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Copper allergy revisited.

S Wöhrl1, W Hemmer, M Focke

  • 1FAZ-Floridsdorf Allergy Centre, Vienna, Austria.

Journal of the American Academy of Dermatology
|November 17, 2001
PubMed
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Positive patch tests to copper are common but often considered irritant. This study suggests copper allergy is mostly specific, linked to nickel sensitization, though clinical relevance is typically low.

Area of Science:

  • Allergenicity and immunology
  • Dermatology
  • Contact dermatitis

Background:

  • Positive patch tests to copper sulfate are frequently observed.
  • Copper is generally considered a rare allergen with low sensitizing potential.
  • Positive copper reactions are often dismissed as irritant and unspecific.

Purpose of the Study:

  • To evaluate the diagnostic relevance of positive copper patch tests.
  • To assess the clinical significance of copper sensitization.

Main Methods:

  • Analysis of 2660 routine patch tests for reactions to copper and other metals.
  • Comparison of copper reaction prevalence (3.53%) with nickel (21.02%), palladium (5.90%), and cobalt (3.31%).
  • Retesting of 26 patients with positive copper patch tests to assess reproducibility and association with nickel sensitization.

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Main Results:

  • Reactions to copper and nickel were significantly associated.
  • Reproducibility of positive copper patch tests was modest (38%).
  • Positive copper tests were significantly associated with nickel sensitization.

Conclusions:

  • Clinical data support a copper-nickel cross-reactivity concept at the T-cell level.
  • Positive patch tests to copper are predominantly specific.
  • However, positive copper patch tests generally have low clinical relevance.