Nickel named ‘Allergen of the Year’: ACDS adds to list of allergies warranting attention

Apr 01, 2008, 4:00am

In an effort to increase awareness of allergens that warrant more attention from dermatologists and other physicians, the American Contact Dermatitis Society names an Allergen of the Year. Recently the ACDS announced that nickel has earned the 2008 designation.

Key Points

National Report - In an effort to increase awareness of allergens that warrant more attention from dermatologists and other physicians, the American Contact Dermatitis Society (ACDS) names an "Allergen of the Year."

Recently, the ACDS announced that nickel has earned the 2008 designation.

According to dermatologist Kathryn A. Zug, M.D., co-author of an article on this year's allergen for the ACDS journal Dermatitis, nickel was chosen for three reasons:

"Also, there's been a very high frequency of nickel allergy among children, particularly girls.

"Third, there's been a renewed concern regarding the role of metal and nickel allergy in complications of biomedical devices, such as coronary stents," she says.

Dr. Zug says that of 391 children patch-tested by the North American Contact Dermatitis Group between 2001 and 2004, 28 percent tested positive to nickel.

She says NACDG data from 2003 to 2004 shows that 25 percent of women tested positive, compared with 8 percent of men.

"Ear piercing is thought to be the most likely reason for this," Dr. Zug tells Dermatology Times.

In their article on nickel, Dr. Zug and co-author Rachel Kornik, a fourth-year Dartmouth Medical School student, urge regulation of products that contain high nickel concentration and typically come into prolonged contact with the skin.

Such regulation, they write, is the norm in European Union countries.

"We summarized several areas of nickel controversy and interest, including nickel from dietary sources and in biomedical devices, as well as nickel regulation in the EU and its apparent success at reducing the incidence of nickel allergy," Dr. Zug says.

"Dermatologists and their patients are looking for guidance regarding nickel allergy and biomedical devices; but regarding nickel and coronary or other stents, there simply is not enough information to say what role metal allergy - nickel or otherwise - may play in some individuals.

"The 'allergen of the year' designation, and our article, are intended to raise awareness of these issues."

Other noted allergens

Past "allergen of the year" designations have helped do just that.

Paraphenylenediamine, in 2006, was chosen due to concerns surrounding reports of severe allergic reactions to temporary henna tattoos containing high concentration of the substance.

Dr. Zug says the ACDS has initiated efforts to have paraphenylenediamine banned in ingredients used for temporary tattoos.

"Another example is bacitracin, the ACDS 2003 'allergen of the year,' which was chosen due to its rising frequency of contact allergy cause," Dr. Zug says.

"This allergen is often not routinely tested. Contact allergy to bacitracin can mimic infection and escape diagnosis if it is not thought about.

"It often occurs in patients with chronic skin conditions, such as stasis dermatitis, but may occur after only brief use, such as post-surgical. A clue is that it is much more itchy than painful," Dr. Zug says,

She adds that gold, 2001's allergen, is a relatively newly recognized allergen, and that contact allergy to hydrocortisone and other corticosteroids - 2005's allergen - has become well-accepted as an important cause of allergic contact dermatitis.