# Clinical Relevance of Contact Allergy to Gold Sodium Thiosulphate in Fibromyalgia

## TL;DR

This study explores the link between gold allergy and fibromyalgia, finding that people with fibromyalgia and gold allergy experience more skin and oral symptoms when exposed to gold.

## Contribution

The study identifies a significant association between gold allergy and reported skin and oral symptoms in fibromyalgia patients.

## Key findings

- 33.6% of fibromyalgia patients tested positive for gold sodium thiosulphate allergy.
- Gold allergy was significantly overrepresented in patients with cutaneous and oral symptoms.
- Fibromyalgia patients with gold allergy may have increased susceptibility to gold-related symptoms.

## Abstract

Fibromyalgia is a chronic syndrome characterized by pain, fatigue, and cognitive disturbances. The increased prevalence of contact allergy to gold in individuals with fibromyalgia when compared with the general population has previously been described. Gold contact allergy can manifest as a systemic contact dermatitis, with cutaneous and extracutaneous manifestations presenting upon systemic administration of gold. This study aimed to establish whether gold allergy is of significance in the fibromyalgia population. Prior to patch testing with the Swedish baseline series and an extended dental series, 119 females with fibromyalgia answered questionnaires including details of past medical history, dental history, and previous cutaneous and mucous membrane intolerance to metals. Prevalence of allergy to gold sodium thiosulphate (2.0% and 5.0%) was 33.6% (40 individuals). There was a statistically significant overrepresentation of gold allergy among individuals who experienced cutaneous symptoms upon direct contact with gold (p = 0.010). Contact allergy to gold was more frequent among patients with oral symptoms (p = 0.024). This study demonstrates concordance between reported cutaneous symptomatology related to gold exposure and gold allergy in the fibromyalgia population. Whether individuals with oral symptoms and gold allergy have objective oral clinical findings and relevant gold exposure is the focus of ongoing study.

People with gold allergy do not usually experience problems with gold in contact with the skin (such as with jewellery). However, when used internally, such as with gold dental restorations, gold can cause symptoms in individuals with gold allergy. In this study we show that individuals who have fibromyalgia and gold allergy experience skin problems when wearing gold jewellery and individuals with gold allergy report more oral problems. Fibromyalgia may make patients more susceptible to problems related to gold allergy, through potential increased exposure to gold, or other factors such as poor oral health.