The Epidemiology of Contact Allergy to Metals in the General Population: Prevalence and New Evidences

Aluminium, Au, Be, Co, Cr, Cu, Hg, Ir, Ni, Pd, Pt, Rh and Ti represent causes of metal-induced allergic contact dermatitis (ACD) which expresses in a broad spectrum of cutaneous adverse manifestations. The exposure is primarily by skin contact with various items and products such as jewellery and piercing, cosmetics and tattoos, detergents, body implants and dental prostheses. To reduce the growth of the metal ACD among people, the European Union issued directives that limit the total Ni content in jewellery alloys and ban metals in cosmetics. Despite these regulations, the diffusion of metal ACD remained quite high. On this basis, a review of the epidemiological evidence of the metal-induced ACD is reported discussing the sources, the prevalence and the prescriptions.