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Media type:
E-Article
Title:
Nickel Sensitization and Dietary Nickel are a Substantial Cause of Symptoms Provocation in Patients with Chronic Allergic-Like Dermatitis Syndromes
Contributor:
Antico, Andrea;
Soana, Roberto
Published:
SAGE Publications, 2015
Published in:
Allergy & Rhinology, 6 (2015) 1
Language:
English
DOI:
10.2500/ar.2015.6.0109
ISSN:
2152-6575;
2152-6567
Origination:
Footnote:
Description:
Data in literature seem to show that, in patients with contact allergic dermatitis, dietary nickel might be a cause of systemic dermatitis, but little information exists in literature about the role of nickel sensitization and dietary nickel in patients with allergic-like chronic dermatitis syndromes. The prevalence of nickel sensitization in patients with chronic allergic-like, non-IgE-mediated skin diseases, and the possible impact of dietary nickel on symptom provocation and persistence has been assessed in the present retrospective study on a case series of 1726 patients referred to our allergy unit for chronic allergic-like skin diseases. IgE-mediated pathogenesis and other differential diagnoses excluded, patients were patch tested. Nickel-positive patients underwent an elimination diet and double-blind placebo-controlled nickel challenge (DBPCNC) test. A total of 339 (20%) tested nickel-positive. Fifty-two patients (15%) recovered by avoiding sources of nickel contact and 29 (10%) dropped out. Out of the remaining nickel-sensitized patients, 277 (80%) achieved complete or near complete recovery with low-nickel content diet, and 185 of them (89%) were positive to DBPCNC. We conclude that nickel sensitization and dietary nickel seem to be the chief trigger for provocation and persistence of symptoms in an important part (~11%) of patients with chronic allergic-like dermatitis syndromes.