Low nickel diet in the treatment of patients with chronic nickel dermatitis

Abstract

Of 28 patients with chronic nickel dermatitis 17 experienced aggravation following oral ingestion of 2.5 mg nickel, but not a placebo tablet. The dermatitis of 9 of the 17 patients improved during a period of 6 weeks on a low nickel diet. The dermatitis of 7 of the 9 patients flared again when a normal diet was resumed. Nickel excretion over a 24-h period was measured for 14 of the 17 patients by atomic absorption spectrophotometry before, during, and after the diet. Reduced excretion was seen during the diet with no statistically significant difference between patients whose dermatitis improved during the diet and those whose dermatitis showed no change.

Systemic contact dermatitis after oral exposure to nickel: a review with a modified meta‐analysis

“…On the basis of the result from the last analysis, exposure doses corresponding to response rates of 50% (ED 50 ), 25% (ED 25 ), 10% (ED 10 ), 5% (ED 5 ) and 1% (ED 1 ) of exposed nickel-sensitive eczema patients were calculated ( Table 2). These calculations predict that an oral nickel exposure with 0.22 mg, 0.35 mg or 0.53 mg nickel (depending on which dose-response curve is used) will make 1% of nickel-sensitive patients respond.…”

“…Flare-up reactions of previous nickel patch test sites after systemic oral exposure appear to be hapten specific (3). There appears to be a dose-response relationship, and the overall trend from several oral exposure studies is that the severity of the reaction after exposure and the number of reacting nickel-sensitive individuals increase with higher exposure doses (Table 1) (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Until now, nobody has tried to summarize the data from the oral exposure studies to determine an oral nickel exposure threshold for elicitation of systemic contact dermatitis.…”

“…However, some studies have shown that an exposure dose equivalent to the maximal nickel exposure through the diet (0.9 mg nickel per day) (21) can induce systemic reactions in some nickel-sensitive individuals (6,8,9,13,20). Additionally, dietary intervention studies (5,(33)(34)(35)(36) indicate that exposure to nickel in diet and drinking water could be a contributing factor to systemic contact dermatitis.…”

Systemic Contact Dermatitis

“…Recently, it has been documented that avoidance of prolonged skin contact with nickel-releasing alloys results in a statistically significant decrease in the frequency of hand eczema in nickel-sensitive individuals [24] . The study of orally provoked fiare-ups of nickel dermatitis was pioneered by Christensen and Moller [9], followed up by Kaaber et al [25,26] and Veien et al [27]. In a double-blind study, Christensen and Moller provoked 12 nickel-sensitive individuals with an oral dose of 5.6 mg nickel.…”

Oral Hyposensitization to Nickel Allergy: Preliminary Clinical Results

“…In all cases, a low-nickel diet was introduced prior to the attempt to hyposensitize [30]. A list of foods to be avoided was given to the pa tient.…”