Allergic contact dermatitis to nickel is a continued health concern internationally. Nickel has been found to be the most prevalent and relevant allergen in tested populations for the last 3 decades. Furthermore, recent data from the North American Contact Dermatitis Group demonstrate positive patch-test reactions to nickel at approximately 19.5% of their tested population and a significant increase in the positivity rates for the last decade (Dermatitis. 2013;24:10–21. J Am Acad Dermatol. 1998;38:911–918). Because of the rise in allergic contact dermatitis rates to nickel, the American Contact Dermatitis Society recognized nickel to be the 2008 Allergen of the Year (J Am Acad Dermatol. 2009;60:1067–1069; Dermatitis. 2008;19:3–8). This article recognizes the importance of nickel avoidance and highlights potential alternatives.
Get full access to this article
View all access options for this article.
References
1.
HsuJW, MatizC, JacobSE. Nickel allergy: localized, id, and systemic manifestations in children. Pediatr Dermatol, 2011; 28(3): 276–280.
2.
McLeanL, YewchukL, IsraelDM, et al.Acute onset of generalized pruritic rash in a toddler. Diagnosis: systemic allergic (contact) dermatitis to nickel from ingestion of metal coins. Pediatr Dermatol, 2011; 28(1): 53–54.
3.
NijhawanRI, MolendaM, ZirwasMJ, et al.Systemic contact dermatitis. Dermatol Clin, 2009; 27(3): 355–364, vii.
4.
NovakN, BaurechtH, SchäferT, et al.Loss-of-function mutations in the filaggrin gene and allergic contact sensitization to nickel. J Invest Dermatol, 2008; 128(6): 1430–1435.
5.
RuiF, BovenziM, ProdiA, et al.Concurrent sensitization to metals and occupation. Contact Dermatitis, 2012; 67(6): 359–366.
SprigleAM, MarksJGJr, AndersonBE. Prevention of nickel release with barrier coatings. Dermatitis, 2008; 19(1): 28–31.
11.
RietschelRL, FowlerJF, WarshawEM, et al.Detection of nickel sensitivity has increased in North American patch-test patients. Dermatitis, 2008; 19(1): 16–19.
12.
MedingB. Epidemiology of nickel allergy. J Environ Monit, 2003; 5(2): 188–189.
EhrlichA, KucenicM, BelsitoDV. Role of body piercing in the induction of metal allergies. Am J Contact Dermat, 2001; 12(3): 151–155.
15.
DeverTT, GibbsNF, JacobSE. Dog tag dermatitis and nickel allergy in the military. Dermatitis, 2012; 23(1): 50.
16.
HaudrechyP, MantoutB, FrappazA, et al.Nickel release from stainless steels. Contact Dermatitis, 1997; 37(3): 113–117.
17.
SchemanA, JacobS, ZirwasM, et al.Contact Allergy: alternatives for the 2007 North American contact dermatitis group (NACDG) standard screening tray. Dis Mon, 2008; 54(1–2): 7–156.
18.
KavithaS, SrinivasCR, Latha. Nickel free safety pins: a boon to women with nickel allergy. Indian J Dermatol Venereol Leprol, 2012; 78(5): 642–643.
19.
HamannD, SchemanAJ, JacobSE. Nickel exposure from keys: alternatives for protection and prevention. Dermatitis, 2013; 24(4): 186–189.
20.
HerroEM, JacobSE, SchemanAJ. Nickel exposure from household items: potential method of protection. Dermatitis, 2012; 23(4): 188–190.
21.
JensenP, JohansenJD, ZachariaeC, et al.Excessive nickel release from mobile phones—a persistent cause of nickel allergy and dermatitis. Contact Dermatitis, 2011; 65(6): 354–358.
22.
WilliamsPJ, KingC, ArslanianV. Allergic contact dermatitis caused by a cell phone cover. Australas J Dermatol, 2012; 53(1): 76–77.
23.
MoennichJN, ZirwasM, JacobSE. Nickel-induced facial dermatitis: adolescents beware of the cell phone. Cutis, 2009; 84(4): 199–200.
24.
JensenP, JellesenMS, MøllerP, et al.Nickel may be released from laptop computers. Contact Dermatitis, 2012; 67(6): 384–385.
25.
AliağaoğluC, TuranH, ErdenI, et al.Relation of nickel allergy with in-stent restenosis in patients treated with cobalt chromium stents. Ann Dermatol, 2012; 24(4): 426–429.
26.
Romero-BrufauS, BestPJ, HolmesDRJr, et al.Outcomes after coronary stent implantation in patients with metal allergy. Circ Cardiovasc Interv, 2012; 5(2): 220–226.
27.
LyellA, BainWH, ThomsonRM. Repeated failure of nickel-containing prosthetic heart valves in a patient allergic to nickel. Lancet, 1978; 2(8091): 657–659.
28.
LusiniM, BarbatoR, SpadaccioC, et al.Aortic valve replacement in a patient with severe nickel allergy. J Card Surg, 2011; 26(6): 618–620.
29.
WalshG, WilkinsonSM. Materials and allergens within spectacle frames: a review. Contact Dermatitis, 2006; 55(3): 130–139.
30.
GawkrodgerDJ. Metal sensitivities and orthopaedic implants revisited: the potential for metal allergy with the new metal-on-metal joint prostheses. Br J Dermatol, 2003; 148(6): 1089–1093.
KręciszB, Kieć-ŚwierczyńskaM, Chomiczewska-SkóraD. Allergy to orthopedic metal implants—a prospective study. Int J Occup Med Environ Health, 2012; 25(4): 463–469.
33.
PföhlerC, KörnerR, VogtT, et al.Contact allergic gastritis: an underdiagnosed entity?. BMJ Case Rep, 2012; 2012.
34.
YilmazA, OzdemirCE, YilmazY. A delayed hypersensitivity reaction to a stainless steel crown: a case report. J Clin Pediatr Dent, 2012; 36(3): 235–238.
35.
SilvestriDL, BarmettlerS. Pruritus ani as a manifestation of systemic contact dermatitis: resolution with dietary nickel restriction. Dermatitis, 2011; 22(1): 50–55.
36.
LuLK, WarshawEM, DunnickCA. Prevention of nickel allergy: the case for regulation?. Dermatol Clin, 2009; 27(2): 155–161, vi–vii.
37.
AnticoA, SoanaR. Chronic allergic-like dermatopathies in nickel-sensitive patients. Results of dietary restrictions and challenge with nickel salts. Allergy Asthma Proc, 1999; 20(4): 235–242.
38.
JensenCS, MennéT, LisbyS, et al.Experimental systemic contact dermatitis from nickel: a dose-response study. Contact Dermatitis, 2003; 49(3): 124–132.
39.
VeienNK, HattelT, LaurbergG. Low nickel diet: an open, prospective trial. J Am Acad Dermatol, 1993; 29(6): 1002–1007.
40.
MatizC, JacobSE. Systemic contact dermatitis in children: how an avoidance diet can make a difference. Pediatr Dermatol, 2011; 28(4): 368–374.
41.
StojanovićD, NikićD, LazarevićK. The level of nickel in smoker’s blood and urine. Cent Eur J Public Health, 2004; 12(4): 187–189.
42.
Prohibition of sale and labeling of certain nickel containing products. In: Statutory Order No. 854. Copenhagen, Denmark: Danish Ministry of the Environment; (1991).
43.
The European directive restricting the use of nickel. In: 94/27/EC 1994.
44.
JohansenJD, MennéT, ChristophersenJ, et al.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(3): 490–495.
45.
SchnuchA, UterW. Decrease in nickel allergy in Germany and regulatory interventions. Contact Dermatitis, 2003; 49(2): 107–108.
46.
JacobSE, MoennichJN, McKeanBA, et al.Nickel allergy in the United States: a public health issue in need of a “nickel directive”. J Am Acad Dermatol, 2009; 60(6): 1067–1069.
47.
SchramSE, WarshawEM, LaumannA. Nickel hypersensitivity: a clinical review and call to action. Int J Dermatol, 2010; 49(2): 115–125.
