Individual variation in nickel patch test reactivity*1

Abstract

The variation in nickel reactivity as shown in this article is of great importance and should be kept in mind when a patient has a positive history of allergic contact dermatitis but negative patch test results to nickel.

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

“…32 Although this may be explained by changing confounding variables, the increase is steepest during the 1980s (which is in accordance with patch test results from Europe). 14,15,33 Finally, nickel continues to be responsible for clinical disease among young US residents. 34 Thus, there are indications to suggest that many US residents are continuously exposed to nickel and that the nickel epidemic remains to be sufficiently managed.…”

Proposal for a risk assessment methodology for skin sensitization based on sensitization potency data

“…Hindsen et al (1999) have determined elicitation thresholds in 18 female subjects with allergic contact dermatitis to nickel in four independent tests spread over a period of seven months. A considerable variation of the LOEL in some of the individuals was observed.…”

Thoughts on sensitizers in a standard patch test series

“…To establish or rule out contact allergy in this situation, patch testing should be repeated. Because of both biological and technical reasons, there might be variation in the test response to the same sensitizer from one time to another (40,41). Thus, reading of the repeated test may be positive, negative or may remain questionable.…”

“…In the latter case, the patient may have been sensitized in the interval between the performances of the patch tests due to environmental exposure to the antigen (53). Furthermore, the positive reaction noted on the second patch test occasion may only represent an increased level of sensitivity (40). However, if patch testing is performed on this occasion with the substance diluted 10-100¿ as compared to the original test concentration, and still gives positive reactions, patch test sensitization must be considered likely (53).…”