfate, graded as weak, moderate, or strong. Doubtful and irritant reactions were counted as negative.
• Patch test results were matched with diagnostic data from the national patient registry to identify autoimmune diseases, which were grouped into six categories: dermatologic, endocrine, gastrointestinal-hepatic, rheumatologic, neurologic, and hematologic.
• The team also checked how often patients with gold allergy reacted to nickel, chromium, or cobalt and whether that changed with the severity of the gold reaction.

TAKEAWAY

• Overall, 643 patients (18.7%) tested positive on the gold patch test: 343 weak, 284 moderate, and 16 strong reactions. Women (odds ratio [OR], 2.38; 95% CI, 1.96-2.94) and patients older than 40 years (OR, 1.32; 95% CI, 1.09-1.60) were more likely to test positive.
• A total of 848 patients had a recorded diagnosis of an autoimmune disease. After adjustment for sex and age, a positive result on the gold patch test was not associated with any autoimmune disease.
• Having allergy to one additional metal (nickel, chromium, or cobalt) became more common with stronger reactions to gold (P < .01 for trend), and a significant trend was also observed for having allergy to two additional metals (P = .04 for trend).

IN PRACTICE

"Clinically, a positive patch test to Au [gold] cannot be considered a risk marker for autoimmune comorbidity," the authors wrote.

SOURCE

Mikkel Bak Jensen, with the National Allergy Research Centre, Gentofte, Denmark, was the corresponding author of the study, which was published online on October 7 in Contact Dermatitis.

LIMITATIONS

The study could not show which occurred first, gold allergy or autoimmune disease, because the data did not allow for the analysis of timing. Cases were too few to reliably detect links with rarer conditions such as autoimmune diseases of the nervous system or blood. Allergy was tested using only one gold compound, gold sodium thiosulfate; therefore, the findings may not apply to other forms of gold.

DISCLOSURES

The study was funded by the Danish Environmental Protection Agency under the Ministry of Environment of Denmark. One author reported receiving speaker fees from Eli Lilly, Janssen Cilag, Galderma, and Sandoz and research funding from the LEO Foundation.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.