Jewelry: Nickel and Metal-Based Allergic Contact Dermatitis

  • Peter BurkeEmail author
  • Howard I. Maibach


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.


Allergic contact dermatitis Metal Nickel Gold Cobalt Palladium 


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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Philadelphia College of Osteopathic MedicinePhiladelphiaUSA
  2. 2.University of California San FranciscoSan FranciscoUSA

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