Systemic Nickel Allergy Syndrome

Background: Hypersensitization to nickel is one of the most common contact allergies in the modern world and it is considered to be a major cause of contact dermatitis, especially for hand eczema. Objective: The aim of this paper is to describe many faces of the nickel allergy and to find out different diagnostic, potential strategies for treatment and prevention in hypersensitized patients. A personal clinical experience with practical clinical cases of contact dermatitis to nickel has also been presented. Methods: Electronic databases on this topic was carried out using PubMed-Medline. Results: The literature review identified many articles reporting for nickel contact allergy and pointing the metal as number one allergen in the frequency of positive skin patch test reactions in a large population worldwide. Herein, a summary of the current understanding and evidence on nickel allergy with practical approach and proposed recommendations to the dermatologist, general practitioner, and the allergist were prepared. Conclusions: The prevalence of nickel allergy represents an important socio-economical and health issue. Metal is one of the most common sensitizing agents worldwide. The morbidity due to this metal represents the allergic contact dermatitis and it is constantly growing in many countries. There are also cases of systemic allergic contact dermatitis, where they could be easily misdiagnosed as adverse drug reactions, which lead to delay of the correct diagnosis and inappropriate treatment.

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Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, Treatment and Prevention Programs

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200128141900 ◽

2020 ◽

Vol 20 (7) ◽

pp. 992-1002 ◽

Cited By ~ 1

Author(s):

Marta Tramontana ◽

Leonardo Bianchi ◽

Katharina Hansel ◽

Daniela Agostinelli ◽

Luca Stingeni

Keyword(s):

Contact Dermatitis ◽

Contact Allergy ◽

Systemic Exposure ◽

Prevention Programs ◽

Nickel Allergy ◽

Type Iv ◽

Treatment And Prevention ◽

Typical Type ◽

Clinical Patterns ◽

Allergic Contact

Nickel is the most common cause of contact allergy in the general population and the most frequently detected allergen in patients patch tested for suspected allergic contact dermatitis (ACD). ACD from nickel is a typical type IV hypersensitivity. Nickel allergy is mostly caused by nonoccupational exposure, such as jewelry and clothing decorations, metal tools, medical devices (mainly orthopedic and orthodontic implants, cardiovascular prosthesis), eyeglasses, utensils, keys, pigment for paint, cosmetics, and food (mainly legumes, chocolate, salmon, peanuts). Occupational exposure can involve several workers (mechanics, metalworkers, platers, hairdressers, jewelers, workers in the constructions and electronic industries), classically involving hands and forearms. The classic clinical pattern of ACD caused by nickel is characterized by eczematous dermatitis involving the sites of direct contact with the metal. Non-eczematous-patterns are reported, including lichenoid dermatitis, granuloma annulare, vitiligo-like lesions, dyshidrosiform dermatitis, and vasculitis. In the case of systemic exposure to nickel, sensitized patients could develop systemic contact dermatitis. Patch testing represents the gold standard for the diagnosis of ACD from nickel. Treatment includes avoidance of contact with products containing nickel and the patient’s education about the possible use of alternative products. A recent EU nickel directive, regulating the content and release of nickel from products, has caused a decrease of nickel contact allergy in some European countries. Nickel allergy is a relevant issue of public health with significant personal, social, and economic impact. This review summarizes epidemiology, pathomechanism, clinical patterns, treatment, and prevention programs.

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Eyelid Dermatitis and Contact Sensitization to Nickel: Results from an Italian Multi-Centric Observational Study

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530318666180731114418 ◽

2019 ◽

Vol 19 (1) ◽

pp. 38-45 ◽

Cited By ~ 2

Author(s):

Alessandro Borghi ◽

Monica Corazza ◽

Elisa Maietti ◽

Cataldo Patruno ◽

Maddalena Napolitano ◽

...

Keyword(s):

Risk Factor ◽

Cross Sectional Study ◽

Sectional Study ◽

Contact Sensitization ◽

Main Risk Factor ◽

Nickel Allergy ◽

Cross Sectional ◽

Triggering Factor ◽

Irritant Action ◽

Allergic Contact

Background: Due to the sensitizing constituents of eye cosmetics, allergic contact dermatitis is considered a frequent cause of eyelid dermatitis. An association between eyelid dermatitis and nickel contained in make-ups remains controversial. Objective: The study aimed to assess the association between nickel allergy, the use of pigmented makeup products and self-reported eyelid dermatitis. Method: This multi-centric, cross-sectional study enrolled 165 women sensitized to nickel (patients) and 103 women without intolerance to metals (controls). We recorded: demographics, atopy, use of pigmented eye cosmetics (mascara, eyeshadow, eyeliner, eyebrow pencil), and previous eyelid dermatitis. Among the patients, any co-sensitization to cosmetics or metals was recorded. Results: 87.3% of the patients and 91.3% of the controls reported their use of eye make-up; 44.9% and 52.4%, respectively, reported previous episodes of eyelid dermatitis, without significant differences. The occurrence of eyelid dermatitis was significantly associated with the use of eye make-up products, both in general and considering each product separately. Age, atopy, or co-sensitization to other metals or cosmetics did not affect the occurrence of eyelid dermatitis. Conclusion: Nickel allergy should not be considered the main risk factor for eyelid dermatitis. The use of pigmented eye make-up may be a triggering factor for eyelid dermatitis, probably due to an irritant action.

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Lymphocyte Transformation in Nickel Allergy: Amplification of T-lymphocyte Responses to Nickel Sulphate by Macrophages in Vitro

Scandinavian Journal of Immunology ◽

10.1111/j.1365-3083.1980.tb00041.x ◽

1980 ◽

Vol 12 (1) ◽

pp. 61-65 ◽

Cited By ~ 25

Author(s):

S. SILVENNOINEN-KASSINEN

Keyword(s):

T Lymphocyte ◽

Lymphocyte Transformation ◽

Nickel Sulphate ◽

Nickel Allergy ◽

Lymphocyte Responses

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Sensing of Nickel(II) Ions by Immobilizing Ligands and Using Different SPEs

Engineering Proceedings ◽

10.3390/i3s2021dresden-10106 ◽

2021 ◽

Vol 6 (1) ◽

pp. 2

Author(s):

Liliana Anchidin-Norocel ◽

Sonia Amariei ◽

Gheorghe Gutt

Keyword(s):

Bismuth Oxide ◽

Human Population ◽

Raw Materials ◽

Sensor Technology ◽

Cyclic Voltammogram ◽

Accurate Analysis ◽

Nickel Allergy ◽

Nickel Ions ◽

Practical Applications ◽

Wide Range

The aim of this paper is the development of a sensor for the quantification of nickel ions in food raw materials and foods. It is believed that about 15% of the human population suffers from nickel allergy. In addition to digestive manifestations, food intolerance to nickel may also have systemic manifestations, such as diffuse dermatitis, diffuse itching, fever, rhinitis, headache, altered general condition. Therefore, it is necessary to control this content of nickel ions for the health of the human population by developing a new method that offers the advantages of a fast, not expensive, in situ, and accurate analysis. For this purpose, bismuth oxide-screen-printed electrodes (SPEs) and graphene-modified SPEs were used with a very small amount of dimethylglyoxime and amino acid L-histidine that were deposited. A potentiostat that displays the response in the form of a cyclic voltammogram was used to study the electrochemical properties of nickel standard solution with different concentrations. The results were compared and the most sensitive sensor proved to be bismuth oxide-SPEs with dimethylglyoxime (Bi2O3/C-dmgH2) with a linear response over a wide range (0.1–10 ppm) of nickel concentrations. Furthermore, the sensor shows excellent selectivity in the presence of common interfering species. The Bi2O3/C-dmgH2 sensor showed good viability for nickel analysis in food samples (cocoa, spinach, cabbage, and red wine) and demonstrated significant advancement in sensor technology for practical applications.

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