1
|
Coşgun S, Polat U, Kaya M, Sezikli M. Nickel Sensitivity in Patients With Irritable Bowel Syndrome. Cureus 2023; 15:e45196. [PMID: 37842435 PMCID: PMC10576166 DOI: 10.7759/cureus.45196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
AIM Nickel (Ni) is the most common contact allergen in the population. We aimed to investigate whether there is a relationship between Ni sensitivity and irritable bowel syndrome (IBS) in our study. MATERIALS AND METHODS This study was conducted in 50 patients with IBS who were followed up between March 2018 and July 2018, and 40 healthy people as a control group in a single center with a dermatology department. European standard contact allergen series Ni preparate and corticosteroid pomace were applied to the back region of the study subjects. The evaluation was performed at 48, 72, and 96 hours according to the scheme proposed by the International Contact Dermatitis Research Group (ICDRG). Those who reacted at 72 hours were considered to have Ni allergy. Results: The female/male ratio was 24/26 and 18/22 in the patient and control groups, respectively. The mean ages of the patient and control groups were 42.82 (±10.65) and 39.77 (±11.21) years, respectively. Ni sensitivity was present in 40% of the patient group and 17.5% of the control group (p=0.03). CONCLUSION We believe that the presence of Ni sensitivity is important in the pathogenesis of IBS disease. In our study, Ni sensitivity was found to be quite high in IBS patients compared to the normal population.
Collapse
Affiliation(s)
- Süleyman Coşgun
- Internal Medicine, Gastroenterology, Kütahya University of Health Sciences, Kütahya, TUR
| | - Umut Polat
- Internal Medicine, Emet Dr. Fazıl Doğan State Hospital, Kütahya, TUR
| | - Muhammed Kaya
- Internal Medicine, Hitit University Faculty of Medicine, Çorum, TUR
| | - Mesut Sezikli
- Gastroenterology, Hitit University Faculty of Medicine, Çorum, TUR
| |
Collapse
|
2
|
Peacock CJH, Fu H, Asopa V, Clement ND, Kader D, Sochart DH. The effect of Nickel hypersensitivity on the outcome of total knee arthroplasty and the value of skin patch testing: a systematic review. ARTHROPLASTY 2022; 4:40. [PMID: 36050799 PMCID: PMC9438335 DOI: 10.1186/s42836-022-00144-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To assess the Nickel sensitizing potential of total knee arthroplasty (TKA), explore the relationship between hypersensitivity and clinical outcomes, and evaluate the utility of skin patch testing pre- and/or postoperatively.
Materials and methods
A literature search was performed through EMBASE, Medline and PubMed databases. Articles were screened independently by two investigators. The level of evidence of studies was assessed using the Oxford Centre for Evidence-Based Medicine Criteria and the quality evaluated using the Methodological Index for Non-randomized Studies and Cochrane risk-of-bias tools.
Results
Twenty studies met the eligibility criteria, reporting on 1354 knee arthroplasties. Studies included patients undergoing primary or revision TKA, pre- and/or postoperatively, and used patch testing to identify Nickel hypersensitivity. Prevalence of Nickel hypersensitivity ranged from 0% to 87.5%. One study compared the prevalence of Nickel hypersensitivity in the same patient group before and after surgery and noted newly positive patch test reactions in three patients (4.2%). Three studies reported lower prevalence of Nickel hypersensitivity in postoperative patients compared to preoperative ones. Seven studies suggested that hypersensitivity might cause adverse clinical outcomes, but six did not support any relationship. Seven studies recommended preoperative patch testing in patients with history of metal allergy, and nine concluded that testing may be valuable postoperatively.
Conclusions
Patients undergoing TKA with no prior history of metal hypersensitivity do not seem to be at an increased risk of developing Nickel hypersensitivity, and there is conflicting evidence that patients with pre-existing hypersensitivity are more likely to experience adverse outcomes. Patch testing remains the most commonly used method for diagnosing hypersensitivity, and evidence suggests preoperative testing in patients with history of metal allergy to aid prosthesis selection, and postoperatively in patients with suspected hypersensitivity once common causes of implant failure have been excluded, since revision with hypoallergenic implants may alleviate symptoms.
Collapse
|
3
|
Gergovska M, Darlenski R, Kazandjieva J. Nickel Allergy of the Skin and Beyond. Endocr Metab Immune Disord Drug Targets 2021; 20:1003-1009. [PMID: 32108006 DOI: 10.2174/1871530320666200228124453] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/25/2020] [Accepted: 03/08/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Hypersensitization to nickel is one of the most common contact allergies in the modern world and it is considered to be a major cause of contact dermatitis, especially for hand eczema. OBJECTIVE The aim of this paper is to describe many faces of the nickel allergy and to find out different diagnostic, potential strategies for treatment and prevention in hypersensitized patients. A personal clinical experience with practical clinical cases of contact dermatitis to nickel has also been presented. METHODS Electronic databases on this topic was carried out using PubMed-Medline. RESULTS The literature review identified many articles reporting for nickel contact allergy and pointing the metal as number one allergen in the frequency of positive skin patch test reactions in a large population worldwide. Herein, a summary of the current understanding and evidence on nickel allergy with practical approach and proposed recommendations to the dermatologist, general practitioner, and the allergist were prepared. CONCLUSION The prevalence of nickel allergy represents an important socio-economical and health issue. Metal is one of the most common sensitizing agents worldwide. The morbidity due to this metal represents the allergic contact dermatitis and it is constantly growing in many countries. There are also cases of systemic allergic contact dermatitis, where they could be easily misdiagnosed as adverse drug reactions, which lead to delay of the correct diagnosis and inappropriate treatment.
Collapse
Affiliation(s)
- Malena Gergovska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Pleven, Bulgaria
| | - Razvigor Darlenski
- Department of Dermatology and Venereology, Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria
| | - Jana Kazandjieva
- Department of Dermatology and Venereology, Faculty of Medicine, Sofia, Bulgaria
| |
Collapse
|
4
|
Rubins A, Romanova A, Septe M, Maddukuri S, Schwartz RA, Rubins S. Contact dermatitis: etiologies of the allergic and irritant type. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2020. [DOI: 10.15570/actaapa.2020.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
5
|
Baruffi FY, Venkatesh KP, Nelson KN, Powell A, Santos DM, Ehrlich A. Systemic Contact Dermatitis: A review. Dermatol Clin 2020; 38:379-388. [DOI: 10.1016/j.det.2020.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
6
|
|
7
|
Baumann CA, Crist BD. Nickel allergy to orthopaedic implants: A review and case series. J Clin Orthop Trauma 2020; 11:S596-S603. [PMID: 32774035 PMCID: PMC7394811 DOI: 10.1016/j.jcot.2020.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/20/2020] [Indexed: 12/21/2022] Open
Abstract
Many of the metals used in orthopaedic surgical implants are immunologically active and can cause hypersensitivity reactions. Most of these metal hypersensitivity (MHS) reactions are type IV/delayed-type hypersensitivity reactions. The most common form of all metal hypersensitivity reactions is allergic contact dermatitis (ACD) caused by nickel. The purpose of this review is to examine the evidence regarding hypersensitivity to orthopaedic implants and provide current recommendations for evaluating these patients. We report on four case examples of patients where it was determined that metal allergy led to complications related to surgery. The most common symptoms for patients with MHS-associated failures are localized soft tissue reaction including delayed wound healing and/or recurrent wound issues. The best way to avoid postoperative issues is to routinely ask patients prior to surgery if they have any known MHS including problems with cosmetic jewelry. If this is known before surgery, titanium or carbon fiber implants should be used for fracture fixation and arthroplasty implantation choice should be modified based on the specific arthroplasty performed. MHS-associated failures are a diagnosis of exclusion and must be contemplated after judicious workup of localized soft tissue reaction including delayed wound healing and/or recurrent wound issues.
Collapse
Affiliation(s)
| | - Brett D. Crist
- University of Missouri, Department of Orthopaedic Surgery, Columbia, MO, USA,Corresponding author. University of Missouri Department of Orthopaedic Surgery, One Hospital Drive, N119, Columbia, MO, 65212, USA.
| |
Collapse
|
8
|
An N, Pourzal S, Luccioli S, Vukmanović S. Effects of diet on skin sensitization by nickel, poison ivy, and sesquiterpene lactones. Food Chem Toxicol 2020; 137:111137. [PMID: 31982450 DOI: 10.1016/j.fct.2020.111137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/20/2019] [Accepted: 01/17/2020] [Indexed: 12/12/2022]
Abstract
Skin contact or exposure to sensitizers often occurs as a consequence of occupational exposures (e.g. poison ivy in forestry), wearing jewelry (e.g. nickel), or use of cosmetics (e.g. fragrances). However, many of the known skin sensitizers or their chemical variants are also consumed orally through foods or other sources. Since oral exposure to antigenic substances can lead to tolerance, consumption of sensitizers may impact the development and potency of skin sensitization, especially if the sensitizer is consumed early in life, prior to the first skin contact. To address this issue, we have reviewed human clinical and epidemiological literature relevant to this subject and evaluated whether early oral exposures to relevant sensitizers, or their chemical variants, are associated with reduced prevalence of skin sensitization to three main allergic sensitizers - nickel, urushiols of poison ivy, and sesquiterpene lactones of chrysanthemum and other plants.
Collapse
Affiliation(s)
- Nan An
- Cosmetics Division, Office of Cosmetics and Colors (OCAC), Center for Food Safety and Applied Nutrition (CFSAN), Food and Drug Administration (FDA), USA
| | - Selma Pourzal
- Cosmetics Division, Office of Cosmetics and Colors (OCAC), Center for Food Safety and Applied Nutrition (CFSAN), Food and Drug Administration (FDA), USA
| | - Stefano Luccioli
- Office of Compliance (OC), Center for Food Safety and Applied Nutrition (CFSAN), Food and Drug Administration (FDA), USA
| | - Stanislav Vukmanović
- Cosmetics Division, Office of Cosmetics and Colors (OCAC), Center for Food Safety and Applied Nutrition (CFSAN), Food and Drug Administration (FDA), USA.
| |
Collapse
|
9
|
Zondervan RL, Vaux JJ, Blackmer MJ, Brazier BG, Taunt CJ. Improved outcomes in patients with positive metal sensitivity following revision total knee arthroplasty. J Orthop Surg Res 2019; 14:182. [PMID: 31208448 PMCID: PMC6580588 DOI: 10.1186/s13018-019-1228-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 06/05/2019] [Indexed: 02/06/2023] Open
Abstract
Background Metal sensitivity as a cause for painful joint replacement has become increasingly prevalent; however, there is a lack of reported clinical outcome data from total knee arthroplasty patients with metal allergies. The purpose of this study was to determine whether patients presenting with a painful total knee arthroplasty with a positive metal sensitivity have improved outcomes following revision to a hypoallergenic implant. Methods A retrospective review was conducted for patients that underwent a revision total knee arthroplasty after metal sensitivity testing over a 3-year period from January 1, 2015, to December 31, 2017. Based on the results of sensitivity testing, patients underwent revision total knee arthroplasty to a hypoallergenic component or a standard component. Following revision, patients returned to the clinic at an interval of 6 weeks, 5 months, and 12 months for functional, pain, and satisfaction assessment. Outcomes were compared within and between sensitivity groups. Results Of the included patients, 78.3% (39/46) were positive for metal sensitivity. The most common metal sensitivity was to nickel (79.5%, 32/39). Both non-reactive and reactive patients significantly improved in range of motion after revision arthroplasty. The reactive group saw a 37.8% decrease in pain at 6 weeks post-revision (p < 0.001) Whereas, the non-reactive group only saw a moderate, non-significant improvement in pain reduction at 6 weeks post-revision (27.0%; p = 0.29). Frequency of pain experienced did not vary significantly between groups. Maximum metal lymphocyte transformation test (LTT) sensitivity score did not correlate with pain level at the time of revision (R2 = 0.02, p = 0.38) or percent improvement after revision (R2 = 0.001, p = 0.81). Overall, all patients reported being very satisfied after revision total knee arthroplasty; there was no difference between positive and negative sensitivity groups (W = 62, p = 0.89). Conclusions Patients presenting with a painful knee arthroplasty and positive metal LTT have improved pain scores, walking function, and range of motion following revision to a hypoallergenic component. This study also provides a treatment algorithm for patients presenting with a painful knee replacement, in order to provide effective and timely diagnosis and management. Electronic supplementary material The online version of this article (10.1186/s13018-019-1228-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Robert L Zondervan
- Michigan State University College of Osteopathic Medicine, 965 Wilson Rd, East Lansing, MI, 48824, USA.
| | - Jonathan J Vaux
- McLaren Orthopedic Hospital, 2727 S Pennsylvania Ave, Lansing, MI, 48910, USA
| | - Michael J Blackmer
- McLaren Orthopedic Hospital, 2727 S Pennsylvania Ave, Lansing, MI, 48910, USA
| | - Brett G Brazier
- Michigan State University College of Osteopathic Medicine, 965 Wilson Rd, East Lansing, MI, 48824, USA
| | - Charles J Taunt
- McLaren Orthopedic Hospital, 2727 S Pennsylvania Ave, Lansing, MI, 48910, USA
| |
Collapse
|
10
|
Contact Dermatitis in Atopic Dermatitis Children—Past, Present, and Future. Clin Rev Allergy Immunol 2018; 56:86-98. [DOI: 10.1007/s12016-018-8711-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
11
|
Abstract
Allergic or hypersensitivity reactions to orthopaedic implants can pose diagnostic and therapeutic challenges. Although 10% to 15% of the population exhibits cutaneous sensitivity to metals, deep-tissue reactions to metal implants are comparatively rare. Nevertheless, the link between cutaneous sensitivity and clinically relevant deep-tissue reactions is unclear. Most reactions to orthopaedic devices are type IV, or delayed-type hypersensitivity reactions. The most commonly implicated allergens are nickel, cobalt, and chromium; however, reactions to nonmetal compounds, such as polymethyl methacrylate, antibiotic spacers, and suture materials, have also been reported. Symptoms of hypersensitivity to implants are nonspecific and include pain, swelling, stiffness, and localized skin reactions. Following arthroplasty, internal fixation, or implantation of similarly allergenic devices, the persistence or early reappearance of inflammatory symptoms should raise suspicions for hypersensitivity. However, hypersensitivity is a diagnosis of exclusion. Infection, as well as aseptic loosening, particulate synovitis, instability, and other causes of failure must first be eliminated.
Collapse
|
12
|
Wezynfeld NE, Bossak K, Goch W, Bonna A, Bal W, Frączyk T. Human annexins A1, A2, and A8 as potential molecular targets for Ni(II) ions. Chem Res Toxicol 2014; 27:1996-2009. [PMID: 25330107 DOI: 10.1021/tx500337w] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Nickel is harmful for humans, but molecular mechanisms of its toxicity are far from being fully elucidated. One of such mechanisms may be associated with the Ni(II)-dependent peptide bond hydrolysis, which occurs before Ser/Thr in Ser/Thr-Xaa-His sequences. Human annexins A1, A2, and A8, proteins modulating the immune system, contain several such sequences. To test if these proteins are potential molecular targets for nickel toxicity we characterized the binding of Ni(II) ions and hydrolysis of peptides Ac-KALTGHLEE-am (A1-1), Ac-TKYSKHDMN-am (A1-2), and Ac-GVGTRHKAL-am (A1-3), from annexin A1, Ac-KMSTVHEIL-am (A2-1) and Ac-SALSGHLET-am (A2-2), from annexin A2, and Ac-VKSSSHFNP-am (A8-1), from annexin A8, using UV-vis and circular dichroism (CD) spectroscopies, potentiometry, isothermal titration calorimetry, high-performance liquid chromatography (HPLC), and electrospray ionization mass spectrometry (ESI-MS). We found that at physiological conditions (pH 7.4 and 37 °C) peptides A1-2, A1-3, A8-1, and to some extent A2-2 bind Ni(II) ions sufficiently strongly in 4N complexes and are hydrolyzed at sufficiently high rates to justify the notion that these annexins can undergo nickel hydrolysis in vivo. These results are discussed in the context of specific biochemical interactions of respective proteins. Our results also expand the knowledge about Ni(II) binding to histidine peptides by determination of thermodynamic parameters of this process and spectroscopic characterization of 3N complexes. Altogether, our results indicate that human annexins A1, A2, and A8 are potential molecular targets for nickel toxicity and help design appropriate cellular studies.
Collapse
Affiliation(s)
- Nina E Wezynfeld
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences , Pawińskiego 5a, 02-106 Warsaw, Poland
| | | | | | | | | | | |
Collapse
|
13
|
Ricciardi L, Carni A, Loschiavo G, Gangemi S, Tigano V, Arena E, Mannucci C, Calapai G. Systemic nickel allergy: oral desensitization and possible role of cytokines interleukins 2 and 10. Int J Immunopathol Pharmacol 2013; 26:251-7. [PMID: 23527730 DOI: 10.1177/039463201302600127] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Nickel ingested with food can elicit either systemic cutaneous or gastrointestinal symptoms causing a systemic nickel allergy syndrome (SNAS) that can be treated with tolerance by oral ingestion of the metal. It has been suggested that interleukins 2 (IL-2) and 10 (IL-10) are involved in the mechanisms underlying oral tolerance. We evaluated the clinical efficacy of oral desensitization therapy in SNAS consisting in the administration of nickel sulphate. Because nickel allergy prevalently affects women, only female subjects (N = 22) were recruited. Oral nickel desensitizing therapy was associated with low-nickel diet for three months. Before and after therapy, clinical conditions were evaluated, and circulating cytokines IL-2 and IL-10 were measured. After the two-year treatment, visual analogue scale (VAS) scores for symptoms were significantly reduced (P less than 0.001). Patients were released by either cutaneous or gastrointestinal symptoms and by tolerating nickel-containing food. At the end of the treatment, nickel oral challenge test was negative in 18 patients, and IL-2 level in the serum was significantly reduced while IL-10 was increased, although this datum was not statistically significant. Our study confirms the clinical efficacy of nickel oral immunotherapy and focuses on the mechanisms triggered by oral tolerance indicating that reduction of IL-2 can be associated with success of oral nickel desensitizing therapy.
Collapse
|
14
|
Zingler S, Erber R, Lux CJ, Seeberger R, Bister D, Ludwig B. Biocompatibility of gold and stainless steel chains used for forced eruption of impacted teeth – an in vitro investigation. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:159-68. [DOI: 10.1016/j.oooo.2013.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/06/2013] [Accepted: 02/19/2013] [Indexed: 02/01/2023]
|
15
|
Affiliation(s)
- Hailey A Clancy
- Department of Chemistry & Life Science, United States Military Academy, West Point, NY 10996, USA
| | - Max Costa
- Department of Environmental Health Sciences, Nelson Institute of Environmental Medicine, New York University School of Medicine, 57 Old Forge Road, Tuxedo, NY 10987, USA
| |
Collapse
|
16
|
Abstract
Hypersensitivity reactions to nickel are one of the most common in the modern world. Nickel allergy prevalence is constantly growing in many countries and represents a major health and socioeconomic issue. Herein the current understanding on nickel allergy is summarized with a practical approach to the dermatologist, allergist, and general practitioner. The personal experience with some practical clinical cases of nickel dermatitis is shared. A special emphasis is put on the possible strategies for treatment and prevention of the disease.
Collapse
|
17
|
Metal allergy and systemic contact dermatitis: an overview. Dermatol Res Pract 2012; 2012:749561. [PMID: 22693488 PMCID: PMC3369403 DOI: 10.1155/2012/749561] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 04/06/2012] [Indexed: 12/03/2022] Open
Abstract
Contact dermatitis is produced by external skin exposure to an allergen, but sometimes a systemically administered allergen may reach the skin and remain concentrated there with the aid of the circulatory system, leading to the production of systemic contact dermatitis (SCD). Metals such as nickel, cobalt, chromium, and zinc are ubiquitous in our environment. Metal allergy may result in allergic contact dermatitis and also SCD. Systemic reactions, such as hand dermatitis or generalized eczematous reactions, can occur due to dietary nickel or cobalt ingestion. Zinc-containing dental fillings can induce oral lichen planus, palmoplantar pustulosis, and maculopapular rash. A diagnosis of sensitivity to metal is established by epicutaneous patch testing and oral metal challenge with metals such as nickel, cobalt, chromium, and zinc. In vitro tests, such as the lymphocyte stimulating test (LST), have some advantages over patch testing to diagnose allergic contact dermatitis. Additionally, the determination of the production of several cytokines by primary peripheral blood mononuclear cell cultures is a potentially promising in vitro method for the discrimination of metal allergies, including SCD, as compared with the LST.
Collapse
|
18
|
Abstract
The term 'immunotherapy' refers to treating diseases by inducing, enhancing or suppressing immune responses. As allergy is an excessive, detrimental immune reaction to otherwise harmless environmental substances, immunotherapy of allergic disease is aimed at the induction of tolerance toward sensitizing antigens. This article focuses on the historical developments, present state and future outlook for immunotherapy with haptens as a therapeutic modality for allergic contact dermatitis. Inspired by the effectiveness of immunotherapy in respiratory allergies, attempts were undertaken at curing allergic contact dermatitis by means of controlled administration of the sensitizing haptens. Animal and human experiments confirmed that tolerance to haptens can be induced most effectively when the induction of tolerance precedes attempted sensitization. In real life, however, therapy is sought by people who are already sensitized and an effective reversal of hypersensitivity seems more difficult to achieve. Decades of research on Rhus hypersensitivity led to a conclusion that immunotherapy can suppress Rhus dermatitis, however, only to a limited degree, for a short period of time, and at a high risk of side effects, which makes this method therapeutically unprofitable. Methodological problems with most available studies of immunotherapy of contact allergy to nickel make any definite conclusions impossible at this stage.
Collapse
Affiliation(s)
- Radoslaw Spiewak
- Department of Experimental Dermatology & Cosmetology, Faculty of Pharmacy, Jagiellonian University Medical College, ul. Medyczna 9, 30-688 Krakow, Poland.
| |
Collapse
|
19
|
Zurawin RK, Zurawin JL. Adverse Events Due to Suspected Nickel Hypersensitivity in Patients with Essure Micro-Inserts. J Minim Invasive Gynecol 2011; 18:475-82. [DOI: 10.1016/j.jmig.2011.04.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Revised: 04/24/2011] [Accepted: 04/30/2011] [Indexed: 12/27/2022]
|
20
|
Abstract
Children's clothes with metal snaps are a potential source of nickel exposure to consider in infants and very young children. Further more avoidance of this exposure may help prevent nickel sensitization.
Collapse
Affiliation(s)
- Sharon E Jacob
- University of California, San Diego and Rady Children's Hospital, San Diego, California, USA.
| | | |
Collapse
|
21
|
Abstract
Nickel is the most common allergen causing allergic contact dermatitis in patch-tested children, especially in female children. Allergy to this metal can manifest in a variety of ways. In this case series, we present four children to illustrate the different presentations of nickel allergy confirmed by patch testing. Localized, id, and systemic nickel reactions are reviewed, as well as the diagnosis and management of nickel allergic contact dermatitis. While localized dermatitis in areas of direct contact to the allergen is the most common and easiest form of nickel allergy to identify, recognition of varying presentations is critical as these can result in more chronic and severe symptoms, and can be misdiagnosed as atopic dermatitis.
Collapse
Affiliation(s)
- Jessica W Hsu
- San Diego School of Medicine, University of California, San Diego, California, USA
| | | | | |
Collapse
|
22
|
|