Chromated metal products may be hazardous to patients with chromate allergy

Background: Hidden allergen exposure may contribute to persistence and relapse of chromate dermatitis. According to case reports, chromated metal products, such as screws, fittings, etc., may be relevant allergen sources for patients sensitized to chromate. Objectives: To examine concomitant patch test reactivity to potassium dichromate 0.5% petrolatum ( pet.) and three different types of chromated metal rings. Patients/Methods: Patients with proven or suspected chromate allergy were patch tested with potassium dichromate 0.5% pet. and three different types of chromated metal rings ( yellow, olive, and black). Hexavalent chromium Cr(VI) release from the patch tested rings was chemically analysed. Results: Ninety-five patients were tested: 49/95 (52%) reacted to potassium dichromate and 25/95 (26%) reacted to black chromated rings. Reactions to chromated rings exclusively occurred in patients reacting to potassium dichromate. Of 20 patients with a strong reaction to potassium dichromate, 14 reacted to black chromated rings. These were shown to have a high Cr(VI) release. Only two patients reacted to the other chromated rings, which had a very low Cr(VI) release. Conclusions: Handling chromated metal products must be regarded a hazard to chromate-sensitive patients, in particular those with a strong sensitization.