**6.1 Case 1: 51-year-old female with dyshidrotic eczema**

The subject was an inpatient of the Dermatological Clinic of Tokushima University Hospital. Results of the patch test at the clinic revealed that the patient had a nickel, cobalt, iridium, zinc, manganese and platinum allergy. The figure 14 shows a picture of the patient's right palm at her initial visit to the Dental Metal Allergy Clinic. Anti-allergic medication and steroid ointment did not result in recovery from her allergic symptoms.

#### Prognosis

At the time she was seen in the clinic, the zirconium ceramic system for complete oral reconstruction was not on the market. Therefore, a semi-fixed prosthesis with four piece

Dental Metal Allergy 105

This patient had no past history of drug or food allergies and did not have allergic rhinitis. He became aware of his dermatitis symptoms on general skin in 1999 and was given external steroid medications at the dermatology clinic. Since he did not recover from his symptoms, he visited a general hospital in 2000 and was diagnosed with photodermatosis. At the hospital he was administered steroids, but exhibited no remarkable recovery. In 2002, he visited another dermatological clinic and was given external steroids and anti-allergic drugs, however, his symptoms remained. In 2005, he visited Tokushima University Hospital to ask for dental implant treatment. After examination by a dentist, the patient was referred

Results of the patch test revealed that the patient had allergy-positive reactions to various kinds of metal reagents. An ultraviolet light test exhibited erythema with more than 5 minutes exposure to ultraviolet A (2.1 J/cm2) and 50 seconds to ultraviolet B (35 J/cm2). The

(a) Before dental treatment (b) After dental treatment

Fig. 15. Intraoral picture, and photos of the ear and back before and after the dental

**6.2 Case 2: 62-year-old male who requested dental implant treatment** 

to the Dental Metal Allergy Clinic.

Prognosis

treatment.

units was designed for maxillary dentition, while a resin clasp denture was fabricated for her missing mandibular molar.

a) Intraoral pictures at first visit (b) Intraoral pictures after dental treatment

(c) A picture of her hand at first visit (d) A picture of her hands after dental treatment

Fig. 14. Intraoral pictures and hands before and after dental treatment.

units was designed for maxillary dentition, while a resin clasp denture was fabricated for

a) Intraoral pictures at first visit (b) Intraoral pictures after dental treatment

treatment

(c) A picture of her hand at first visit (d) A picture of her hands after dental

Fig. 14. Intraoral pictures and hands before and after dental treatment.

her missing mandibular molar.
