**Allergic Contact Dermatitis to Specific Allergens**

86 Contact Dermatitis

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*cells predicts contact allergens from irritants.* Toxicol In Vitro 20:117-124. Vandebriel, R.J.; Pennings, J.L.; Baken, K.A.; Pronk, T.E.; Boorsma, A.; Gottschalk, R.; Van

*irritating compounds.* Toxicol Sci 117:81-89.

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U.F.; Herr, W. (2008). Rapid identification and sorting of viable virus-reactive CD4(+) and CD8(+) T cells based on antigen-triggered CD137 expression. J

**6** 

*Japan* 

**Dental Metal Allergy** 

Maki Hosoki and Keisuke Nishigawa *The University of Tokushima Graduate School* 

Dental metal allergy is the general term used to describe allergic diseases caused by reactions to dental metal materials. Recently, allergic symptoms involving other dental materials, such as organic compounds, have been reported, and these allergic diseases need to be referred to as either a dental allergy or dental material allergy. When safety evaluations involving biomaterials are performed, various kinds of risk factors, including the potential for cytotoxicity and/or allergization, need to be taken into consideration

At the present time, even ordinal dental treatment requires the use of many kinds of metallic and organic materials, some of which are known to cause allergic symptoms. The first clinical cases of dental metal allergy involved a mercurial allergy to intraoral amalgam fillings that led to stomatitis and dermatitis around the anus (Fleischmann, 1928). Previous studies in many countries have reported a variety of symptoms to be associated with different metals (Hubler&Hubler, 1983, Lundstrom, 1984, Magnusson et al., 1982, Wiesenfeld et al., 1984). Nickel, chromium, mercury, palladium, and cobalt are typical of metals used in dentistry that have caused allergies, which have included reactions to these materials not only in the mucosa of the oral cavity, but also on the skin of the hands, feet,

Typical allergies reported to be associated with dental materials have included contact dermatitis, systemic contact dermatitis, and contact dermatitis syndrome. Since most of the intraoral dental materials cannot be removed from home environments, these allergic reactions tend to be intractable, with repetitions of symptomatic treatments, such as external medications, found in many of these cases. Sometimes general and local dermatitis is found in the skin apart from the intraoral dental material, and it exhibits pathognomonic symptoms of the allergy that are different from those noted in other contact dermatitis.

The prevalence of dental metal allergy has gradually increased over the last decade (Fig. 1). The demography of the dental metal allergy patients who visited Tokushima University Hospital is seen in Table 1. During July 2000 to June 2005, a total of 148 out of 212 patients (69.8%) exhibited a positive allergic reaction to at least one kind of the patch-test reagents. Since more than 80% of these patients were referred from dentists and dermatologists at other medical institutions, we expected to find a higher positive reaction rate as compared

and/or entire body (Gawkrodger, 2005, Hamano et al., 1998, Yanagi et al., 2005).

**1. Introduction** 

**2. Epidemiology** 

(Geurtsen, 2002, Wataha, 2000).
