Metals Allergy Testing

MetALLs® Patch Testing

What is MetALLs® patch testing?

Your doctor has recommended patch testing to metals and bone cement as part of the evaluation at National Jewish Health. Patch testing is a method of placing small amounts of possible allergens, including metal salts and cements, on the skin for 2 days, and then examining the skin for a reaction for several days after. A positive reaction is red, raised, and often itchy. This method helps diagnose a metal or cement allergy, and will help your doctor identify the best treatment for you.

How do you get ready for the test?

Please follow these directions when getting ready for this test:

• The skin of your back and arms should be clear for 2 weeks before the test if possible.
• Avoid exposing your skin to the sun for 2 weeks before the testing, as tanned skin is less reactive. 
• Do not apply topical steroids, or calcineurin inhibitors such as Elidel or Protopic, to your back or arms for at least 1 week before your appointment.
• If your doctor agrees, stop taking oral steroids for at least 3 weeks before the test. Doses of 10mg per day or less of Prednisone is OK to continue taking. Call us if you have questions about the dose or can’t stop all oral steroids.
• Wait at least 3 weeks after a steroid injection to complete the patch testing.
• Do not apply any ointments, creams or lotions to your back or arms for 24 hours before the appointment.
• Shower before your first visit, as you won’t be able to take one for the next 2 days while the patches are on your back.
• Wear comfortable, loose fitting shirts and pants 
• Continue to take all your other medications as you normally do.

What is done during the MetALLs patch skin testing?

On your first visit, we will place several panels of patch tests on your skin, usually the back.  These are four or more rectangular panels with small amounts of pre-applied allergens.  Adhesive around the patches will adhere the panels to the skin.

After two days, you will remove the panels at home and photograph the skin reactions.

You will return to clinic from 4 to 6 days later, after the panels were first placed, to assess the skin reactions. 30% of positive reactions are not visible when the patches are first removed.

The entire series of tests will take about a week to complete. You will typically have an answer on the last day of testing, if you had your blood drawn three weeks before the final visit. Please remember that the blood tests for nickel and cobalt allergy take from 2 to 3 weeks to get the results. We encourage you to get your blood drawn 3 weeks before the patch testing so that all the results will be available at your last visit.

What should you do once the patch tests are in place?

Please follow these directions while the patch test panels are in place:

• Keep the panels and the skin around the panels dry during the two days the panels are on your back.
• Avoid physical activities that cause sweating or excessive movement during those two days the patches remain applied.
• It is best to continue to wear loose fitting clothing while wearing the patch. 
• You can take a shallow bath or sponge bath but avoid getting the patch test site (back or arms) wet. 
• You can take Benadryl or any other antihistamine for itching – it will not affect the patch test results.
• If you have too much itching or burning under a particular patch, call to speak with a nurse, (303-398-1355, Option 4.)  
• After 2 days, remove the panels at home, and use a sharpie to go over the corner markings. Then, take a photo with your cell phone of the skin reactions. Bring in the photo for your last visit.
• You can take a shower or bath after the panels are removed. Just do not scrub your back and make sure the markings are still visible afterwards.

How long will the MetALLs patch skin testing take?

You will visit us twice during the patch testing. The initial visit will take about 1 hour, and the subsequent visit will take up to 30 minutes.

How do you get to your test?

On the day of your scheduled test, check in at the Admissions Desk in the Smith Clinic.

If you have questions, please call our program representative at 303.398.1679.

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