Allergic contact dermatitis pattern in Kuwait: nickel leads the pack. In-depth analysis of nickel allergy based on the results from a large prospective patch test series report

Al-Mutairi, Nawaf; Almutawa, Fahad

doi:10.5114/ada.2017.67843

Cited by 10 publications

(9 citation statements)

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“…[14][15][16][17] Our frequency was similar to values from Italy (25.4%), Spain (25.4%), China (25.7% and 24.4%), and Kuwait (23.9%). [18][19][20][21][22] Second, frequency of nickel sensitivity significantly increased over the 12-year study period from 24.3% to 27.9% ( P < 0.001). Unfortunately, detailed analysis of trends in nickel sensitivity in Canada over time is lacking.…”

Section: Discussionmentioning

confidence: 99%

“…21,30,32,34 This has been suggested to be due to the decreasing incidence in piercings and reduced contact with imitation jewelry in older generations. 21 However, contrary to our results, other studies have found young age to be a prominent risk factor in nickel allergy with significantly higher prevalence of nickel sensitivity in pediatric patients compared with adults 19 years and older. 10,32 Unfortunately, with only 3.0% of our study population being pediatric patients, this population is underrepresented in our data set and likely lacks power to draw meaningful conclusions (Supplemental File 1, http://links.lww.com/DER/A84).…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Contact Allergy to Nickel: A Retrospective Chart Review

2021

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Background: No recent studies reporting nickel sensitivity prevalence in Canadians exist. Objectives: The aim of this study was to quantify nickel sensitivity prevalence in patients at a patch test clinic in Vancouver. Methods: Retrospective chart review of 3263 patients patch tested for nickel sensitivity at our clinic in Vancouver between 2008 and 2020.Results: In total, 24.3% (n = 792 of 3263) of patients were sensitive to nickel. Nickel sensitivity significantly increased over time from 24.3% to 27.9% from 2008 to 2020. Nickel-sensitive patients were significantly more likely to be women ( P < 0.001), between the ages of 19 and 64 years ( P = 0.010), and have dermatitis affecting the face ( P = 0.001) and hands ( P = 0.001). Nickel-sensitive patients were significantly less likely to be 65 years or older ( P = 0.001) and have dermatitis affecting the legs ( P = 0.002). Approximately half of nickel-sensitive reactions were new positive reactions at the second reading.Conclusions: Nickel sensitivity occurred in approximately one quarter of patients and significantly increased over time. Nickel-sensitive patients were more likely to be women, aged 19 to 64 years, and have dermatitis affecting the face and hands; and less likely to be 65 years or older and have dermatitis affecting the legs. Capsule Summary• Clinicians should be aware of a significant increase in nickel sensitivity over time in Canada from 24.3% to 27.9% from 2008 to 2020. • In addition, nickel-sensitive patients were significantly more likely to be women, between the ages of 19 and 64 years, and have dermatitis affecting the face and hands; and significantly less likely to be 65 years or older and have dermatitis affecting the legs.• Further, approximately half of nickel-sensitive reactions were new positive reactions at the second reading, reinforcing the importance of delayed readings in determining nickel sensitivity.A llergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction characterized by pruritic erythematous macules, patches, papules, vesicles, or bullae presenting approximately 48 hours after exposure to an allergen in susceptible individuals with previous sensitization. [1][2][3] Patch testing is the standard for diagnosing causative allergens responsible for ACD. 4 Patch testing attempts to recreate, in vivo, an allergic reaction to nonirritating concentrations of an allergen suspended in a vehicle, aiming to identify a chemical or chemicals that can be removed from the patient's environment, resulting in clearing of an ACD, which may have been present for years. 4 Nickel, a ubiquitous metal used in a wide range of industrial and household products, is the most common contact allergen among metals. Exposures occur through cell phones, body piercings, and stenting procedures to name a few. 5 Nickel allergy is currently the most common cause of contact dermatitis in the industrial world, particularly affecting women. [6][7][8][9][10][11] In fact, nickel allergy is on the rise in the United States, an increase larg...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of Contact Allergy to Nickel: A Retrospective Chart Review

2021

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“…Nickel salts being soluble in water and sweat easily cause sensitization. The reason for the relatively high prevalence of nickel ACD could be the use of nickel in consumer items that come in direct and prolonged contact with the skin ( 15 ). However, exposure may also occur in certain occupational settings generally associated with soluble nickel salts.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Epicutaneous Patch Test Results in Patients with Contact Dermatitis

Kasumagić-Halilovic

Ovčina-Kurtović

2018

Med Arch

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Background:Allergic contact dermatitis (ACD) is a delayed type of hypersensitivity from contact with a specific allergen to which the patients has developed a specific sensitivity. The aim of the study was to evaluate the results of epicutaneous patch testing with standard series of contact allergen in patients suspected to have ACD.Methods:355 cases of ACD were included in the study. Test substances were applied on the upper part of the patient’s back, on clinically uninvolved and untreated skin. All patients were free from therapy with oral antihistamines, steroids and immunosuppressants. The patch test was removed and reaction were evaluated after 48 h and 72 h. Grading of negative (-) to positive (+ to ++++) patch test was done according to the International Contact Dermatitis Research Group. Statistical data analysis was performed by using χ2–test.Results:Of the 355 cases, 146 patients were male (41.1%) and 209 were female (58.9%). The youngest patients in the study was 16 years of age and the oldest was 67 years of age. The commonest age group affected was 41-50 years. Hands were the most common site of involvement. The occupational character of skin lesions was find in 75 (21.1%). The most common positive reactions were recorded to nickel sulphate 99 (27.8%), cobalt chloride 46 (12.9%), thimerosal 31 (8.7%), colophony 23 (6.5%), carba mix 21 (5.9%), potassium dichromate 20 (5.6%), acid chromici 19 (5.3%), fragrance mix 18 (5%), balsam of Peru 13 (3.7%), formaldehyde 9 (2.5%), and other allergens 26 (7.3%). Females were significantly more likely to show a positive response to two or more allergens (p<0.05). There was no statistically significant impact of age, occupation and duration of disease on results of patch testing (p>0.05).Conclusions:Our results indicate that nickel sulphate, cobalt chloride and thimerosal are the most common allergens responsible for induction of ACD. These findings are crucial in the treatment, long term management, an education of patients with ACD.

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“…Indeed, according to a Danish study on current self-reported metallic exposures leading to dermatitis in nickel-allergic patients and the minimum contact time needed for dermatitis to occur, 21.4% of the patients reported dermatitis reactions within 10 min of contact, and dermatitis reactions within 30 min of contact were reported by 30.7% of patients [ 23 ]. In other regions of the world, such as Kuwait, nickel is a very important contact allergen, with 40% positive reactions in 2461 consecutively patch tested patients; the authors recommend adoption of nickel regulation limiting exposure [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

Contact Allergy: A Review of Current Problems from a Clinical Perspective

Uter

Werfel

White

et al. 2018

IJERPH

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Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.

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Allergic contact dermatitis pattern in Kuwait: nickel leads the pack. In-depth analysis of nickel allergy based on the results from a large prospective patch test series report

Cited by 10 publications

References 50 publications

Prevalence of Contact Allergy to Nickel: A Retrospective Chart Review

Prevalence of Contact Allergy to Nickel: A Retrospective Chart Review

Analysis of Epicutaneous Patch Test Results in Patients with Contact Dermatitis

Contact Allergy: A Review of Current Problems from a Clinical Perspective

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