Contact Urticaria to Nickel: A Series of 11 Patients Who Were Prick Test Positive and Patch Test Negative to Nickel Sulfate 2.5% and 5.0%

Saluja, Sandeep; Davis, Crystal; Chong, Tracie A.; Powell, D. L.

doi:10.1097/der.0000000000000211

Cited by 18 publications

(7 citation statements)

References 23 publications

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“…Furthermore, since patch testing relies on a type IV hypersensitivity reaction, it may not capture all types of nickel allergy. A case series identified 11 patients who tested negative with the patch test but positive with the prick test 29. This limitation of the patch test may explain discrepancies between test results and symptoms of hypersensitivity.…”

Section: Discussionmentioning

confidence: 99%

Nickels and tines: the myth of nickel allergy in intracranial stents

Vanent

Federico

Bass

et al. 2022

J NeuroIntervent Surg

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BackgroundMost intracranial stents contain nickel alloy, and nickel allergy or hypersensitivity is common. Neurological injury following endovascular treatment with a nickel containing intracranial stent has been reported in patients with purported nickel allergy, but it is unclear whether these reactions represent true nickel hypersensitivity. We quantified nickel release from commonly used intracranial stents to investigate whether such stents should be avoided in patients with nickel allergy.MethodsWe examined nickel release from seven commonly used intracranial stents: Enterprise, LVIS Jr, Neuroform, Wingspan, Zilver, Pipeline Flex Embolization Device, and Surpass Evolve. We incubated each stent in human plasma-like media for 30 days. Dimethylglyoxime (DMG) spot testing was performed on each stent to detect released nickel at 0 and 30 days. Inductively coupled plasma–optical emission spectroscopy (ICP-OES) was then used to quantify the nickel concentration of the media at 30 days. Nickel currency and nickel standard for atomic absorption spectrometry were used as positive controls.ResultsDMG spot tests indicated nickel release only from nickel currency at 0 and 30 days of incubation. No nickel release was detected from any stent at 30 days using ICP-OES.ConclusionsNickel release from commonly used intracranial stents is negligible. These results suggest that previously reported hypersensitivity to these stents may be misattributed to nickel allergy, and that patients with nickel allergy may be safely treated with select nickel-containing stents.

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Section: Discussionmentioning

confidence: 99%

Nickels and tines: the myth of nickel allergy in intracranial stents

Vanent

Federico

Bass

et al. 2022

J NeuroIntervent Surg

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“…Our center also performs prick testing due to concern for underrecognized metal contact urticaria, and immunoglobulin E-mediated type-1 hypersensitivity reaction. 12,17 Surgical removal was performed in nearly all patients through a minimally invasive right anterior thoracotomy on the beating heart with peripheral cannulation for cardiopulmonary bypass. After removal of the device, residual septal defects were either directly repaired or patched closed.…”

Section: Methodsmentioning

confidence: 99%

Surgical explantation of atrial septal closure devices for refractory nickel allergy symptoms

Sharma

DeShazo

Skidmore

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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“…Clinically, these urticarial reactions often present as chronic cutaneous urticaria, which may be driven by metal exposures in a device or even in foods. Systemic nickel exposures are known to cause systemic urticarial (type I, immediate type) reactions (20). Chronic urticaria may be caused and perpetuated by nickel exposure, either internally through the placement of a device or through dietary exposures (20,21).…”

Section: Epidemiology and Mechanism Of Allergic Diseasementioning

confidence: 99%

“…Systemic nickel exposures are known to cause systemic urticarial (type I, immediate type) reactions (20). Chronic urticaria may be caused and perpetuated by nickel exposure, either internally through the placement of a device or through dietary exposures (20,21). A nickel restricted diet usually is helpful in many cases.…”

Section: Epidemiology and Mechanism Of Allergic Diseasementioning

confidence: 99%