P03Type‐I and ‐IV hypersensitivity to platinum salts

A 28‐year‐old female analytical chemist visited our patch test clinic with initially complaints of severe hand dermatitis. Later on she developed rhinitis, bronchial asthma and tightness of the chest. The complaints seemed work related: her condition improved during holidays and on sick leaves. She worked in a laboratory with several platinum salts and used different kinds of gloves (latex, nitril, etc.).
Methods:  Patch tests were performed with the European Standard series and prick tests with common inhalant allergens. Patch‐, prick‐ and open patch tests were carried out with various aqueous dilutions of platinum chloride (PtCl2).
Results:  Patch tests with 0.01–2% PtCl2 were positive on day 2, 3 and 6, and at 0.001% a follicular reaction was found. The prick‐test was already positive at the lowest concentration tested (0.001%). The open patch test, carried out retro‐auricular, showed a positive reaction at 1 and 2% PtCl2 after 20 min. Controls in healthy volunteers (n = 5) were all negative.
Discussion:  It is well known that platinum salts can cause type‐I hypersensitivity reactions like allergic rhinitis, conjunctivitis, bronchial asthma and urticaria, also referred to as platinosis. Contact dermatitis to platinum salts, however, is very rare. In our patch test clinic, 78 patients were tested between 1987 and 2001 with PtCl2 2%. Only 2 women showed a positive patch test for PtCl2. The patient presented here, stopped working with platinum salts and recovered from all complaints. We interpret our case as occupational type‐I and type‐IV hypersensitivity to platinum salts with mucosal and dermal manifestations.