Managing Allergic Nickel Dermatitis in Occupational Settings: A Case Report

Main Article Content

Rui Mendes Ribeiro https://orcid.org/0009-0006-8829-9634
Vanessa Teófilo
Salomé Moreira
Paulo Pinho
Pedro Norton
Teresa Pereira

Keywords

allergic contact dermatitis, nickel allergy, occupational dermatitis, case report, hand eczema

Abstract

Contact dermatitis is a common cutaneous inflammatory condition, triggered by exposure to irritant substances or allergens. Nickel is the most prevalent allergen, a metal widely used in accessories, furniture, office materials, food and in industry, with multiple exposure pathways, making it difficult to assess which exposure is causing allergic dermatitis. Here, we report a case of an administrative worker with chronic hand eczema, limited to the radial metacarpophalangeal region of the left hand, caused by occupational exposure to nickel, confirmed by nickel deposition test on the hand and a positive test with a metallic stapler used at her workplace.

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References

1. Li Y, Li L. Contact Dermatitis: Classifications and Management. Clinical reviews in allergy & immunology. 2021;61(3):245-81. Doi: 10.1007/BF02914439
2. Diepgen TL, Ofenloch RF, Bruze M, et al. Prevalence of contact allergy in the general population in differ-ent European regions. The British journal of dermatology. 2016;174(2):319-29. Doi: 10.1111/bjd.14167
3. Ahlström MG, Thyssen JP, Wennervaldt M, et al. Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment. Contact dermatitis. 2019;81(4):227-41. Doi: 10.1111/cod.13327
4. Ahlström MG, Thyssen JP, Menné T, Johansen JD. Prevalence of nickel allergy in Europe following the EU Nickel Directive - a review. Contact dermatitis. 2017;77(4):193-200. Doi: 10.1111/cod.12846
5. Johansen JD, Aalto-Korte K, Agner T, et al. European Society of Contact Dermatitis guideline for diagnos-tic patch testing – recommendations on best practice. Contact Dermatitis. 2015;73(4):195-221. Doi: 10.1111/cod.12432
6. Julander A, Skare L, Vahter M, Lidén C. Nickel deposited on the skin-visualization by DMG test. Contact dermatitis. 2011;64(3):151-7. Doi: 10.1111/j.1600-0536.2010.01856.x
7. Wennervaldt M, Ahlström MG, Menné T, et al. Diagnostic workup of occupational allergic nickel dermati-tis in a nurse with multiple nickel exposures. Contact Dermatitis. 2019;81(4):311-3. Doi: 10.1111/cod.13301
8. Blaser P, Rothmund B, Schmid P, et al. Nickel release from metal items in contact with skin: a comparison of methods and practical implications for regulation in Europe. J Environ Sci Health A Tox Hazard Subst Environ. 2022;57(1):45-51. Doi: 10.1080/10934529.2021.2024058
9. Jensen P, Thyssen JP, Johansen JD, et al. Occupational hand eczema caused by nickel and evaluated by quantitative exposure assessment. Contact Dermatitis. 2011;64(1):32-6. Doi: 10.1111/j.1600-0536.2010.01819.x
10. Gawkrodger DJ, McLeod CW, Dobson K. Nickel skin levels in different occupations and an estimate of the threshold for reacting to a single open application of nickel in nickel-allergic subjects. British J Dermatol. 2012;166(1):82-7. Doi: 10.1111/j.1365-2133.2011.10644.x
11. Rui F, Bovenzi M, Prodi A, et al. Nickel, cobalt and chromate sensitization and occupation. Contact Der-matitis. 2010;62(4):225-31. Doi: 10.1111/j.1600-0536.2009.01650.x
12. Lidén C, Skare L, Nise G, Vahter M. Deposition of nickel, chromium, and cobalt on the skin in some occu-pations - assessment by acid wipe sampling. Contact Dermatitis. 2008;58(6):347-54. Doi: 10.1111/j.1600-0536.2008.01326.x
13. Shum K W, Meyer J D, Chen Y, et al. Occupational contact dermatitis to nickel: experience of the British dermatologists (EPIDERM) and occupational physicians (OPRA) surveillance schemes. Occup Environ Med. 2003: 60: 954–957. Doi: 10.1136/oem.60.12.954