Topical and Systemic Therapies for Nickel Allergy

Tammaro, Antonella; Narcisi, Alessandra; Persechino, Severino; Caperchi, Cristiano; Gaspari, Anthony A.

doi:10.2310/6620.2011.11015

Cited by 15 publications

(9 citation statements)

References 5 publications

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“…A pivotal criticism concerns the doses needed to elicit a positive response by challenge test, because in most studies, they exceed up to 10 times the nickel amount deemed present in a normal diet. [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] Also in our experience, the average challenge dose was higher than in normal diet but just of a light increase (from 0.78 to 1.38 mg above the maximum and the minimum estimated intake by diet), and at least for a certain number of cases, mainly those with stronger and prompter response to the challenge, the dose proved very small (less than or equal to 0.2 mg).…”

Section: Discussionmentioning

confidence: 99%

Nickel Sensitization and Dietary Nickel are a Substantial Cause of Symptoms Provocation in Patients with Chronic Allergic-Like Dermatitis Syndromes

Antico¹,

Soana²

2015

Allergy�Rhinol (Providence)

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Data in literature seem to show that, in patients with contact allergic dermatitis, dietary nickel might be a cause of systemic dermatitis, but little information exists in literature about the role of nickel sensitization and dietary nickel in patients with allergic-like chronic dermatitis syndromes. The prevalence of nickel sensitization in patients with chronic allergic-like, non-IgE-mediated skin diseases, and the possible impact of dietary nickel on symptom provocation and persistence has been assessed in the present retrospective study on a case series of 1726 patients referred to our allergy unit for chronic allergic-like skin diseases. IgE-mediated pathogenesis and other differential diagnoses excluded, patients were patch tested. Nickel-positive patients underwent an elimination diet and double-blind placebo-controlled nickel challenge (DBPCNC) test. A total of 339 (20%) tested nickel-positive. Fifty-two patients (15%) recovered by avoiding sources of nickel contact and 29 (10%) dropped out. Out of the remaining nickel-sensitized patients, 277 (80%) achieved complete or near complete recovery with low-nickel content diet, and 185 of them (89%) were positive to DBPCNC. We conclude that nickel sensitization and dietary nickel seem to be the chief trigger for provocation and persistence of symptoms in an important part (∼11%) of patients with chronic allergic-like dermatitis syndromes.

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Section: Discussionmentioning

confidence: 99%

Nickel Sensitization and Dietary Nickel are a Substantial Cause of Symptoms Provocation in Patients with Chronic Allergic-Like Dermatitis Syndromes

Antico¹,

Soana²

2015

Allergy�Rhinol (Providence)

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“…A severe form of this allergy is the systemic nickel allergy syndrome, clinically characterized by cutaneous manifestations (contact dermatitis, pompholyx, hand dermatitis dyshidrosis, urticaria) with a chronic course and systemic symptoms (headache, asthenia, itching, and gastrointestinal disorders related to histopathological alterations of gastrointestinal mucosa, borderline with celiac disease) [13]. …”

Section: Introductionmentioning

confidence: 99%

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

Almutawa

2017

pdia

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A b s t r a c tIntroduction: Contact dermatitis is a relatively common dermatosis reported among several population groups from all around the globe. However, the data from Kuwait is unavailable. Patch tests are essential for the diagnosis of contact sensitization. Aim: To determine a relative frequency and pattern of sensitizers to different allergens in patients of suspected contact dermatitis in Kuwait and, also to study the role of the commonest sensitizer in detail. Material and methods: Patch tests were performed in 2461 consecutive patients with a clinical diagnosis of contact dermatitis seen at our hospital between September 1, 2014 and August 31, 2015. Out of the total of 1381 (56.1%) patients with positive patch test results to at least one allergen, 546 (22.2%) patients with a single positive reaction to nickel only (single largest sensitizer) were selected as the study population for further detailed analysis. Results: At least one positive patch test reaction was found in 1381 (56.12%) patients. Nickel was found to be the most common sensitizer seen in 546 (40%) patients. The mean age was 37.3 ±13.8 years and the mean duration of disease was 27.3 ±13.8 months. Most (387/546) patients sensitized were females. The forearms/hands and wrists were the most prevalent sites (52.56% of the participants). In 58.91% of women, dermatitis was more often confined to other sites, mostly ears and the neck due to earrings and necklaces. Just more than half of the number (51.09%) of nickel allergic patients were found in the age group of 15-25 years. Hairdressers/beauticians were the most affected group followed by house workers (housewives, cleaners, housekeepers). Conclusions: Nickel is the single most common sensitizer found in our patients, and female sex, young age, occupation with long hours of contact to nickel are high risk factors. We recommend that a directive, which limits the release of nickel from products with extended skin contact, be approved in Kuwait.

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“…Other nickel-specific therapeutic options include disulfiram, acting as a chelating agent for nickel ions, and disodium cromoglycate, on the basis of a decreased nickel intestinal absorption [44].…”

Section: Treatment and Preventionmentioning

confidence: 99%

Allergic Contact Dermatitis to Nickel: From Clinical Aspects to Therapeutic Measures

Bonamonte¹,

Guida²,

Vestita³

et al. 2015

CIEMD

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Nickel is the major cause of allergic contact dermatitis. It is a widely spread metal, being therefore very difficult to avoid. Nickel cutaneous allergy can occur in occupational and non-occupational contexts and can result from direct cutaneous contact, systemic as well as airborne exposure. Such allergy can manifest with typical lesions of allergic contact dermatitis or with peculiar features such as follicular erythemato-micropapularvescicular lesions. Diagnosis of allergic contact dermatitis to nickel is based on patch testing, employing nickel sulfate 5% in petroleum jelly. Reactions to patch test have to be assessed at 48-72 hours, and up to 6 days. Nickel contact dermatitis can be managed with the traditional therapeutic approach used in allergic contact dermatitis. As of today, hyposensitization therapy with oral nickel represents to be the only treatment acting on the pathogenetic mechanisms of nickel allergy.

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Topical and Systemic Therapies for Nickel Allergy

Cited by 15 publications

References 5 publications

Nickel Sensitization and Dietary Nickel are a Substantial Cause of Symptoms Provocation in Patients with Chronic Allergic-Like Dermatitis Syndromes

Nickel Sensitization and Dietary Nickel are a Substantial Cause of Symptoms Provocation in Patients with Chronic Allergic-Like Dermatitis Syndromes

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

Allergic Contact Dermatitis to Nickel: From Clinical Aspects to Therapeutic Measures

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