Reports of immune reactions of both the immediate and delayed types due to cutaneous or systemic exposure to
copper have been reviewed, in the endeavor to draw a comprehensive profile of the immunogenic potential of that
metal and its compounds. The
metal's immunotoxic potential is also briefly reviewed. In principle, as noted for other transition metals, the electropositive
copper ion is potentially immunogenic due to its ability to diffuse through biological membranes to form complexes in contact with tissue
protein. Based on predictive guinea pig test and the local lymph node assay (LLNA),
copper has a low sensitization potential. Reports of immune reactions to
copper include immunologic contact
urticaria (ICU),
allergic contact dermatitis (ACD), systemic
allergic reactions (SAR) and contact
stomatitis (STO), but considering the widespread use of
copper IUDs and the importance of
copper in coinage, items of personal adornment and industry, unambiguous reports of sensitization to the
metal are extremely rare, and even fewer are the cases, which appear clinically relevant. Reports of immune reactions to
copper mainly describe systemic exposure from
intrauterine devices and prosthetic materials in dentistry, implicitly excluding induction of the
hypersensitivity from contact with the skin as a risk factor. We provide a diagnostic algorithm that might clarify the frequency of
copper hypersensitivity.