Nickel dermatitis is increasingly common Nickel is a leading cause of allergic contact dermatitis and is responsible for more cases than all other metals combined.
Certain occupations with high exposure to nickel, such as cashiers, hairdressers, metal workers, domestic cleaners, food handlers, bar workers, and painters, are also at risk for acquiring nickel dermatitis.
Nuts, legumes, and chocolate can cause a flare-up reaction in a previously positive patch test site or previous site of nickel dermatitis.
Therefore, in some clinical situations, as in the presented cases, it is appropriate to make a presumptive diagnosis of nickel dermatitis, confirm the presence of nickel with a DMG test, remove the offending metal item, treat with topical anti-inflammatory medications, and confirm the diagnosis by monitoring the patient's response.
Acute episodes of nickel dermatitis are treated with topical steroid creams to break the scratch-itch cycle (which potentiates the reaction) and to reduce the inflammation.
2 The incidence of nickel dermatitis in Denmark varied with the total imports of nickel during and after World War II which suggests that the incidence of sensitivity is determined by the total nickel exposure in the environment.
6 In women, the most common cause of nickel dermatitis is direct contact primarily from jewellery, garments, spectacles, wrist watches, and the household environment.
Calnan classified nickel dermatitis into two groups.
Nickel dermatitis represents a type IV immunologic reaction.