Detection of Nickel Sensitivity Has Increased in North American Patch-Test Patients

Robert L. Rietschel; Joseph F. Fowler; Erin M. Warshaw; Donald Belsito; Vincent A. DeLeo; Howard I. Maibach; James G. Marks; C.G. Toby Mathias; Melanie Pratt; Denis Sasseville; Frances J. Storrs; James S. Taylor; Kathryn A. Zug


Dermatitis. 2008;19(1):16-19. 

In This Article


From 1992 to 2004, 25,626 patients were patch-tested by the NACDG ( Table 1 ). During this time, the ratio of women who were patch-tested to men who were patch-tested remained fairly constant, at 61.4 to 66.3% women to 33.6 to 38.6% men. The data show a steady increase in nickel sensitivity from 14.5% in 1992 to 18.8% in 2004 (p <.0001).

While more males were allergic to nickel in the late group (2001-2004) as compared to the early group (1992-1995), this difference did not quite achieve statistical significance (p = .067). However, females were at 1.1 to 1.2 times more likely to be nickel allergic in the late (2001-2004) group as compared with either the early (1992-1995) group (relative risk [RR], 1.2; 95% confidence interval [CI], 1.10-1.28; p < .0001) or the middle (1996-2000) group (RR, 1.12; 95% CI, 1.04-1.19; p = .0011).

The younger patients in our patch-test clinics were more frequently found to be nickel sensitive than were patients who were 19 years of age or older ( Table 2 and Table 3 ); 11 to 15% of younger males and 19 to 37% of younger females were nickel allergic whereas only 4 to 7% of males and 18 to 24% of females older than 18 years were nickel sensitive. Younger men were 2.33 times more likely to be nickel allergic than were older men (95% CI, 1.80-3.01; p <.0001), and younger women were 1.51 times more likely to be nickel allergic than were older women (95% CI, 1.34- 1.72; p <.0001). Evaluating only those individuals who were allergic to nickel, we found no statistically significant associations between time period for age (≤18 years vs >18 years) for men (p = .5361) or for women (p = .6506)


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