Did a patch test trigger a broader allergic response?

December 18, 2018 1:59 PM

Could a positive finding on a patch test trigger a reaction to a material that I have been continually exposed to since my wedding day?

In October, I had a patch (T.R.U.E.) test done for various substances, including metals. After testing positive for gold allergy only (gold sodium thiosulfate), I shrugged, declared that it's not an issue as I never wear gold jewelry, and trotted off. The area where the patch had been remained raised, itchy, and red for a few weeks, then gradually went away.

About a month after the test, I noticed two localized skin reactions: a patch under my eye became scaly, inflamed, and itchy. Also, an area on my ring finger (below my wedding rings) became red, scaly, and extremely itchy. I have never had that reaction on my finger, though I have had some issues with seborrheic dermatitis. I removed my rings and treated both areas with hydrocortisone and hypoallergenic lotion. Now that a few weeks have passed, both skin reactions have cleared up. I wouldn’t have posited any connection at all, but I suddenly remembered that my wedding band is white gold (as opposed to my wedding ring, which is platinum). I’ve worn this ring for 15+ without ever having a reaction.

Weird, right? Any chance that the patch test may have set off an extra/systemic sensitivity to the white gold? And also cause the facial skin issues? Or just one of those bad-luck coincidences?

posted by dreamphone to Health & Fitness (4 answers total)

Not a doctor, not an expert in metal alllergies, but allergic to my own white gold ring. White gold triggers my nickel allergy which manifests as you’ve described. It’s also systemically cumulative, so wearing earrings with nickel can make my finger react to my ring. Earrings can be fine with no ring, but add a ring or a belt touching my body and then my ears get red and scaly. It’s magic.

So with zero expertise and just anecdata, I would think this could happen. However, wouldn’t the allergy test have shown you were allergic to nickel if that were the case?
posted by OrangeVelour at 2:08 PM on December 18, 2018

I'm allergic to nickel. I found out because after wearing a $6 silver ring (that was prob like 98.9% nickel) for weeks/months, my lips swelled up so bad that my then wife thought my silhouette in the moonlight looked like Donald Duck. My wife then threw away the ring in retribution (even though we're now divorced and I've remarried, I still think that was a bit harsh for the poor ring), and I've never had the problem again.

Obviously 15+ years (I'm guessing you forgot "years") is a lot different than my timeline, but my allergy was definitely a "not a problem until it was" situation.
posted by sideshow at 2:22 PM on December 18, 2018

I guess the question is, why were you having a patch test? If you were already having some skin reactions, even if in locations that don't necessarily seem related to a gold allergy, it's more likely that you became sensitized to gold from extended exposure to your wedding band that contains a gold alloy, which you've been wearing for more than 15 years.

The T.R.U.E. test insert (PDF) does mention, "Sensitization to one or more of the allergens may occur with initial or repeat testing." But since the test was far from your first exposure to this particular allergen, I wouldn't think that's the most likely scenario.
posted by limeonaire at 6:09 PM on December 18, 2018

Response by poster: Thanks much for the comments. The patch test was to find out if I had contact dermatitis with bacitracin (apparently I don’t), from a reaction that I’d had last year.
posted by dreamphone at 7:54 AM on December 19, 2018 [1 favorite]