An 86-year-old female patient was diagnosed with seropositive rheumatoid arthritis (RA) in March 2019 and she also had approximately ten-year history of diabetes mellitus, hypertension, dyslipidemia, osteoporosis, and total knee replacement in her left knee joint in 2014. She had been treated with methotrexate, leflunomide, and prednisolone for RA, then tofacitinib was added for uncontrolled disease activity of RA in December 2019, symptoms and signs of arthritis subsided and she was treated on methotrexate, tofacitinib and methylprednisolone 2 mg daily thereafter. In April 2020, she developed erythematous papules, palpable purpura, and ulcers on the left lower leg, and visited the department of dermatology. There were no other systemic symptoms and signs, and laboratory tests were nonspecific. Suspicious of leukocytoclastic vasculitis (LCV), an al-

Background: Nail stickers and nail tips are increasingly used nail products in Korea, and the rest of the world. However, no studies have examined if these specific consumer products might contain nickel, cobalt, and/or chromium, that is, metals known to provoke contact allergy.Objective: We aimed to assess the release and content of nickel, cobalt, and chromium in nail stickers and tips by performing qualitative and quantitative analyses, respectively, of 50 convenience samples purchased in Korea.Methods: Eighty-six qualitative spot tests were performed to determine the release of nickel, cobalt, and chromium on 35 nail stickers and 15 nail tips across five brands. Subsequently, the metal contents were quantified using inductively coupled plasmaoptical mass spectrometry (ICP-MS).Results: According to the spot tests, nickel was released in 7/86 (8.1%) tests before and 10/86 (11.6%) tests after exposure to artificial sweat. Cobalt and chromium (VI) spot test results were negative. However, ICP-MS detected nickel, cobalt, and chromium in 11%, 6.3%, and 16.7% of the samples, respectively. Detection rates were higher in nail tips than in stickers and were most common in rhinestones. Conclusion:Nail stickers and tips may contain nickel, cobalt, and/or chromium.