Gold Contact Sensitization, Clinical Characteristics and Associations With Autoimmune Disease: A Retrospective Cohort Study With Registry Linkage

ABSTRACT Background Gold sensitization is common, but its clinical and immunologic significance remains unclear. European data from consecutively patch tested patients are scarce. Animal models suggest that gold can induce systemic autoimmunity, but studies in humans are limited. Objectives To characterize gold sodium thiosulphate (GST) patch test positive patients, including co‐sensitization patterns to other metals and determine whether gold sensitization is linked to autoimmune diseases. Methods A retrospective register‐based study including 3436 dermatitis patients consecutively patch tested between 2015 and 2024 at Odense University Hospital, Denmark. Patch test results were linked to diagnostic data from the Danish National Patient Registry. Autoimmune diseases were grouped into six categories analysed using logistic regression. Results Gold sensitization was found in 18.7% of tested patients and was more common in women (OR 2.38, 95% CI 1.96–2.94) and at an age above 40 years (OR 1.32, 95% CI 1.09–1.60). Concomitant sensitization to Ni, Cr and Co increased with higher gold reactivity ( p < 0.01). No association was observed between gold sensitization and autoimmune diseases, overall (OR 1.00, 95% CI 0.82–1.22). Conclusions A positive patch test to GST was associated with other metal allergies but not with any autoimmune diseases.