Gold Allergy to a Permanent Gold Acupuncture Needle

A 68-year-old female had slightly elevated, dusky erythematous nodules on the right infraorbital and the right temple area. Topical, intralesional corticosteroids and oral antihistamines provided temporary but incomplete improvement. Follow up biopsy, four months after the first visit revealed a tiny gold acupuncture needle lodged at the center of the nodule. Subsequent skull series revealed seven more linear radiopaque densities on the corresponding sites to the skin nodules. A patch test and an intradermal test with gold chloride showed strongly positive reactions. Removal of the embedded needles led to disappearance of the cutaneous nodules and itching sensation in seven days.