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The clinical condition is characterized by localized skin rash, pruritus, redness, swelling, and lesions, which are mainly detected by patch tests and lymphocyte stimulation. Heavy metals such as palladium (Pd), platinum (Pt), and titanium (Ti) are ubiquitous in our environment. These heavy metals have shown CD effects as allergic agents. Immunological responses result from the interaction of cytokines and T cells. Occupational metal CD accounts for most cases of work\u2010related cutaneous disorders. In this systematic review, the allergic effects of heavy metals, including Pd, Pt, and Ti, and the mechanisms, clinical manifestations, prevalence, and therapeutic approaches are discussed in detail. Furthermore, the therapeutic approaches introduced to treat CD, including corticosteroids, topical calcineurin inhibitors, systemic immunosuppressive agents, phototherapy, and antihistamines, can be effective in the treatment of these diseases in the future. Ultimately, the insights identified could lead to improved therapeutic and diagnostic pathways.<\/jats:p>","DOI":"10.1002\/mco2.386","type":"journal-article","created":{"date-parts":[[2023,10,22]],"date-time":"2023-10-22T05:14:06Z","timestamp":1697951646000},"source":"Crossref","is-referenced-by-count":17,"title":["Systemic allergic contact dermatitis to palladium, platinum, and titanium: mechanisms, clinical manifestations, prevalence, and therapeutic approaches"],"prefix":"10.1002","volume":"4","author":[{"given":"Ali","family":"Sadrolvaezin","sequence":"first","affiliation":[{"name":"Medical Toxicology and Drug Abuse\u00a0Research Center Birjand University of Medical Sciences  Birjand Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arezou","family":"Pezhman","sequence":"additional","affiliation":[{"name":"School of Medicine Zahedan Azad University of Medical Sciences  Zahedan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0056-5576","authenticated-orcid":false,"given":"Iman","family":"Zare","sequence":"additional","affiliation":[{"name":"Research and Development Department Sina Medical Biochemistry Technologies Co. 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