title: The histological and immunohistochemical pattern of positive patch test reactions to gold sodium thiosulfate.
abstract: Gold sodium thiosulfate, inserted in the patch test standard series, gives a surprisingly high yield of positive reactions, about 10% of tested eczema patients, but with a low degree of clinical relevance. A histopathological study on patch test reactions was carried out in patients selected because of a combined contact allergy to gold sodium thiosulfate and nickel. Biopsies were taken from macroscopically similar reactions in dilution series of each allergen. The histological picture was clearly eczematous, without irritative features. In a blind comparison, test reactions induced by the two allergens could not be differentiated from each other. Long-lasting patch test reactions to gold sodium thiosulfate were characterized by an intense lymphocytic dermal infiltrate without epidermal involvement. Immunohistochemically, CD4+ and CD8+ T lymphocytes could be detected already 4-8 h post-challenge, and "naive" as well as "memory"-type T cells were demonstrated. Apparently, our findings reflect a true contact allergy to gold sodium thiosulfate.
authors.affiliation: Department of Dermatology, Lund University, Malmö, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Möller
authors.forename: A
authors.initials: A
authors.lastname: Larsson
authors.forename: B
authors.initials: B
authors.lastname: Björkner
authors.forename: M
authors.initials: M
authors.lastname: Bruze
mesh_terms: D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D003713:Dendritic Cells / Q000473:pathology; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000473:pathology; D004485:Eczema / Q000139:chemically induced / Q000378:metabolism / Q000473:pathology; D005260:Female; D012971:Gold Sodium Thiosulfate / Q000009:adverse effects*; D006801:Humans; D007150:Immunohistochemistry; D007156:Immunologic Memory / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects; D010328:Patch Tests; D016037:Single-Blind Method; D012867:Skin / Q000187:drug effects / Q000378:metabolism / Q000473:pathology*; D016176:T-Lymphocyte Subsets / Q000473:pathology
chemical_list: D009532:Nickel; D012971:Gold Sodium Thiosulfate