Severe generalized dermatitis in a nickel-allergic patient with a popliteal artery nitinol stent

Guerra, Andres; Kirkwood, Melissa L.

doi:10.1016/j.jvscit.2016.08.002

Cited by 20 publications

(16 citation statements)

References 11 publications

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“…Following insertion, the development or aggravation of vesicular hand eczema and dermatitis in the overlying skin have been described . Dermatitis in nickel‐allergic individuals resulting from the use of various surgical utensils and materials has been described . The prostheses used for hip replacement have changed over time.…”

Section: Sources Of Nickel Exposurementioning

confidence: 99%

“…79 Dermatitis in nickel-allergic individuals resulting from the use of various surgical utensils and materials has been described. 84,85 The prostheses used for hip replacement have changed over time. In the 1960s, they were made of metal-on-metal and had high rates of metal release; from the 1970s, metal-on-plastic models were used, which produced fewer wear particles.…”

Section: Surgical Implantsmentioning

confidence: 99%

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Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

et al. 2019

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Nickel is the most frequent cause of contact allergy worldwide and has been studied extensively. This clinical review provides an updated overview of the epidemiology, exposure sources, methods for exposure quantification, skin deposition and penetration, immunology, diagnosis, thresholds for sensitization and elicitation, clinical pictures, prevention, and treatment. The implementation of a nickel regulation in Europe led to a decrease in the prevalence of nickel allergy, and changes in the clinical picture and disease severity. Nevertheless, the prevalences of nickel allergy in the European general population are approximately 8% to 19% in adults and 8% to 10% in children and adolescents, with a strong female predominance. Well‐known consumer items such as jewellery and metal in clothing are still the main causes of nickel allergy and dermatitis, although a wide range of items for both private and occupational use may cause dermatitis. Allergic nickel dermatitis may be localized to the nickel exposure site, be more widespread, or present as hand eczema. Today, efficient methods for exposure quantification exist, and new insights regarding associated risk factors and immunological mechanisms underlying the disease have been obtained. Nevertheless, questions remain in relation to the pathogenesis, the persistent high prevalence, and the treatment of severe cases.

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Section: Sources Of Nickel Exposurementioning

confidence: 99%

Section: Surgical Implantsmentioning

confidence: 99%

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

et al. 2019

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“…Regarding the method of reconstruction after stent removal, in some case reports, bypass surgery using an autologous vein was performed; however, in our case, direct suturing was possible since the stent could be removed while leaving sufficient vascular wall, and the suturing distance was short [7,8]. In fact, the findings of two-year follow-up computed tomography showed no aneurysm or stenosis after revascularization, direct suturing seemed to be a good reconstruction method without leaving any artifacts for this case.…”

Section: Discussionmentioning

confidence: 79%

Metallic allergy requiring removal of iliac stent: report of a case

et al. 2020

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Background: The use of metallic stents, which are predominantly composed of nickel, in the treatment of patients with nickel allergy has not been well studied. Case presentation: A patient who suffered from contact dermatitis due to implantation of an iliac stent was successfully treated by removing the stent that caused nickel allergy. The patient has exhibited no symptoms of claudication or severe pruritic rash in the 2-year follow-up period after iliac stent removal. Conclusions: We herein report a case of nickel allergy in which a metallic iliac stent that was predominantly composed of nickel was removed. The patient showed a marked recovery from her contact dermatitis. In cases of suspected metallic allergy, it is necessary to consider revascularization without using a metal device.

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“…The gold-standard treatment for contact allergy is removal of the causative material. Guerra and Kirkwood 6 reported that nickel contact allergy led to severe generalized dermatitis after stent placement in the superficial femoral artery, but the symptoms resolved after removal of the stent. However, we could not simply remove the device from our patient because it was used to treat a ruptured aorta, and it involved replacement of the ruptured aorta with a thoracoabdominal aortic clamp because the stent-graft has a suprarenal stent.…”

Section: Discussionmentioning

confidence: 99%

A case of nickel allergy after endovascular aortic repair

Kawatani

Kurobe

Nakamura

et al. 2018

Asian Cardiovasc Thorac Ann

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A 78-year-old man with no history of allergy, underwent endovascular aortic repair for abdominal aortic aneurysm rupture. Postoperatively, he had low-grade fever and persistently raised white blood cell counts, but tests showed no infection. A skin rash appeared on the trunk and upper arms; we suspected a drug allergy. Despite withdrawal and/or change of medications, the symptoms remained. Finally, a patch test for nickel showed a strongly positive result. Oral prednisone 5 mg·day was started, and the clinical findings resolved thereafter. No recurrence of allergy, infection, or exacerbation of the treated abdominal aortic aneurysm was noted at the 2-year follow-up.

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Severe generalized dermatitis in a nickel-allergic patient with a popliteal artery nitinol stent

Cited by 20 publications

References 11 publications

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

Metallic allergy requiring removal of iliac stent: report of a case

A case of nickel allergy after endovascular aortic repair

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