Women with nickel contact dermatitis were able to maintain clinical improvement through a restrictive diet followed by hyposensitization therapy or continuation of the diet, 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 Portugal studied 12 women (mean age, 41 years) with nickel contact dermatitis and positive patch tests to nickel sulfate. Despite avoiding cutaneous contact with nickel, the women had widespread eczema lesions. The effect of a restrictive diet in high nickel-content foods was examined, and an oral challenge test to nickel sulfate confirmed diagnosis. The first test showed positivity for a median dose of 6 ± 3 mg. Patients who did not want to continue a long-term restrictive diet received oral hyposensitization therapy to nickel.
All patients experienced gradual decreases in eczema intensity with skin lesions disappearing after adhering to a low-nickel diet for 6 weeks. Late reaction was experienced by all patients, with eczema flares occurring predominantly on the neck, abdomen and wrist flexor area. Three patients had a reactivation during nickel patch testing.
Six patients did not have eczema relapse while on a normal diet after 1 year of oral hyposensitization therapy. After 4 months of therapy, prohibited foods were gradually reintroduced. Decreased sensitivity was confirmed with repeated patch testing and oral challenge to nickel. The other six patients continued to follow the restrictive diet to maintain improvement after declining hyposensitization therapy.
“Reduction of daily intake of metal, with the diet plan, may explain the clearing up of eczema,” the researchers concluded. “The oral hyposensitization therapy allowed patients to follow a normal diet without the appearance of skin lesions.”
For more information:
Carrapatoso I. Abstract 243: Diagnostic and Therapeutic Approach in Nickel Systemic Contact Dermatitis. Presented at: EAACI-WAO World Allergy and Asthma Congress 2013; June 23-26, Milan.