Skip to main content
Log in

Systemic Contact Dermatitis to Foods: Nickel, BOP, and More

Current Allergy and Asthma Reports Aims and scope Submit manuscript

Cite this article

Abstract

Systemic contact dermatitis (SCD), a cutaneous reaction that is a direct manifestation of systemic exposure to a known allergen in a sensitized individual, has been increasingly recognized as a cause of persistent cutaneous contact dermatitis that is refractory to conventional therapies. While SCD in response to drugs has been described well in the literature, SCD to allergens in common foodstuffs is a less well-articulated phenomenon. Several foods that are universally consumed throughout the world contain potent allergens including nickel, balsam of Peru, trace metals, urushiol, and sesquiterpene lactones as well as a host of others that may cause a distinctive clinical picture. In this review article, the authors review the typical presentation and prevalence of SCD to foods, pathophysiology, the most common offensive ingestible food allergens, several appropriate diets, and effectiveness of dietary avoidance for situations in which SCD is suspected.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently have been highlighted as: • Of importance •• Of major importance

  1. Bajaj AJ, Saraswat A. Systemic contact dermatitis. Int J Derm Venerol Leprol. 2006;72(2):99–102.

    Article  CAS  Google Scholar 

  2. Kaaber K, Sjolin KE, Menne T. Elbow eruptions in nickel and chromate dermatitis. Contact Dermatitis. 1983;9(3):213–6.

    Article  CAS  PubMed  Google Scholar 

  3. Häusermann P, Harr T, Bircher AJ. Baboon syndrome resulting from systemic drugs: is there strife between SDRIFE and allergic contact dermatitis syndrome? Contact Derm. 2004;51(5–6):297–310.

    Article  PubMed  Google Scholar 

  4. Schiavino D. Systemic nickel allergy syndrome. Int J Immunopathol Pharmacol. 2005;18(4S):7–10.

    CAS  PubMed  Google Scholar 

  5. Falagiani P, Gioacchino MD, Ricciardi L, et al. Systemic nickel allergy syndrome: a review. Rev Port Imunol. 2008;16(2):135–47.

    Google Scholar 

  6. Jensen CS, Lisby S, Larsen JK, et al. Characterization of lymphocyte subpopulations and cytokine profiles in peripheral blood of nickel-sensitive individuals with systemic contact dermatitis after oral nickel exposure. Contact Dermatitis. 2004;50(1):31–8.

    Article  CAS  PubMed  Google Scholar 

  7. Niyama S, Tamauchi H, Amoh Y, et al. Th2 immune response plays a critical role in the development of nickel-induced allergic contact dermatitis. Int Arch Allerg Immunol. 2010;153(3):303–14.

    Article  Google Scholar 

  8. Petrucci F et al. Role of diet in nickel dermatitis. The Open Chem Biomed Methods. 2009;2:55–7.

    Article  CAS  Google Scholar 

  9. Sharma AD. Low nickel diet in dermatology. Indian J Dermatol. 2013;58:240.

    Article  Google Scholar 

  10. Jensen CS, Menné T, Lisby S, et al. Contact Dermatitis. 2003;49(3):124–32. Experimental systemic contact dermatitis from nickel: a dose-response study.

    Article  CAS  PubMed  Google Scholar 

  11. Anke M, Angelow L, Glei M, et al. The biological importance of nickel in the food chain. Fresenius J Anal Chem. 1995;352:92–6.

    Article  CAS  Google Scholar 

  12. Veien NK, Hattel T, Laurberg G. Low nickel diet: an open, prospective trial. J Am Acad Dermatol. 1993;29(6):1002–7.

    Article  CAS  PubMed  Google Scholar 

  13. Veien NK. Systemic contact dermatitis. Int J Dermatol. 2011;50:1445–56. Comprehensive review of endogenous and exogenous causes of systemic contact dermatitis with pertinent overview of possible cutaneous manifestations.

    Article  CAS  PubMed  Google Scholar 

  14. Matiz C, Jacob SE. Systemic contact dermatitis in children: how an avoidance diet can make a difference. Ped Dermatol. 2011;28:368–74.

    Article  Google Scholar 

  15. Mislankar M, Zirwas MJ. Low-nickel diet scoring system for systemic nickel allergy. Dermatitis. 2013;24(4):190–5.

    Article  CAS  PubMed  Google Scholar 

  16. Kaaber K, Menné T, Veien N, et al. Treatment of nickel dermatitis with Antabuse; a double blind study. Contact Dermatitis. 1983;9(4):297–9.

    Article  CAS  PubMed  Google Scholar 

  17. Christensen OB, Kristensen M. Treatment with disulfiram in chronic nickel hand dermatitis. Contact Dermatitis. 1982;8:59–63.

    Article  CAS  PubMed  Google Scholar 

  18. Mario CA. Systemic nickel allergy syndrome. Biological monitoring of dietary nickel intake and induction of immunotolerance. Clin Transl Allergy. 2011;S1:P108.

    Article  Google Scholar 

  19. Krecisz B, Chomiczewska D, Kiec-Swierczynska M, Kaszuba A. Systemic contact dermatitis to nickel present in cocoa in 14-year-old boy. Pediatr Dermatol. 2011;28(3):335–6.

    Article  PubMed  Google Scholar 

  20. Fowler JF, Kentucky L. Systemic contact dermatitis caused by oral chromium picolinate. Cutis. 2000;65:116.

    PubMed  Google Scholar 

  21. Stuckert J, Nedorost S. Low cobalt diet for dyshidrotic eczema patients. Contact Dermatitis. 2008;59(6):361–5.

    Article  CAS  PubMed  Google Scholar 

  22. Yoshihisa Y, Shimizu T. Metal allergy and systemic contact dermatitis: an overview. Dermatol Res Pract. 2012. doi:10.1155/2012/749561. Discusses clinical presentations of common metal allergies known to cause systemic contact dermatitis such as nickel and reviews proposed pathophysiological mechanisms.

    PubMed Central  PubMed  Google Scholar 

  23. Asano Y, Makino T, Norisugi O, Shimizu T. Occupational cobalt induced systemic contact dermatitis. Eur J Dermatol. 2009;19(2):166–8.

    PubMed  Google Scholar 

  24. Belsito DV. Surviving on a balsam-restricted diet: cruel and unusual punishment or medically necessary therapy? J Am Acad Dermatol. 2001;45(3):470–2.

    Article  CAS  PubMed  Google Scholar 

  25. Brancaccio G, Ronald R, Alvarez MS. Contact allergy to food. Dermatol Ther. 2004;17:302–13.

    Article  PubMed  Google Scholar 

  26. Lowther A, McCormick T, Nedorost S. Systemic contact dermatitis from propylene glycol. Dermatitis. 2006;19(2):105–8.

    Google Scholar 

  27. Fisher AA. Systemic contact dermatitis caused by ingestion of certain foods in propylene glycol-sensitive patients. Dermatitis. 1996;7(4):259.

    Article  CAS  Google Scholar 

  28. Scheman A, Cha C, Jacob SE, Nedorost S. Food avoidance diets for systemic, lip, and oral contact allergy: an American contact alternatives group article. Dermatitis. 2012;23(6):248–57. Comprehensive list of food elimination diets to food ingredients described in this review that was created by using widely available nutritional data.

    Article  CAS  PubMed  Google Scholar 

  29. Rodriguez SM, Sanchez-Motilla JM, Ramon R, et al. Allergic and systemic contact dermatitis from Matricaria chamomilla tea. Contact Dermatitis. 1998;39(4):192–3.

    Article  Google Scholar 

  30. Kulberg A, Schliemann S, Elsner P. Contact dermatitis as a systemic disease. Clin Dermatol. 2014;32(3):414–9. Brief review of known agents that are causative of systemic contact dermatitis as well as new potential treatment mechanisms such as oral hyposensitization.

    Article  PubMed  Google Scholar 

  31. Hill AM, Belsito DV. Systemic contact dermatitis of the eyelids caused by formaldehyde derived from aspartame. Contact Dermatitis. 2003;49:258–9.

    Article  PubMed  Google Scholar 

  32. Hamilton TK, Zug KA. Systemic contact dermatitis to raw cashew nuts in a pesto sauce. Dermatitis. 1998;9(1):51–4.

    Article  CAS  Google Scholar 

  33. Park SD, Lee SW, Chun JH, et al. Clinical features of 31 patients with systemic contact dermatitis due to the ingestion of Rhus (lacquer). Br J Dermatol. 2000;142(5):937–42.

    Article  CAS  PubMed  Google Scholar 

  34. Burden AD, Wilkinson SM, Beck MH, et al. Garlic-induced systemic contact dermatitis. Contact Dermatitis. 1994;30(5):299–300.

    Article  CAS  PubMed  Google Scholar 

  35. Veien NK. Ingested food in systemic allergic contact dermatitis. Clin Dermatol. 1997;15(4):547–55.

    Article  CAS  PubMed  Google Scholar 

  36. DL Silvestri (2014) Systemic contact dermatitis: the dermatologist www.the-dermatologist.com/content/systemic-contact-dermatitis. Accessed 9 June 2014.

  37. Rietschel RL, Fowler Jr JF. Systemic contact-type dermatitis. In: Rietschel RL, Fowler Jr JF, editors. Fisher’s contact dermatitis. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 89–101.

    Google Scholar 

  38. Ricciardi L, Arena A, Arena E, et al. Systemic nickel allergy syndrome: epidemiological data from four Italian allergy units. Int J Immunopathol Pharmacol. 2014;27(1):131–6.

    CAS  PubMed  Google Scholar 

  39. Veien NK, Christiansen AH, Svejgaard E, et al. Anti-bodies against nickel-albumin in rabbits and man. Contact Dermatitis. 1979;5:378–82.

    Article  CAS  PubMed  Google Scholar 

  40. Thyssen JP. Drug-elicited systemic allergic (contact) dermatitis—update and possible pathomechanisms. Contact Dermatitis. 2008;4:195.

    Article  Google Scholar 

  41. Sharma AD. Low chromate diet in dermatology. Ind J Dermatol. 2008;54(3):293–5.

    Article  Google Scholar 

  42. Dejobert Y, Delaporte E, Piette F, et al. Vesicular eczema and systemic contact dermatitis from sorbic acid. Contact Dermatitis. 2001;45(5):291.

    Article  CAS  PubMed  Google Scholar 

  43. Giordano-Labadie F, Pech-Ormieres C, Bazex J. Systemic contact dermatitis from sorbic acid. Contact Dermatitis. 2001;34(1):61–2.

    Article  Google Scholar 

  44. Walgrave SE, Warshaw EM, Glesne LA. Allergic contact dermatitis from propolis. Dermatitis. 2005;16(4):209–15.

    PubMed  Google Scholar 

  45. Cho E, Lee JD, Cho SH. Systemic contact dermatitis from propolis ingestion. Ann Dermatol. 2001;23(1):85–8.

    Article  Google Scholar 

  46. Warshaw EM, Botto NC, Zug KA, et al. Contact dermatitis associated with food: retrospective cross-sectional analysis of North American Contact Dermatitis Group data, 2001–2004. Dermatitis. 2008;19(5):252–60.

    CAS  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Matthew J. Zirwas declares the receipt of consulting fees from Smart Practice, outside of the submitted work.

Stephanie K. Fabbro declares no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Matthew J. Zirwas.

Additional information

This article is part of the Topical Collection on Allergic Skin Diseases

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fabbro, S.K., Zirwas, M.J. Systemic Contact Dermatitis to Foods: Nickel, BOP, and More. Curr Allergy Asthma Rep 14, 463 (2014). https://doi.org/10.1007/s11882-014-0463-3

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11882-014-0463-3

Keywords

Navigation