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Dermal contact dermatitis caused by allergy to palladium

Case Report A 70-year-old woman had a 1-year history of itchy, edematous erythematous eruptions over the mandibles, forehead and frontal scalp (Fig. 1). She had been treated with topical corticosteroid without success. No enanthema was detected. Histopathological examination revealed a dense perivascular lymphocytic infiltrate in the dermis, without epidermal involvement, compatible with dermal contact dermatitis (Fig. 2). Patch testing with a metals series resulted in a ππ reaction to palladium chloride (1% aq.). The edematous and erythematous reactions were still active 1 month later. No reaction was detected to nickel or other dental alloys. She had not worn jewelry for a couple of years. Her dental crowns containing palladium were replaced with a resin substitute, and the skin lesion improved re-