Is Nickel Vasculitis a Clinical Entity?

Summary

Seventeen nickel-sensitive patients (16 women and 1 man) had widespread, symmetrical, pruritic, excoriated, papular lesions. One had purpuric lesions of the lower legs. Histological examination of biopsy samples from 11 of the patients disclosed 2 cases of leukocytoclastic vasculitis, 1 of these in the patient with purpuric lesions. The remaining biopsies showed moderately dense perivascular lymphohistiocytic infiltrates of the superficial plexus with few eosinophils, usually without epidermal involvement. Twelve of the patients were challenged orally with nickel, cobalt, and a placebo in a randomized, double-blind trial. Of these patients, six had flares after oral challenge with nickel, three had no reaction and three had other types of reactions, including placebo reactions.