Abstract
Metal allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction. Nickel allergy is the most prevalent of ACD and is the most common positive reaction from diagnostic patch testing. Recently, there has been a growing prevalence of patch test reactivity among other metals such as gold, cobalt, and palladium. Classically, the allergy is associated with pre-sensitization and resultant erythema, edema, and lichenification in the distribution of metal contact. The diagnostic standard is patch testing using the standard NACDRG (North American Contact Dermatitis Research Group) series, or the allergen suspended in petrolatum. The primary method of treatment consists of prevention of metal contact; however, medical therapy may be employed for symptomatic relief. Therapy consists of the use of topical corticosteroids in mild–moderate cases and the use of systemic corticosteroids in moderate–severe cases, while other symptoms such as pruritus may be controlled with antipruritics or oral sedating antihistamines.
Keywords
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Sharma AD. Relationship between nickel allergy and diet. Indian J Dermatol 2007;73(5):307–12.
Pratt MD, Belsito DV, DeLeo VA, et al. North America contact dermatitis group patch test results, 2001–2002 study period. Dermatitis 2004;15(4):176–83.
Johansen J, Menne T, Christophersen J, Kaaber K, Veien N. Changes in the pattern of sensitization to common contact allergens in Denmark between 1985–86 and 1997–98, with a special view to the effect of preventive strategies. Br J Dermatol 2000;142:490–5.
Commission Directive 2004/96/EC of September 2004 amending Council Directive 76/769/EEC as regards restriction on the marketing and use of nickel for piercing post assemblies for the purpose of adapting its Annex I to technical progress.
Ruff C, Belsito D. The impact of various patient factors on contact allergy to nickel, cobalt and chromate. J Am Dermatol 2006;55:32–9.
Neilsen NH, Menne T. Nickel sensitisation and earpiercing in an unselected Danish population. Glostrup allergy study. Contact Derm 1993;29:16–21.
Xu H, DiIulio NA, Fairchild RL. T cell populations primed by hapten sensitization in contact sensitivity are distinguished by polarized patterns of cytokine production: Interferon gamma-producing (Tc1) effector CD81 T cells and interleukin(Il) 4/Il-10-producing (Th2) negative regulatory CD41 T cells. J Exp Med 1996;183:1001–12.
Frosch, P, Menne, T. et. al. Contact Dermatitis, 4th Edition. 2006. Berlin: Springer Berlin Heidelberg New York, pp. 12–14.
Larsen, J, Bonefeld C, Poulsen S. IL-23 and TH17-mediated inflammation in human allergic contact dermatitis. J Allergy Clin Immunol 2009;123:486–92.
Bjorkner B, Bruze M, Moller H. High frequency of contact allergy to gold sodium thiosulfate, an indication of gold allergy? Contact Derm 1994;30:144–51.
Christiansen J, Farm G, Eid-Forest R. Interferon-γ secreted from peripheral blood mononuclear cells as a possible diagnostic marker for allergic contact dermatitis to gold. Contact Derm 2006;55:98–109.
Juliander A, Hindes M, Skare L. Cobalt-containing alloys and their ability to release cobalt and cause dermatitis. Contact Derm 2009;60:165–70.
Liden C, Wahlberg JE. Cross-reactivity to metal compounds studied in Guinea pigs induced withchromate or cobalt. Acta Derm Venereal (Norway) 1994;74(5):341–3.
Vincenzi C, Tosti A, Guerra L, et al. Contact dermatitis to palladium: A study of 2300 patients. Am J Contact Derm 1995;6:110–2.
Cohen DE, Jacob SE. Allergic Contact Dermatitis. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest B, Paller AS, Leffell DJ: Fitzpatrick’s Dermatology in General Medicine, 7th Ed. New York, NY: The McGraw-Hill Companies, Inc; 2008: http://www.accessmedicine.com/content.aspx?aID=2966976.
Kanerva L, Forstrom L. Allergic nickel and chromate hand dermatitis induced by orthopaedic metal implant. Contact Derm 2001;44:103–4.
Thyssen J, Maibach H. Nickel release from earrings purchased in the United States: The San Francisco earring study. J Am Acad Dermatol 2008;58:1000–5.
Lachapelle JM, Maibach HI. Patch Testing and Prick Testing. A Practical Guide, 2nd Edition. Berlin: Springer-Verlag Berlin Heidelberg 2003, pp. 46–50.
Davis M, Bhate K, Rohlinger A. Delayed patch reading after 5 days: The Mayo Clinic experience. J Am Acad Dermatol 2008;59:225–33.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Burke, P., Maibach, H.I. (2010). Jewelry: Nickel and Metal-Based Allergic Contact Dermatitis. In: Mahmoudi, M. (eds) Challenging Cases in Allergic and Immunologic Diseases of the Skin. Springer, New York, NY. https://doi.org/10.1007/978-1-60761-296-4_10
Download citation
DOI: https://doi.org/10.1007/978-1-60761-296-4_10
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-60761-295-7
Online ISBN: 978-1-60761-296-4
eBook Packages: MedicineMedicine (R0)