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      Management of contact dermatitis due to nickel allergy: an update

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          Abstract

          Nickel is the major cause of allergic contact dermatitis in the general population, both among children and adults, as well as in large occupational groups. This metal is used in numerous industrial and consumer products, including stainless steel, magnets, metal plating, coinage, and special alloys, and is therefore almost impossible to completely avoid in daily life. Nickel contact dermatitis can represent an important morbidity, particularly in patients with chronic hand eczema, which can lead to inability to work, a decrease in quality of life and significant healthcare expenses. Therefore, its management is of great importance. This article reviews diagnostic, preventive and therapeutic strategies in this field.

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          The epidemiology of contact allergy in the general population--prevalence and main findings.

          Jeanne Johansen, Torkil Menné, Allan Linneberg … (2007)
          A substantial number of studies have investigated the prevalence of contact allergy in the general population and in unselected subgroups of the general population. The aim of this review was to determine a median prevalence and summarize the main findings from studies on contact allergy in the general population. Published research mainly originates from North America and Western Europe. The median prevalence of contact allergy to at least 1 allergen was 21.2% (range 12.5-40.6%), and the weighted average prevalence was 19.5%, based on data collected on all age groups and all countries between 1966 and 2007. The most prevalent contact allergens were nickel, thimerosal, and fragrance mix. The median nickel allergy prevalence was 8.6% (range 0.7-27.8%) and demonstrates that nickel was an important cause of contact allergy in the general population and that it was widespread in both men and women. Numerous studies demonstrated that pierced ears were a significant risk factor for nickel allergy. Nickel was a risk factor for hand eczema in women. Finally, heavy smoking was associated with contact allergy, mostly in women. Population-based epidemiological studies are considered a prerequisite in the surveillance of national and international contact allergy epidemics.
          Article 0 comments Cited 100 times – based on 0 reviews     Review now
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            Nickel, chromium and cobalt in consumer products: revisiting safe levels in the new millennium.

            Arieh Ingber, P Kern, D. A. Basketter … (2003)
            The transition metals nickel (Ni), chromium (Cr) and cobalt (Co) are common causes of allergic contact dermatitis (ACD). Given the high frequency with which these allergens can be associated with hand eczema in those responsible for domestic work, it has been suggested that contamination of household consumer products with these metals may be of relevance to the causation/chronicity of hand dermatitis. Dose-response studies using 48 h occlusive patch test conditions in sensitized individuals show that >/=90% of sensitized patients fail to react below 1 p.p.m., even on irritated skin. Assessment under more realistic exposure conditions has shown that in the presence of irritants and/or following repeated exposures, such individuals rarely react to levels below 10 p.p.m. On the basis of this information, it was recommended a decade ago that household (and other consumer) products should not contain more than 5 p.p.m. of each of Ni, Cr or Co and that, for an even greater degree of protection, the ultimate target level should be 1 p.p.m. The data generated since the original recommendations were made serve to reinforce the validity of these recommendations. Indeed, it is our view that typically the level of each of these transition metals should not normally exceed 1 p.p.m. Then, where consumer products meet this guideline fully, modern quantitative risk assessment shows clearly that elicitation of ACD is highly improbable, and the chance of the induction of sensitization is even lower.
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              The baboon syndrome: systemically-induced allergic contact dermatitis.

              Kell K. Andersen, T Menné, N Hjorth (1984)
              The catchword "baboon syndrome" is used to denote a characteristic distribution pattern of systemic allergic contact dermatitis. Diffuse erythema of the buttocks, upper inner surface of the thighs, and axillae are characteristic features. We describe 3 cases provoked by ampicillin, nickel and mercury. The condition may be overlooked and suspected of being a textile dermatitis or seborrhoeic dermatitis of the elderly.
              Article 0 comments Cited 40 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Cosmet Investig Dermatol
                Journal ID (publisher-id): Clinical, Cosmetic and Investigational Dermatology
                Title: Clinical, cosmetic and investigational dermatology : CCID
                Publisher: Dove Medical Press
                ISSN (Electronic): 1178-7015
                Publication date Collection: 2009
                Publication date (Electronic): 17 April 2009
                Volume: 2
                Pages: 39-48
                Affiliations
                [1 ] Department of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
                [2 ] Occupational Dermatology Sector, Center for the Study of Worker Health and Human Ecology, National School of Public Health, FIOCRUZ, Rio de Janeiro, Brazil
                [3 ] Department of Dermatology, University of Bologna, Bologna, Italy
                Author notes
                Correspondence: Antonella Tosti, Department of Dermatology, University of Bologna, Via Massarenti, 1-40138, Bologna, Italy, Tel +39 051 6364840, Fax +39 051 347847, Email antonella.tosti@ 123456unibo.it
                Article
                Publisher ID: ccid-2-039
                DOI: 10.2147/ccid.s3693
                PMC ID: 3047925
                PubMed ID: 21436967
                SO-VID: f45e222c-1853-46de-8dd7-ed37a8de0438
                Copyright © © 2009 Torres et al, publisher and licensee Dove Medical Press Ltd.
                License:

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Subject: Review

                ScienceOpen disciplines: Dermatology
                Keywords: metals,children,contact dermatitis,contact hypersensitivity,occupational exposure,allergic contact dermatitis
                Data availability:
                ScienceOpen disciplines: Dermatology
                Keywords: metals, children, contact dermatitis, contact hypersensitivity, occupational exposure, allergic contact dermatitis

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