Tag Archive for: detection of nickel sensitization

Nickel Summit Webinar

Nickel Contact Dermatitis Summit Webinar

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Nickel Contact Dermatitis Summit

For 53 years, nickel has been unparalleled as the most common allergen documented in patch-tested patients of all ages worldwide, which we call attention to as the Nickel Contact Dermatitis Summit approaches.  And yet, nickel sensitivity is a much wider problem than the documentation suggests, as Peltonen alarmingly and poignantly pointed out over 30 years ago: “half of the subjects sensitized to nickel have never consulted a doctor because of their nickel dermatitis; still fewer have visited a dermatologist”.    In the US we are in the midst of a prospering hidden nickel epidemic akin to that seen in Europe prior to nickel regulation legislation.  There are millions of adults and children sensitized each year – the rates are UNACCEPTABLE, because this is a PREVENTABLE cause of allergic contact dermatitis.  The Nickel Summit webinar by Dr. Jennifer Chen discusses the impact of nickel allergy in the US and the lack of regulation.

 

Article Synopsis

Below is a summary of an article speaking more to this topic.

Synopsis by Janna Vassantachart, MD Loma Linda University School of Medicine

Article: Goldenberg A, Vassantachart J, Lin EJ, Lampel HP, Jacob SE. Nickel Allergy in US Adults-A 53-Year Review of Indexed Cases. Dermatitis. 2015 Jul 14.

For 53 years, nickel has been unparalleled as the most common allergen documented in patch-tested US patients of all ages. In 1994, the European Union (EU) decreased rates of sensitization by enacting a Nickel Directive to regulate nickel release to no more than 0.5 µg/cm2/week. No such directive currently exists in the USA.

This study conducted a literature review of peer-reviewed adult nickel dermatitis cases published within the United States to identify trends over the past decades, sources of nickel sensitization, and regional variations.  It highlights the problem we are encountering at the top of the nickel contact dermatitis summit.   The results of the study demonstrated:

  • Between 1962 and 2015, there were 74 articles published reporting 18,251 cases of nickel sensitivity in US adults.
  • Over the past decades, the frequency of published articles on nickel sensitivity has continuously increased with a significant correlation (r = 0.798, P = 0.057). Compared to only one article published between 1960 and 1970, in the last 5 years, 30 articles have been published.
  • Five articles reported occupational exposures such as a stethoscope, chalk, and a military-issued lanyard chain from an identification neck tag (aka ‘‘dog tag’’). The most commonly reported nonoccupational sources were Essure contraceptive microinserts and Amplatzer septal occluders for atrial septal defects.
  • Geographically, 27 US states have had at least 1 reported case of adult nickel dermatitis.

Most nickel dermatitis cases seen clinically are neither patch-tested nor captured in the literature, allowing for a prospering hidden nickel epidemic towards the nickel summit. However, this study reveals that even the literature has seen a significant increase in published cases over the past decades. Rising rates of US nickel ACD highlight the need for medical professionals, legislators, and manufacturers to advocate for an EU-like Nickel Directive to regulate the release of free nickel.

 

 

Nickel Contact Dermatitis

Nickel Contact Dermatitis in US Adults-A 53-Year Review- Synopsis

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Authors: Goldenberg A, Vassantachart J, Lin EJ, Lampel HP, Jacob SE. Nickel Allergy in US Adults-A 53-Year Review of Indexed Cases. Dermatitis. 2015 Jul 14.

Synopsis by Janna Vassantachart, MSIV — Loma Linda University School of Medicine

For 53 years, nickel has been unparalleled as the most common allergen documented in patch-tested US patients of all ages. In 1994, the European Union (EU) decreased rates of sensitization by enacting a Nickel Directive to regulate nickel release to no more than 0.5 µg/cm2/week. No such directive currently exists in the USA.
This study conducted a literature review of peer-reviewed adult nickel dermatitis cases published within the United States to identify trends over the past decades, sources of nickel sensitization, and regional variations. The results of the study demonstrated:
• Between 1962 and 2015, there were 74 articles published reporting 18,251 cases of nickel sensitivity in US adults.
• Over the past decades, the frequency of published articles on nickel sensitivity has continuously increased with a significant correlation (r = 0.798, P = 0.057). Compared to only one article published between 1960 and 1970, in the last 5 years, 30 articles have been published.
• Five articles reported occupational exposures such as a stethoscope, chalk, and a military-issued lanyard chain from an identification neck tag (aka ‘‘dog tag’’). The most commonly reported nonoccupational sources were Essure contraceptive microinserts and Amplatzer septal occluders for atrial septal defects.
• Geographically, 27 US states have had at least 1 reported case of adult nickel dermatitis.

Most nickel dermatitis cases seen clinically are neither patch-tested nor captured in the literature, allowing for a prospering hidden nickel epidemic. However, this study reveals that even the literature has seen a significant increase in published cases over the past decades. Rising rates of US nickel ACD highlight the need for medical professionals, legislators, and manufacturers to advocate for an EU-like Nickel Directive to regulate the release of free nickel.

nickel allergy cartoon

Detection of Nickel Sensitization – Article Review

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Original article: HERE

Rietschel RL, Fowler JF, Warshaw EM, Belsito D, DeLeo VA, Maibach HI, Marks JG, Mathias CG, Pratt M, Sasseville D, Storrs FJ, Taylor JS, Zug KA. Detection of Nickel Sensitivity has Increased in North American Patch-test Patients. Dermatitis. 2008 Jan-Feb;19(1):16-9.

Review by Daniel No, BA. MSIII Loma Linda University School of Medicine

The prevalence of nickel contact allergy has steadily increased in men and women since the 1990s. The authors, Rietschel et al., enrolled 25,626 patients during the years 1992 to 2004 to undergo patch testing to detect nickel sensitivity. The data from this study demonstrated:

  • The nickel sensitization rate has steady increased from 14.5% in 1992 to 18.8% in 2004. The upward trend further emphasizes the importance of public awareness and education of nickel contact dermatitis. significant impact this allergen has on the North American population.
  • Females from 2001 to 2004 were 1.1 to 1.2 times more likely to be sensitive to nickel in comparison to females tested from 1992 to 2000. Similar results were found in the male population, however, the findings were not statistically significant.
  • Younger males (< 19 years old) were 2.33 times more likely to be sensitive to nickel than their older counterparts. Similarly, younger females were found to be 1.51 times more likely to be nickel sensitive.
  • The patch test is essential in identifying specific allergens in allergic contact dermatitis. Patches containing 2.5% nickel sulfate were applied and left in place for 2 days and subsequently interpreted when removed. A follow-up interpretation was conducted one to five days later.