Allergic contact hypersensitivity to nickel, neomycin, ethylenediamine, and benzocaine. Relationships between age, sex, history of exposure, and reactivity to standard patch tests and use tests in a general population

Abstract

A study population of 1,158 paid adult volunteers was obtained. Prior to patch testing, a history of previous exposure to four allergens also was obtained. Prevalence of positive reactions to patch tests was nickel, 5.8%; neomycin, 1.1%; ethylenediamine, 0.43%; and benzocaine, 0.17%. Nine percent of women reacted to nickel compared with 0.9% of men. There was a strong correlation of nickel sensitivity with a history of pierced ears, earlobe rash, and jewelry rash. Ten of 12 neomycin-positive subjects used neomycin for one week or longer on an inflammatory dermatosis, compared with six of 36 age-, race-, and sex-matched controls. By history, 85% were exposed to benzocaine, 48% to neomycin, and 15% to Mycolog (ethylenediamine). Of 127 patients referred to clinics for evaluation of contact dermatitis, 11% yielded positive tests to nickel, 6.3% to neomycin, 3.1% to ethylenediamine, and 1.6% to benzocaine. Data obtained from testing contact dermatitis patients are not applicable to the general population.

Effect of age and sex on the induction and elicitation of allergic contact dermatitis

“…There is a strong correlation of nickel sensitivity with a history of pierced ears, earlobe rash and jewelry rash (25). Widstrom & Erikssohn (27) also reported a strong correlation of ear piercing and nickel allergy in women.…”

“…On the other hand, among the older members, men were more susceptible because of heavy occupational exposure, which causes a higher prevalence of hand dermatitis and multiple sensitivities. In the general population, the incidence of nickel positive patch tests varies from 4.5-11.0% (5,25); the female-to-male ratio also varies from about 10:1 to 13:1 and nickel remains the most common sensitizer in women. The highest prevalence rate of nickel allergy was found in the 45-year-old group (29).…”

Comparison of Torquing Ability of 0.019” × 0.025” Nickel Titanium and Fiber Composite Archwires -A Cone Beam Computed Tomography Study

“…This functional advantage over metallic wires allows practitioners to practice variablemodulus orthodontic technique (6,7). These wires may also provide a viable alternative in patients allergic to nickel (8)(9)(10).…”

Nickel release from earrings purchased in the United States: The San Francisco earring study

“…1 Positive patch test reactions to nickel have been assessed in 5.8% of US adults (9% in women and 0.9% in men) 2 and in 7.6% to 12.9% of 399 US infants and children. 3,4 Furthermore, the North American Contact Dermatitis Group (NACDG) determined that 16.7% of 4913 patients were nickel sensitized in 2001 and 2002.…”

“…3,4 Furthermore, the North American Contact Dermatitis Group (NACDG) determined that 16.7% of 4913 patients were nickel sensitized in 2001 and 2002. 5 Nonoccupational risk factors of nickel sensitization include young age (probably because of exposure to nickel-releasing jewelry), 2,6 smoking (mechanism unknown), 7 and ear piercing. 6,8 The risk of sensitization from ear piercing is especially high when damaged epidermis and epithelialized channels are exposed to nickel.…”