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To the Editor.—
Drs. Roenigk and Handel, in their article describing a case of gold vasculitis (Arch Dermatol 109:253, 1974) present an interesting observation. They fail, however, to give any evidence that would indicate that the gold leaf they employed in the patch testing was indeed absolutely pure gold. This leaves open to speculation a number of possibilities, including the presence of many other metals in trace to reasonably substantial amounts. Additionally, one must be concerned with the possibility that there was surface contamination of the gold leaf with organic or inorganic allergens.Was a neutron activation analysis performed on the metallic gold leaf? What techniques were used to exclude surface contamination by other materials? The answer to these questions must be evaluated prior to lending any credulence to their observation.
Steele DR. Gold Vasculitis. Arch Dermatol. 1974;110(2):297. doi:10.1001/archderm.1974.01630080085033