Topical and Systemic Therapies for Nickel Allergy

Antonella Tammaro; Alessandra Narcisi; Severino Persechino; Cristiano Caperchi; Anthony Gaspari

Disclosures

Dermatitis. 2011;22(05):251-255. 

In This Article

Systemic Immunosuppressive Therapy

Systemic immunosuppressive therapy may be considered for those cases of hand eczema that are refractory to topical steroids and phototherapy. If ACD involves an extensive area of the skin (> 20%), systemic steroid therapy is required. In general, oral prednisone should be tapered over 2 or 3 weeks because rapid discontinuation can cause rebound dermatitis.[9] Similarly, the usefulness of cyclosporine for this condition seems limited to the short term. Although one study demonstrated prolonged disease remission in 74% of patients 1 year after a 6-week course of cyclosporine (3 mg/kg/d), other studies have shown high relapse rates within weeks of drug discontinuation.[5]

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