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


To our knowledge, this study is the first study to evaluate trends for nickel sensitivity in a large cohort of patch-tested patients in North America. We found that nickel sensitivity has increased over the last 12 years and that most of this increase is due to the prevalence in women. Our results are similar to those of other studies evaluating trends in allergy to nickel. A Danish study of 2,166 patients during 12 years found a small but statistically significant increase in nickel allergy when data from 1985 to 1986 were compared to data from 1997 to 1998.[18] In the earlier period, 4.2% of men were nickel sensitive, as compared to 4.9% in the later period. For women, the numbers were 18.3% in the earlier period and 20.0% in the later period. The Danish study found that nickel allergy had actually decreased among children 0 to 18 years of age, dropping from 24.8% in 1985 to 1986 to 9.2% in 1997 to 1998. A similar report, on 7,988 patients from Poland, examined nickel allergy from 1995 to 2004 and found that 13.96% of all patients were nickel sensitive in 1995 as compared to 19.89% in 2004.[19] In 1995, 2.2% of patients 0 to 20 years of age were nickel allergic as compared to 1.7% in 2004; for those older than 20 years, nickel sensitivity increased from 11.7% to 15.2%. Both the Danish and Polish reports suggest that reduced environmental exposures in Europe secondary to nickel exposure regulation might account for the lower numbers in younger patients and that greater awareness of the problem of nickel allergy might be an additional factor. In contrast, however, an Italian study of 42,839 cases of contact dermatitis compared nickel allergy in 1984 to 1988 to that in 1989 to 1993 and found no significant difference in the sensitization rate (28.7% in the former period and 28.9% in the latter) although the study did not report sensitization groups by age.[20]


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