Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

Nickel is the most frequent cause of contact allergy worldwide and has been studied extensively. This clinical review provides an updated overview of the epidemiology, exposure sources, methods for exposure quantification, skin deposition and penetration, immunology, diagnosis, thresholds for sensit...

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Bibliographic Details
Published in:Contact dermatitis Vol. 81; no. 4; pp. 227 - 241
Main Authors: Ahlström, Malin G., Thyssen, Jacob P., Wennervaldt, Michael, Menné, Torkil, Johansen, Jeanne D.
Format: Journal Article
Language:English
Published: Oxford, UK Blackwell Publishing Ltd 01.10.2019
Wiley Subscription Services, Inc
Subjects:
Adolescents
allergic nickel dermatitis
Allergies
clinical review
contact allergy
Contact dermatitis
Dermatitis
Dermatitis, Allergic Contact - epidemiology
Dermatitis, Allergic Contact - etiology
Dermatitis, Allergic Contact - immunology
Dermatitis, Allergic Contact - therapy
Diet - adverse effects
Eczema
Epidemiology
Europe - epidemiology
Humans
Immunology
Jewelry - adverse effects
Nickel
Nickel - adverse effects
Nickel - analysis
Nickel - immunology
Nickel - pharmacokinetics
Occupational Exposure - adverse effects
Patch Tests
Prevalence
Prostheses and Implants - adverse effects
Risk factors
Skin
Europe
clinical review
contact allergy
nickel
allergic nickel dermatitis
ISSN:0105-1873, 1600-0536, 1600-0536
Online Access:Get full text
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Summary:Nickel is the most frequent cause of contact allergy worldwide and has been studied extensively. This clinical review provides an updated overview of the epidemiology, exposure sources, methods for exposure quantification, skin deposition and penetration, immunology, diagnosis, thresholds for sensitization and elicitation, clinical pictures, prevention, and treatment. The implementation of a nickel regulation in Europe led to a decrease in the prevalence of nickel allergy, and changes in the clinical picture and disease severity. Nevertheless, the prevalences of nickel allergy in the European general population are approximately 8% to 19% in adults and 8% to 10% in children and adolescents, with a strong female predominance. Well‐known consumer items such as jewellery and metal in clothing are still the main causes of nickel allergy and dermatitis, although a wide range of items for both private and occupational use may cause dermatitis. Allergic nickel dermatitis may be localized to the nickel exposure site, be more widespread, or present as hand eczema. Today, efficient methods for exposure quantification exist, and new insights regarding associated risk factors and immunological mechanisms underlying the disease have been obtained. Nevertheless, questions remain in relation to the pathogenesis, the persistent high prevalence, and the treatment of severe cases.
Bibliography:Funding information
This study was funded by the Environmental Protection Agency under the Ministry of Environment and Food of Denmark.
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ISSN:0105-1873
1600-0536
1600-0536
DOI:10.1111/cod.13327