2016 Volume 76 Issue 4 Pages 480-485
Palmoplantar pustulosis is a chronic inflammatory skin condition, and although its cause is unclear, it was suggested that smoking, stress, focal infection of the throat, and metal allergy may contribute to its development. To evaluate the effect of metal allergy in palmoplantar pustulosis patients, diagnostic patch testing with 18 metals was performed. 1,025 patients (210 men and 815 women, ranging in age from 4 to 85 years; mean 40.1, S.D ± 18.1 years) were so tested. Metals were applied on the back for 2 days with Patch test unit mini (Torii Pharmaceutical Co. Ltd, Tokyo) or Patch tester Torii (Torii Pharmaceutical Co. Ltd, Tokyo), and results were read with the ICDRG (International Contact Dermatitis Research Group) scoring system 3 days after application. Reactions of ＋ to ＋＋＋ were regarded as positive. Differences of positive rate to each metal between patients with 148 palmoplantar pustulosis and 877 with other diseases were analyzed with the χ2 test. Ten palmoplantar pustulosis patients (1 man and 9 women, mean 49.8, S.D ±13.5 years) positively reacted to platinum. There were significantly more patients reacting to 0.5% platinum chloride (p＜0.05) in the former (6.8%: 10 of 148) than in the later (2.6%: 23 of 877). Our data suggests that platinum allergy may play a role in the development of palmoplantar pustulosis. Since none of the 8 patients receiving dental treatment knew composition of their dental fillings, dentists should give patients such information.
