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Excipient and Dose per Unit Area Affect Sensitivity When Patch Testing With Gold Sodium Thiosulfate.

Dathan Hamann, Magnus Bruze1, Joseph F Fowler2

  • 1Department of Occupational and Environmental Dermatology, Lund University, Ska˙ne University Hospital, Malmö, Sweden.

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Summary
This summary is machine-generated.

This study establishes the optimal hydrogel dose for gold sodium thiosulfate patch testing, improving diagnosis of gold allergy. Late reactions are essential for accurate gold contact allergy detection.

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Area of Science:

  • Dermatology
  • Allergology
  • Contact Dermatitis

Background:

  • Current gold patch testing methods lack standardization worldwide.
  • Controversies exist regarding optimal dose/area and reading paradigms for gold patch tests.

Purpose of the Study:

  • Determine the optimal patch test dose of gold sodium thiosulfate (GST) in a hydrogel (HYD).
  • Evaluate the safety and efficacy of GST HYD.
  • Characterize the normal morphology and time course of GST reactions.

Main Methods:

  • Twenty gold-allergic patients were patch tested with a dilution series of GST HYD and 2% GST petrolatum (pet).
  • The optimal GST HYD dose was compared to 0.5% GST pet in 19 known-allergic and 216 consecutive subjects.

Main Results:

  • The optimal GST HYD dose was determined to be 0.075 mg/cm², comparable to 2% GST pet.
  • GST HYD showed superior performance over 0.5% GST pet in identifying gold allergy.
  • Late reactions were frequent and necessary for diagnosis, with GST HYD showing more persistent reactions than 0.5% GST pet.

Conclusions:

  • 0.075 mg/cm² of gold sodium thiosulfate hydrogel is the optimal dose for diagnosing gold contact allergy.
  • 0.5% GST petrolatum may lead to false-negatives due to inadequate dosing.
  • Late readings are crucial and expected for diagnosing gold contact allergy.