Clinical patterns and patch test reactivity in nickel dermatitis: Our experience

Background: Nickel is one of the most common allergen, especially in females and it can give rise to diverse clinical manifestations. We evaluated the different clinical patterns and patch test reactivity in patients with nickel dermatitis presenting to the Patch Test Clinic of our department. Patients and methods: 83 cases (71 females and 12 males, mean age 30.8±12.6 years showing positive result on patch testing done in accordance with the International Contact Dermatitis Research Group guidelines, were evaluable. Detailed history and clinical examination with special reference to aggravating factors, atopy, clinical patterns and patch test reactivity were elicited. Results: Nickel dermatitis was significantly more common among females. About half of the cases had a history of metal allergy. Primary nickel dermatitis was much more common as compared to secondary type and hand and foot eczema were usual presentations. Patch test results were relevant in 54% of cases. Polysensitivity was more common than monosensitivity and cobalt, p-tert-butylphenolformaldehyde resin, formaldehyde and fragrance mix. were usual co-allergens. Conclusion: Nickel dermatitis is more prevalent among females and it shows diverse clinical presentations. Nickel can be a potential allergen in cases with foot eczema. Nickel allergy is usually associated with other allergies.