Clinical Evaluation of Metal Panel Allergens: Dose Response Study

A 48-hour application (approximate) of investigational allergen panels, excipient controls
and corresponding reference allergens will be applied to the skin of human subjects to test
for potential positive allergic responses. Test sites will be evaluated at 3-4, 7-8, 10-14
and 19-23 days after application. Ascending allergen dosages will be randomized within each
panel into three different configurations which will be randomly assigned to subjects as they
enter the study. The investigators and subjects will be aware of the allergens and the patch
test doses but will not be aware of the location of individual allergens within each panel.

Inclusion Criteria:

1. 18 years of age or older.

2. Past positive patch test result within the past 10 years (to one of the dilution
series metals being tested on this study) or strong suspicion of metal contact allergy
based on results of the Qualification Questionnaire.

3. Unable to become pregnant or willing to use an acceptable method of contraception to
prevent pregnancy if female of childbearing potential; (Inability to become pregnant
includes all male subjects and female subjects who are postmenopausal for at least 1
year, or surgically sterile- have had a hysterectomy, bilateral ovariectomy, uterine
ablation or bilateral tubal ligation. Acceptable methods of contraception include: 1)
systemic birth control; 2) double barrier method; 3) intrauterine device; 4)
vasectomized partner; or 5) abstinence from sexual intercourse. Subject must agree to
use acceptable contraception for the duration of the entire study.)

4. Understands and signs the approved Informed Consent form which is consistent with all
institutional, local and national regulations.

Exclusion Criteria:

1. Breastfeeding or pregnant (as determined by urine pregnancy test) or intending to
become pregnant during the course of the study.

2. Topical treatment with corticosteroids or other immunosuppressive agents on or near
the test area during the 14 days prior to inclusion in this study.

3. Systemic treatment with corticosteroids (equivalent to > 10 mg prednisone) or other
immunosuppressive agents during the 14 days prior to inclusion in this study. Inhaled
treatments are permitted. NOTE: Steroidal nose or eye drops are permitted.

4. Treatment with ultraviolet (UV) light (including tanning) during the 3 weeks prior to
inclusion in this study.

5. Acute dermatitis outbreak or dermatitis on or near the test area on the back.

6. Conditions such as; fibromyalgia, chronic fatigue, depression, cognitive impairment,
flu-like symptoms, diarrhea and/or headache without at least one of the symptoms
related to metal exposure listed in Section 10.1 under physical examination

7. Inability to comply with patch test study requirements including multiple return
visits and activity restrictions (e.g., protecting test panels from excess moisture
due to showering or vigorous activity).

8. Participation in a clinical trial of an investigational drug, treatment or device
during this study or 3 weeks prior to inclusion in this study.

9. An opinion of the Investigator that deems the potential subject to be non-compliant,
unable to return for study visits or complete the study as detailed in the protocol.