Histological distinction between early allergic and irritant patch test reactions: follicular spongiosis may be characteristic of early allergic contact dermatitis

Vestergaard, Louise; Clemmensen, Ole; Sørensen, Flemming Brandt; Andersen, Klaus Ejner

doi:10.1111/j.1600-0536.1999.tb06131.x

Cited by 49 publications

(23 citation statements)

References 14 publications

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“…Follicular reactions of the poral type have been described after nickel contact, but whether these reactions are irritant or allergic is unknown . Nevertheless, follicular spongiosis may be observed in early allergic, but not irritant, reactions . A follicular reaction may also be a result of a low level of allergen exposure…”

Section: Diagnosing Nickel Allergymentioning

confidence: 99%

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

et al. 2019

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Nickel is the most frequent cause of contact allergy worldwide and has been studied extensively. This clinical review provides an updated overview of the epidemiology, exposure sources, methods for exposure quantification, skin deposition and penetration, immunology, diagnosis, thresholds for sensitization and elicitation, clinical pictures, prevention, and treatment. The implementation of a nickel regulation in Europe led to a decrease in the prevalence of nickel allergy, and changes in the clinical picture and disease severity. Nevertheless, the prevalences of nickel allergy in the European general population are approximately 8% to 19% in adults and 8% to 10% in children and adolescents, with a strong female predominance. Well‐known consumer items such as jewellery and metal in clothing are still the main causes of nickel allergy and dermatitis, although a wide range of items for both private and occupational use may cause dermatitis. Allergic nickel dermatitis may be localized to the nickel exposure site, be more widespread, or present as hand eczema. Today, efficient methods for exposure quantification exist, and new insights regarding associated risk factors and immunological mechanisms underlying the disease have been obtained. Nevertheless, questions remain in relation to the pathogenesis, the persistent high prevalence, and the treatment of severe cases.

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Section: Diagnosing Nickel Allergymentioning

confidence: 99%

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

et al. 2019

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“…14 Furthermore, ACD produces a pattern of follicular spongiosis whereas ICD does not. 15 Differences in cytokine expression include the demonstration that ACD results in high levels of IL-10 in the elicitation phase whereas ICD does not, 16 and that the chemokines IP-10, Mig, and IP-9 are increased in ACD but not in ICD. 17 However, these methods require invasive, costly, and timeconsuming procedures and are not widely available for clinical application.…”

mentioning

confidence: 98%

Reflectance confocal microscopy may differentiate acute allergic and irritant contact dermatitis in vivo

Swindells

Burnett

Rius-Díaz

et al. 2004

Journal of the American Academy of Dermatology

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“…These data prove that it may be difficult to interpret follicular reactions and make clinical judgements from them. Recently, it was shown that it is possible to make a distinction between early (6–8 hr after exposure) allergic and irritant patch test reactions as follicular spongiosis may be observed in allergic reactions (326).…”

mentioning

confidence: 99%

Nickel and cobalt allergy before and after nickel regulation – evaluation of a public health intervention

Thyssen

2011

Contact Dermatitis

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Over the 20th century, the frequent use of nickel in consumer products resulted in an increasing prevalence of nickel allergy. Risk items included suspenders in the 1950s-1960s; buttons, zippers and rivets in the 1970s; and ear-piercing jewellery in the 1980s. When subjects allergic to nickel were exposed to nickel in high concentrations, it often resulted in allergic nickel contact dermatitis and hand eczema. In 1990, the Danish government began to regulate consumer nickel exposure as a response to the increasing nickel allergy problem. In 1994, the EU Nickel Directive was passed, a regulation that was based on the Danish and Swedish nickel regulations. These major public health interventions were expected to change the epidemiology of nickel allergy and dermatitis in Europe. Furthermore, it was debated whether nickel would be replaced by cobalt in inexpensive jewellery and result in higher prevalence of cobalt allergy. An evaluation of the possible effects of the European nickel regulations is of importance to ensure protection of consumers and dermatitis patients. This doctoral thesis aimed to evaluate the effects of regulatory interventions on nickel exposure by investigating the development of nickel allergy and dermatitis before and after nickel regulation. Furthermore, a change in the association between nickel allergy and hand eczema was evaluated. The nickel spot test was validated to determine its value when used for screening purposes. Possible explanations for the persistence of nickel allergy were explored including genetic predisposition and consumer nickel exposure from jewellery and accessories. A cobalt spot test was developed and validated. Finally, it was evaluated whether a cobalt allergy epidemic had replaced the nickel allergy epidemic after nickel regulation in terms of increasing cobalt sensitization and cobalt exposure. The thesis showed that the prevalence of nickel allergy decreased significantly after nickel regulation in young Danish women from the general population (18-35 years) and in young Danish female dermatitis patients from a university patch test clinic (0-30 years). Stratification by ear-piercing status revealed that women ear pierced before 1990 had a significantly higher prevalence of nickel allergy and dermatitis than women ear pierced after 1990. Furthermore, the association between hand eczema and nickel allergy decreased in young women aged 18-35 years when a comparison was made between women who were patch tested and questioned in, respectively, 1990 and 2006. Despite the decreasing prevalence of nickel allergy, this condition remains prevalent in young Danish women, as about 10% are nickel allergic. Genetic predisposition to nickel allergy was evaluated by investigating the possible association between filaggrin null mutation status and nickel allergy. A positive association was found but it was also concluded that environmental nickel exposure is of much greater importance. Thus, of 354 consumer items purchased from 36 different stores in Copenhagen, 22% released ni...

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Histological distinction between early allergic and irritant patch test reactions: follicular spongiosis may be characteristic of early allergic contact dermatitis

Cited by 49 publications

References 14 publications

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

Nickel allergy and allergic contact dermatitis: A clinical review of immunology, epidemiology, exposure, and treatment

Reflectance confocal microscopy may differentiate acute allergic and irritant contact dermatitis in vivo

Nickel and cobalt allergy before and after nickel regulation – evaluation of a public health intervention

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