Allergic contact dermatitis (ACD), specifically to metals, remains a prevalent skin disease globally. Metal exposure continues to be a common cause of chronic and recurrent dermatitis in both occupational and non-occupational settings. This study aimed to determine the demographic and clinical profiles of patients with metal-induced ACD and to identify the most common metal allergens in a tertiary hospital setting. A retrospective cross-sectional analysis was conducted among 421 patients who tested positive for metal allergy between 2012 and 2024. Records were reviewed for demographic characteristics, clinical presentation, anatomical distribution of lesions, reported allergen exposures, and patch test results. Data were analyzed descriptively to identify patterns of metal sensitization and exposure relevance. Nickel was the most prevalent metal allergen, followed by cobalt, chromium, and gold. Female patients and younger individuals were more frequently sensitized to nickel, often associated with non-occupational exposures such as jewelry and personal accessories. In contrast, cobalt and chromium allergies were more common among male patients, aligning with occupational exposures including cement, construction materials, and industrial products. Lesions predominantly affected the hands, feet, and arms. More than half of the participants reported exposures relevant to their identified allergen, supporting the clinical relevance of patch testing. This study confirms the predominance of nickel allergy among patients with metal-induced ACD and highlights recognizable patterns in demographics, clinical presentation, and exposure history. These findings may assist clinicians in the diagnosis and management of suspected metal allergy, and patch testing remains a valuable diagnostic tool, particularly for patients with chronic, atypical, or overlapping dermatoses. 

Dr. Camille Ysabel V. Bautista is a third-year Dermatology resident at Jose R. Reyes Memorial Medical Center, Philippines. She leads the Contact Dermatitis section, is a member of the Dermatologic Surgery section, and focuses on allergic contact dermatitis and advanced dermatologic procedures. She has received awards for research and academic excellence.