Jewelry and nickel-containing dental alloys were apparent risk factors in developing systemic nickel allergy, according to research presented at the European Academy of Allergy and Clinical Immunology-World Allergy Organization World Allergy and Asthma Congress in Milan.
Researchers in Turkey studied 70 patients (56 women, mean age, 48.91 years; 14 men, mean age, 51.57 years) who had nickel allergy, and determined demographic features, symptoms, atopic status and dietary habits. History of concerns about jewelry, nickel and other metals was taken, and serum total immunoglobulin E (IgE) and antinuclear antibody (ANA) levels were measured.
Sixty-six patients had nickel-containing crowns, bridgework and prostheses. Forty-seven patients had oral lichen, mucosal wounds and burning mouth, and 18 of them experienced concomitant skin symptoms. Skin disorders including urticaria, pruritus and dermatitis were the primary reason that 20% of the patients had been referred. Eight patients experienced laryngeal edema.
Local reactions to jewelry were experienced by 46 patients, while 27 described worse symptoms after consuming nickel-rich foods.
Based on skin patch tests, nickel sensitivity was isolated in 13 patients while in the others it was concomitant with other metals, including palladium, cobalt, potassium dichromate and gold.
Patients who adhered to a nickel-free diet for at least 1 month saw improvement with all patients showing negative ANA levels and mean total IgE of 171.3 ± 213.9 IU/L.
“Wearing jewelry and dental alloys seem to be the most important risk factors in the development of systemic nickel allergy,” the researchers concluded. “Exposures through nickel-containing dental alloys may cause a systemic sensitization and eventually important systemic symptoms. Therefore, being cautious about the nickel content in presensitized patients is necessary.”
For more information:
Unal D. Abstract 244: Systemic Nickel Allergy: The Importance of Dental Alloys. Presented at: EAACI-WAO World Allergy and Asthma Congress 2013; June 23-26, Milan.