Allergic contact dermatitis caused by cobalt in leather - clinical cases

Heavy metals in contact dermatitis: A review

Contact dermatitis is an inflammatory skin reaction caused by direct contact with chemical substances in the environment and can either be irritant or allergic in nature. The clinical symptoms of contact dermatitis, include local skin rash, itching, redness, swelling, and lesions. Nowadays, 15-20% of people have some degree of contact dermatitis, which can be more or less severe. Immune responses in allergic contact dermatitis (ACD) are due to the effects of cytokines and allergen-specific CD4⁺ and CD8⁺ T cells on the skin. Acids and alkalis such as drain cleaners, plants such as poinsettias, hair colors, and nail polish remover, are all prominent causes of irritant contact dermatitis (ICDs). Heavy metals are metallic elements with a high atomic weight that are hazardous in low quantities and are known to cause dermatitis after systemic or local exposure. Nickel (Ni), chromium (Cr), lead (Pb), and copper (Cu) are among the most common heavy metals used in various industries. Metal allergies may cause ACD and also systemic contact dermatitis (SCD). Contact dermatitis is detected by laboratory tests such as patch testing, lymphocyte stimulation test (LST), and evaluation of cytokine production by primary cultures of peripheral blood mononuclear cells. This article presents an update on the epidemiological and clinical characteristics of ACD and SCD caused by three heavy metals (Cr, Cu, and Pb). Ni is not discussed due to recent coverage. Furthermore, the effects of contact sensitivity to some other heavy metals, such as gold (Au), cobalt (Co), palladium (Pd), and mercury (Hg) are discussed.

Cobalt and nickel impair DNA metabolism by the oxidative stress independent pathway

The oxidative stress that evolves under cobalt and nickel exposure is thought to exert toxicity, though the exact routes of such metal poisoning remain ambiguous. We revisited the metal toxicity in Escherichia coli to show that cobalt and nickel exposure at levels as low as 0.5 and 1 mM, respectively, visibly inhibits growth. We also observed that acidic conditions aggravated, while alkaline conditions alleviated the metal toxicity. Besides, 1 mM manganese, which is non-cytotoxic, as judged by the growth of E. coli, synergistically elevated cobalt and nickel stress. However, the metal toxicity did not lead to oxidative stress in E. coli. On the other hand, we show that cobalt and nickel, but not manganese, reduced the rate of DNA replication to 50% within 2 hours. Interestingly, the metal ions promoted DNA double-strand breaks but did not induce SOS repair pathways, indicating that the metal ions could block SOS induction. To test this, we show that cobalt and nickel, but not manganese, suppressed the nalidixic acid-induced SOS response. Finally, using an in vitro assay system, we demonstrated that cobalt and nickel inhibit RecBCD function, which is essential for SOS induction. Therefore, our data indicate that cobalt and nickel affect DNA replication, damage DNA, and inhibit the SOS repair pathway to exert toxicity.

Contact Allergy: A Review of Current Problems from a Clinical Perspective

Contact allergy is common, affecting 27% of the general population in Europe. Original publications, including case reports, published since 2016 (inclusive) were identified with the aim of collating a full review of current problems in the field. To this end, a literature search employing methods of systematic reviewing was performed in the Medline^® and Web of Science™ databases on 28 January 2018, using the search terms (“contact sensitization” or “contact allergy”). Of 446 non-duplicate publications identified by above search, 147 were excluded based on scrutiny of title, abstract and key words. Of the remaining 299 examined in full text, 291 were deemed appropriate for inclusion, and main findings were summarised in topic sections. In conclusion, diverse sources of exposures to chemicals of widely-differing types and structures, continue to induce sensitisation in man and may result in allergic contact dermatitis. Many of the chemicals are “evergreen” but others are “newcomers”. Vigilance and proper investigation (patch testing) are required to detect and inform of the presence of these haptens to which our populations remain exposed.