Allergie a metalli e manifestazioni cutanee

The incidence and the prevalence of allergy to metals is rising worldwide, implicating that skin allergy to metals is a very common disorder. It affects persons of all ages and is most common in women but our experience is that skin allergy to metals is significantly more frequent in the fourth and fifth decades. Skin manifestations due to metal overexposure may overlap skin allergy to metals, creating an association between two conditions. This article does not consider every metal allergen related to skin disorders, we focus on the major skin and muco-cutaneous allergy to metals in humans (mercury, gold, nickel, palladium, cobalt, chromium, copper, indium, arsenic, silver, titanium). The first-line treatment of skin allergy to metals combines metal allergen avoidance and education of the patient. For mercury-related skin diseases, safe dental amalgam removal is mandatory intervention, including avoidance of fish. Treatment with corticosteroids does not appear to have the same degree of attenuation of metal-induced signs and symptoms as antihistamines and may lead to adverse health events.