Metal hypersensitivity affects 10-15% of foot and ankle patients, usually presenting with an eczematous-type rash overlying metallic implants and representing a type IV delayed hypersensitivity reaction.  Relevance of jewelry allergy A history of jewelry or contact allergy is an important clue. Research shows that 60% of patients with prosthesis-related hypersensitivity (PRH) patients had a known contact allergy – 25.7% to metals and 34.6% to other substances. In a patch test