Allergy to metal
Allergy to metal – rather often found intolerance type caused by hit in a human body of ions of metal elements and their linkng with proteins. Symptoms depend on interaction type with provocative substance, dermatitis in the form of reddening, a skin itch, burning most often is registered. Diagnostics is made on the basis of results of survey and studying of the anamnesis of the patient, the method of allergologichesky tests is in some cases used. Treatment consists in elimination of contacts with metal, holding the symptomatic and supporting actions.
Allergy to metal
The allergy to metal is registered at 7-10% of the population of the planet, however the considerable share of cases remains not diagnosed. It is promoted by weakness and not specificity of symptoms of a disease, their slow development, and also tendency of pathology to spontaneous disappearance. Wide circulation of a state is caused by mass use of metal products in the form of elements of clothes, jewelry, objects of use, ware. Sometimes the metal which is a part of dental and surgical tools, cosmetics, medicines is capable to cause allergic reactions. It is established that among patients adults whereas such problem occurs at children much less often prevail. It distinguishes intolerance of ions of metals from other types of an allergy.
Reasons of an allergy to metal
Hypersensitivity develops only to some chemical elements from group of metals. The reasons of its emergence are authentically not established, influence of ecological and genetic factors is supposed. The supporting role in development of skin forms of this allergy is played by the increased sweating or specific features of sebaceous glands. It facilitates penetration of ions into epidermis that is necessary for reaction development. Are capable to provoke emergence of intolerance not only "pure" metals, but also the connections supporting them in the structure. Most often pathology is caused by contact of an organism with the following substances:
- Nickel. Causes a considerable part of cases of the allergic dermatitis developing as a result of contact with metals. Is a part of alloys from which the set of elements of clothes, costume jewelry, medical tools is created.
- Chrome. It is widely applied as an anticorrosive and decorative covering of products. Getting into fabrics, promotes not only to allergic reactions, but also formation of some toxic connections (for example, salts of chromic acid).
- Aluminum. Earlier it was used for production of ware, now its application in life is strongly reduced. Salts of aluminum contain in antiperspirants and other cosmetics.
- Zinc. Is popular metal in stomatology where on its basis make sealing materials. Compounds of zinc are a part of some types of ointments and cosmetics.
Often bring cobalt and mercury in the list of the elements provoking an allergy to metal, however it is not absolutely correct. At contact of an organism with these substances or their alloys the allocated ions really cause characteristic symptoms (irritation and an inflammation of fabrics). However they are caused not by immunological processes and hypersensitivity, and toxic properties of these elements. Precious metals (gold, silver, platinum) purely extremely seldom provoke pathological reactions. The itch and irritation arising when wearing jewelry are explained by availability of additives of other substances in them – for example, copper.
The pathogenesis of an allergy to metal is based on penetration into fabrics of ions which are dissolved in water and can interact with biological molecules. Diffusion of metal parts from a surface of costume jewelry, elements of clothes and other products happens because of skin allocations (sweat). They dissolve microscopic amounts of metal, is promoted their penetration into epidermis and blankets by terms therefore , the increased air temperature and other factors increasing production of sweat glands lead to more bystry development of allergic reaction. At contact of metal products with other liquids (saliva, a lymph, blood) process of dissolution goes even quicker, hypersensitivity is shown earlier.
Ions of metals in itself are incapable to start immunological reactions as represent defective anti-genes. However they interact with some proteins of body tissues, changing properties and turning them into peculiar allergens. The further course of pathological process can be various, the 4th type of hypersensitivity most often takes place. Reaginovy options of intolerance with allocation of IgE and a histamine are possible. Other types of reaction to metal differ only by penetration of ions into fabrics – for example, through mucous membranes of a mouth (from crowns and seals) or with food. In the latter case the symptomatology of a disease is almost indistinguishable from food allergic reactions.
Symptoms of an allergy to metal
The most widespread option of pathology is the contact dermatitis arising in a zone of long contact with a metal product (a plaque, buttons, jewelry). At first at contact of metal with skin no reactions are observed. Duration of the asymptomatic period depends on a set of factors – qualities of alloy, level of activity of sweat glands, an organism sensitization. Then on integuments the zone of reddening, an itch, puffiness is formed. Most often such manifestations are found on a stomach (from a belt buckle), a neck, wrists and ears (from chains and costume jewelry). At women of irritation can be registered on a back and shoulders because of metal elements of a bra.
When ignoring symptoms and the continuing contacts with a metal subject on the surface of skin there can be erosion and grazes. They are caused by combing and violation of processes of microcirculation in the field of defeat. System manifestations (temperature increase, a general malaise) at an allergy develop extremely seldom. Strengthening of symptoms is promoted by direct contact of fabric liquids with metal elements – for example, at piercing, installation of various implants. The inflammatory phenomena can be aggravated with the becoming wet eczema and a small tortoiseshell.
In stomatology a part of allergic complications after sealing or implantation is caused by intolerance of metal materials and tools. They are shown by development of stomatitis – hypostasis of a mucous membrane of a mouth, emergence on its surface of erosion and ulcers. At a sensibilized organism such symptoms arise in 2-3 days after medical manipulations. The allergy developing in response to the use of ions of metals with food has some features. For example, the intolerance of nickel is in that case shown by eritematozny rash in genitals and an anus.
Heavy or dangerous complications at an allergy to metal practically do not meet. Presumably some cases of hypostasis of Quincke after dental manipulations can be explained with intolerance of metal ceramics or material for sealing with the content of zinc. Skin displays of a disease can be complicated by the secondary bacterial infection brought during the combing and injury of epidermis. Development of bacterial asthma in employees of metallurgical branch by some experts is considered as one of hypersensitivity consequences to metal dust.
The allergologist is engaged in definition of an allergy to metal. Often patients to it are directed by the dermatologist whom most of patients originally . In certain cases diagnostics can be complicated – skin displays of pathology are not specific, they not always manage to be connected with influence of metal materials. Efficiency and reliability of laboratory analyses or test systems at a disease very low. For this reason an important role in definition of an allergy is played by poll and studying of the anamnesis, and also indirect symptoms of pathology. Identification and confirmation of existence of hypersensitivity is made on the following algorithm:
- Fizikalny survey. At defeat of integuments reddening, eritematozny rashes, sometimes a peeling is found. Frequent localization – a bottom of a stomach, wrist, a neck, fingers of hands, lobes of ears, axillary hollows. Sometimes allergic stomatitis develops – in an oral cavity erosion, ulcerations, hypostasis of mucous membranes come to light.
- Collecting anamnesis. During inquiry the doctor finds out with what objects (the contact of affected areas of skin in the last several days was clothes elements, jewelry). The expert specifies how long the patient visited the stomatologist and in what occasion (at an inflammation mucous a mouth). At suspicion on a food form of an allergy to metal the patient's diet before development of pathology is studied.
- Allergic tests. Specific skin tests with standards of allergens at this type of intolerance it is not developed. The option of provocative test at which the patient contacts to metal some time (of several o'clock) can be used, then it is in a day examined at the expert. The food kind of an allergy can decide by means of the eliminative test – elimination from a diet of products on presumably high content of metal ions.
When determining pathology consider that contact not only with free metals, but also with their connections can cause reaction. The last can be a part of cosmetics, antiperspirants, some drugs. Differential diagnosis of a disease is carried out with contact dermatitis of other etiology and other skin pathologies of inflammatory character. At damage of mucous membranes of an oral cavity exclude stomatitis of infectious genesis. Food kinds of intolerance of metals are almost indistinguishable from a usual allergy to foodstuff, only some options (for example, hypersensitivity to nickel) have clinical features.
Treatment of an allergy to metal
In allergology therapeutic actions at this disease come down to elimination of contacts with provocative metals and symptomatic treatment. At skin forms of pathology the patient should refuse use of costume jewelry, clothes with metal products (fasteners, buckles, buttons). If the allergy is caused by cosmetics – it is necessary to exclude their application completely. Allergic stomatitis against the background of sealing of teeth, installation of implants, briquettes is eliminated after removal of elements on the basis of metal alloys. Treatment of food intolerance of metallic products demands correction of a diet, sometimes – changes of kitchen ware for preparation on ceramic or enameled.
Skin violations at an allergy are facilitated by application of local means (ointments, gels) with the maintenance of glucocorticoids. The last effectively eliminate an itch and promote reduction of activity of an inflammation. At heavy stomatitis or angioneurotic hypostasis Prednisolonum is appointed. In rare instances at infectious complications (suppuration) antimicrobic medicines are used. Antihistamines at this pathology have limited efficiency, but at many patients accelerate disappearance of skin symptoms. Also the hardening and vitamin therapy promoting strengthening of immunity and correction of its activity are recommended.
Forecast and prevention
The forecast of an allergy to metal favorable, extremely seldom results a disease in serious condition or complications. The certain inconveniences connected with need to avoid contacts with metal substances or cosmetic and medicines on their basis are possible. Pathology imposes restrictions for the list of dental procedures available to the patient, there are special requirements to the materials used at the same time. In a diet it is necessary to avoid some preserved foods, especially in a metal container. Specific prevention of an allergy does not exist, there are only general recommendations – a hardening, providing an organism with vitamins and minerals, avoiding of long carrying products from ignoble metals.