{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:26:51Z","timestamp":1787837211149,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T00:00:00Z","timestamp":1594598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metal hypersensitivity reactions (MHR) as a cause of implant\u2010related complications are highly debated and recommendations regarding pre\u2010procedural allergy evaluation vary dramatically.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine patients referred before or after device implantation and identify factors that could be useful to guide the value of patch testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent patch testing pre\u2010 or post\u2010device implantation between July 2006 and September 2016 were analyzed retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A series of 127 patients underwent patch testing: pre\u2010implantation (n = 40) and post\u2010implantation (n = 87). In the pre\u2010implant group, a history of metal allergy demonstrated high sensitivity (0.94; 95% CI: 0.83\u20131.00) and negative likelihood ratio (0.17; 95% CI:0.02\u20131.29) for diagnosing MHR. No predictive value could be ascribed to any of the clinical symptoms (eg dermatitis, pain, swelling, implant failure, and\/or other symptoms) for patients referred following orthopaedic and dental post device implantation. Eight patients in the orthopaedic group and six patients in dental group with relevant patch test reactions underwent implant revisions, and seven and five patients improved, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pre\u2010implant patch testing for selected individuals with a history of metal allergy can help guide implant choice. Post\u2010implant patch testing may be helpful in some patients if other causes have been excluded, as patients with confirmed MHR benefited from revisions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cod.13637","type":"journal-article","created":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T18:11:56Z","timestamp":1592071916000},"page":"398-407","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical factors before or after device implantation in predicting metal hypersensitivity reactions: A retrospective study"],"prefix":"10.1111","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-3905","authenticated-orcid":false,"given":"Idy","family":"Tam","sequence":"first","affiliation":[{"name":"Tufts University School of Medicine  Boston Massachusetts"},{"name":"Department of Dermatology Massachusetts General Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0874-3170","authenticated-orcid":false,"given":"JiaDe","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Dermatology Massachusetts General Hospital  Boston Massachusetts"},{"name":"Harvard School of Medicine  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6281-2421","authenticated-orcid":false,"given":"Lauren N.","family":"Ko","sequence":"additional","affiliation":[{"name":"Harvard Combined Dermatology Residency Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8953-4639","authenticated-orcid":false,"given":"Peter C.","family":"Schalock","sequence":"additional","affiliation":[{"name":"Department of Dermatology Geisel School of Medicine at Dartmouth  Hanover New 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