Materiały źródłowe

• #1 Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, …: Ingenta Connect

  https://www.ingentaconnect.com/contentone/ben/emiddt/2020/00000020/00000007/art00005

  Nickel is the most common cause of contact allergy in the general population and the most frequently detected allergen in patients patch tested for suspected allergic contact dermatitis (ACD). […] Nickel allergy is a relevant issue of public health with significant personal, social, and economic impact. This review summarizes epidemiology, pathomechanism, clinical patterns, treatment, and prevention programs.

• #2 Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, Treatment and Prevention Programs – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31994473/

  Nickel is the most common cause of contact allergy in the general population and the most frequently detected allergen in patients patch tested for suspected allergic contact dermatitis (ACD). […] Nickel allergy is a relevant issue of public health with significant personal, social, and economic impact. […] A recent EU nickel directive, regulating the content and release of nickel from products, has caused a decrease of nickel contact allergy in some European countries.

• #3 Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, Treatment and Prevention Programs – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31994473/

  Nickel is the most common cause of contact allergy in the general population and the most frequently detected allergen in patients patch tested for suspected allergic contact dermatitis (ACD). […] Nickel allergy is a relevant issue of public health with significant personal, social, and economic impact. […] A recent EU nickel directive, regulating the content and release of nickel from products, has caused a decrease of nickel contact allergy in some European countries.

• #4 Systemic Nickel Allergy Syndrome (SNAS) – Research Article

  https://www.gavinpublishers.com/article/view/systemic-nickel-allergy-syndrome-taking-stock-of-medical-nutrition-therapy-snas-and-nutrition

  Nickel is a ubiquitous metal present in different products such as soil, food, and water. […] SNAS prevalence in patients with ACD is largely unknown. In one recent study, up to 6% of patients in Europe were identified as being allergic to Nickel while diagnosed with SNAS, implying that it may be under-identified in the population affected by dermatitis. […] On the contrary, a high prevalence of Nickel Allergy has been observed globally. The highest number of cases has been registered in Asia and in North America, underlying an increasing trend from 15.5% in 2009-2010 to 18.5% in 2011-2012. […] Nickel allergy mainly affects adults (approximately 8% to 19% of the general population) and children and adolescents (8% to 10%). […] According to data published by the European Contact Allergy Surveillance System (ESSCA), Italy is the first country in Europe regarding the prevalence of Nickel allergy (32.1%), while Denmark is the last, with a 9.7% prevalence rate.

• #5 Nickel allergy – Wikipedia

  https://en.wikipedia.org/wiki/Nickel_allergy

  Nickel allergy is the most common contact allergy in industrialized countries, affecting around 8% to 19% of adults and 8% to 10% of children. […] Women are affected 410 times as frequently as men. […] Nickel allergy is estimated to affect 4% of men and 16% of women worldwide. […] In southern European countries, nickel allergy is more common than in northern countries, 16% versus 10%. The results are similar in the USA.

• #6 Nickel Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557638/

  Nickel allergy is a type of contact dermatitis caused by direct contact with nickel. It is the most common identifiable cause of metal-related contact dermatitis and may be encountered in a variety of healthcare settings, from primary care clinics to emergency departments. […] Nickel allergy is a type of allergic contact dermatitis. […] In a cross-sectional analysis of over 44,000 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014, the average frequency of nickel sensitivity was 17.5 percent, and 55.5 percent of those reactions were thought to be clinically relevant. […] In a meta-analysis of 28 studies, including over 20,000 patch-tested individuals from the general population, the pooled prevalence of contact allergy was 20.1 percent, with nickel being the most common allergen. […] There is a female predominance. […] Sensitization to nickel may correlate directly with the number of body piercings, suggesting that increased frequency of exposure increases the risk for developing a nickel allergy.

• #7 Nickel Allergy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25877

  Nickel allergy is a type of allergic contact dermatitis. A nickel allergy is commonly encountered with jewelry, kitchen tools, and silverware. In a cross-sectional analysis of over 44,000 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014, the average frequency of nickel sensitivity was 17.5 percent, and 55.5 percent of those reactions were thought to be clinically relevant. In a meta-analysis of 28 studies, including over 20,000 patch-tested individuals from the general population, the pooled prevalence of contact allergy was 20.1 percent, with nickel being the most common allergen. There is a female predominance. Sensitization to nickel may correlate directly with the number of body piercings, suggesting that increased frequency of exposure increases the risk for developing a nickel allergy. […] Nickel allergy dermatitis is often a diagnosis that will require multiple visits within the healthcare system. The overall prognosis for nickel allergy is excellent.

• #8 Nickel Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557638/

  Nickel allergy is a type of contact dermatitis caused by direct contact with nickel. It is the most common identifiable cause of metal-related contact dermatitis and may be encountered in a variety of healthcare settings, from primary care clinics to emergency departments. […] Nickel allergy is a type of allergic contact dermatitis. […] In a cross-sectional analysis of over 44,000 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014, the average frequency of nickel sensitivity was 17.5 percent, and 55.5 percent of those reactions were thought to be clinically relevant. […] In a meta-analysis of 28 studies, including over 20,000 patch-tested individuals from the general population, the pooled prevalence of contact allergy was 20.1 percent, with nickel being the most common allergen. […] There is a female predominance. […] Sensitization to nickel may correlate directly with the number of body piercings, suggesting that increased frequency of exposure increases the risk for developing a nickel allergy.

• #9 Nickel Allergy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25877

  Nickel allergy is a type of allergic contact dermatitis. A nickel allergy is commonly encountered with jewelry, kitchen tools, and silverware. In a cross-sectional analysis of over 44,000 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014, the average frequency of nickel sensitivity was 17.5 percent, and 55.5 percent of those reactions were thought to be clinically relevant. In a meta-analysis of 28 studies, including over 20,000 patch-tested individuals from the general population, the pooled prevalence of contact allergy was 20.1 percent, with nickel being the most common allergen. There is a female predominance. Sensitization to nickel may correlate directly with the number of body piercings, suggesting that increased frequency of exposure increases the risk for developing a nickel allergy. […] Nickel allergy dermatitis is often a diagnosis that will require multiple visits within the healthcare system. The overall prognosis for nickel allergy is excellent.

• #10 Epidemiology of nickel sensitivity: Retrospective cross-sectional analysis of North American Contact Dermatitis Group data 1994-2014 – blog dermatologico – Dermatologia – SIDeMaST

  https://www.sidemast.org/blog/epidemiology-of-nickel-sensitivity-retrospective-cross-sectional-analysis-of-north-american-contact-dermatitis-group-data-1994-2014

  Nickel allergy is of substantial public health importance in North America. The frequency of nickel sensitivity in patients referred for patch testing has significantly increased over a 20-year period. […] To examine the epidemiology of nickel sensitivity in North America. […] The average frequency of nickel sensitivity was 17.5% (1994-2014). Nickel sensitivity significantly increased over time (from 14.3% in 1994-1996 to 20.1% in 2013-2014). […] Nickel allergy is of substantial public health importance in North America. The frequency of nickel sensitivity in patients referred for patch testing has significantly increased over a 20-year period.

• #11 Systemic Nickel Allergy Syndrome (SNAS) – Research Article

  https://www.gavinpublishers.com/article/view/systemic-nickel-allergy-syndrome-taking-stock-of-medical-nutrition-therapy-snas-and-nutrition

  Nickel is a ubiquitous metal present in different products such as soil, food, and water. […] SNAS prevalence in patients with ACD is largely unknown. In one recent study, up to 6% of patients in Europe were identified as being allergic to Nickel while diagnosed with SNAS, implying that it may be under-identified in the population affected by dermatitis. […] On the contrary, a high prevalence of Nickel Allergy has been observed globally. The highest number of cases has been registered in Asia and in North America, underlying an increasing trend from 15.5% in 2009-2010 to 18.5% in 2011-2012. […] Nickel allergy mainly affects adults (approximately 8% to 19% of the general population) and children and adolescents (8% to 10%). […] According to data published by the European Contact Allergy Surveillance System (ESSCA), Italy is the first country in Europe regarding the prevalence of Nickel allergy (32.1%), while Denmark is the last, with a 9.7% prevalence rate.

• #12 Nickel allergy – Wikipedia

  https://en.wikipedia.org/wiki/Nickel_allergy

  Nickel allergy is the most common contact allergy in industrialized countries, affecting around 8% to 19% of adults and 8% to 10% of children. […] Women are affected 410 times as frequently as men. […] Nickel allergy is estimated to affect 4% of men and 16% of women worldwide. […] In southern European countries, nickel allergy is more common than in northern countries, 16% versus 10%. The results are similar in the USA.

• #13 Systemic Nickel Allergy Syndrome (SNAS) – Research Article

  https://www.gavinpublishers.com/article/view/systemic-nickel-allergy-syndrome-taking-stock-of-medical-nutrition-therapy-snas-and-nutrition

  Nickel is a ubiquitous metal present in different products such as soil, food, and water. […] SNAS prevalence in patients with ACD is largely unknown. In one recent study, up to 6% of patients in Europe were identified as being allergic to Nickel while diagnosed with SNAS, implying that it may be under-identified in the population affected by dermatitis. […] On the contrary, a high prevalence of Nickel Allergy has been observed globally. The highest number of cases has been registered in Asia and in North America, underlying an increasing trend from 15.5% in 2009-2010 to 18.5% in 2011-2012. […] Nickel allergy mainly affects adults (approximately 8% to 19% of the general population) and children and adolescents (8% to 10%). […] According to data published by the European Contact Allergy Surveillance System (ESSCA), Italy is the first country in Europe regarding the prevalence of Nickel allergy (32.1%), while Denmark is the last, with a 9.7% prevalence rate.

• #14 Nickel Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557638/

  Nickel allergy is a type of contact dermatitis caused by direct contact with nickel. It is the most common identifiable cause of metal-related contact dermatitis and may be encountered in a variety of healthcare settings, from primary care clinics to emergency departments. […] Nickel allergy is a type of allergic contact dermatitis. […] In a cross-sectional analysis of over 44,000 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014, the average frequency of nickel sensitivity was 17.5 percent, and 55.5 percent of those reactions were thought to be clinically relevant. […] In a meta-analysis of 28 studies, including over 20,000 patch-tested individuals from the general population, the pooled prevalence of contact allergy was 20.1 percent, with nickel being the most common allergen. […] There is a female predominance. […] Sensitization to nickel may correlate directly with the number of body piercings, suggesting that increased frequency of exposure increases the risk for developing a nickel allergy.

• #15 Nickel Allergy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/25877

  Nickel allergy is a type of allergic contact dermatitis. A nickel allergy is commonly encountered with jewelry, kitchen tools, and silverware. In a cross-sectional analysis of over 44,000 patients patch tested by the North American Contact Dermatitis Group from 1994 to 2014, the average frequency of nickel sensitivity was 17.5 percent, and 55.5 percent of those reactions were thought to be clinically relevant. In a meta-analysis of 28 studies, including over 20,000 patch-tested individuals from the general population, the pooled prevalence of contact allergy was 20.1 percent, with nickel being the most common allergen. There is a female predominance. Sensitization to nickel may correlate directly with the number of body piercings, suggesting that increased frequency of exposure increases the risk for developing a nickel allergy. […] Nickel allergy dermatitis is often a diagnosis that will require multiple visits within the healthcare system. The overall prognosis for nickel allergy is excellent.

• #16 Nickel allergy – Wikipedia

  https://en.wikipedia.org/wiki/Nickel_allergy

  Nickel allergy is the most common contact allergy in industrialized countries, affecting around 8% to 19% of adults and 8% to 10% of children. […] Women are affected 410 times as frequently as men. […] Nickel allergy is estimated to affect 4% of men and 16% of women worldwide. […] In southern European countries, nickel allergy is more common than in northern countries, 16% versus 10%. The results are similar in the USA.

• #17 Nickel allergy – Wikipedia

  https://en.wikipedia.org/wiki/Nickel_allergy

  Nickel allergy is the most common contact allergy in industrialized countries, affecting around 8% to 19% of adults and 8% to 10% of children. […] Women are affected 410 times as frequently as men. […] Nickel allergy is estimated to affect 4% of men and 16% of women worldwide. […] In southern European countries, nickel allergy is more common than in northern countries, 16% versus 10%. The results are similar in the USA.

• #18 Nickel Allergy – ECARF

  https://www.ecarf.org/en/information-portal/allergies-overview/nickel-allergy/

  True symptoms in the form of allergic eczema triggered by nickel or other substances develop in 8.0% of German adults over the course of their lifetime. This was revealed in an extensive patient survey conducted by the Robert Koch Institute between 2008 and 2011 in which 12.7% of women in Germany indicated that they had once received a contact allergy diagnosis. For men, the figure was 3.4%. For children, 5.6% had contact eczema. […] The EU nickel directive stipulates that nickel-containing products intended for direct and prolonged contact with the skin may release no more than 0.5 g Ni/cm2/week. For post assemblies inserted into piercings, the rate of nickel release is restricted to no more than 0.2 g/cm/week. The release of nickel from toys is also restricted by the EU REACH regulation to 0.5 g/cm2/week. […] Research is currently underway to investigate immunotherapy options for nickel allergy.

• #19 Nickel Allergy – ECARF

  https://www.ecarf.org/en/information-portal/allergies-overview/nickel-allergy/

  Nickel is the most common contact allergen in the world. There are a number of studies that have determined how many people have developed a sensitivity (allergic disposition) to nickel based on skin tests. For Germany, a study that analysed the data of more than 100,000 patients between 2005 and 2014 revealed that an average of 8.5% of children from birth to tens years, 12.35 % of adolescents between 13 and 17 years, and 15.5% of adults have a nickel sensitivity. […] While sensitisation does not mean that all of those who tested positive experience allergy symptoms, it is clear that sensitisation is a condition for the manifestation of an allergy. In other words: the more sensitised people there are in a given country, the greater the chances are that they will develop contact eczema. As it turns out, women are generally at higher risk of developing a nickel allergy than men. This is due in part to the fact that contact with costume jewellery and body piercings promotes nickel sensitisation.

• #20 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel is unrivaled as the most common cause of contact allergy worldwide. Nickel continues to be the most common cause of contact allergy worldwide. Data from the 2015-2016 North American Contact Dermatitis Group patch test cycle (N=5597) showed nickel sulfate to be positive in 17.5% of patients patch tested to nickel. The prevalence of nickel allergy has been relatively stable in North America since 2005. Although Ni-ACD historically was identified as an occupational disease of the hands in male nickel platers, the epidemiology of nickel allergy has shifted. Today, most cases are nonoccupational and affect women more often than men, in part due to improved industrial hygiene, pervasive incorporation of nickel in consumer items, and differences in cultural practices such as piercings. Piercings in particular have been implicated as important sources of nickel exposure, as this practice disrupts normal skin barrier function and is a potentially sensitizing event. Multiple studies including a large-scale epidemiologic analysis from 2017 have found piercings to be associated with an increased frequency of Ni-ACD (24.4% with piercing vs 9.6% without piercing). Interestingly, the degree of nickel sensitivity also was found to increase with the number of piercings (14.3% with 1 piercing vs 34.0% with 5 piercings).

• #21 Nickel allergy – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nickel-allergy/symptoms-causes/syc-20351529

  Nickel allergy: Epidemiology, pathomechanism, clinical patterns, treatment and prevention programs. […] Nickel allergy is a common cause of allergic contact dermatitis an itchy rash that appears where your skin touches a usually harmless substance. […] The exact cause of nickel allergy is unknown. […] Your immune system’s sensitivity to nickel may develop after your first exposure or after repeated or prolonged exposure. […] Certain factors may increase your risk of developing nickel allergy, including: Having ear or body piercings. […] If you work in an occupation that constantly exposes you to nickel, your risk of developing an allergy may be higher than it is for someone who doesn’t work with the metal. […] Females are more likely to have a nickel allergy than are males. […] You may have inherited a tendency to develop a nickel allergy if other people in your family are sensitive to nickel.

• #22 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel is unrivaled as the most common cause of contact allergy worldwide. Nickel continues to be the most common cause of contact allergy worldwide. Data from the 2015-2016 North American Contact Dermatitis Group patch test cycle (N=5597) showed nickel sulfate to be positive in 17.5% of patients patch tested to nickel. The prevalence of nickel allergy has been relatively stable in North America since 2005. Although Ni-ACD historically was identified as an occupational disease of the hands in male nickel platers, the epidemiology of nickel allergy has shifted. Today, most cases are nonoccupational and affect women more often than men, in part due to improved industrial hygiene, pervasive incorporation of nickel in consumer items, and differences in cultural practices such as piercings. Piercings in particular have been implicated as important sources of nickel exposure, as this practice disrupts normal skin barrier function and is a potentially sensitizing event. Multiple studies including a large-scale epidemiologic analysis from 2017 have found piercings to be associated with an increased frequency of Ni-ACD (24.4% with piercing vs 9.6% without piercing). Interestingly, the degree of nickel sensitivity also was found to increase with the number of piercings (14.3% with 1 piercing vs 34.0% with 5 piercings).

• #23 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel is unrivaled as the most common cause of contact allergy worldwide. Nickel continues to be the most common cause of contact allergy worldwide. Data from the 2015-2016 North American Contact Dermatitis Group patch test cycle (N=5597) showed nickel sulfate to be positive in 17.5% of patients patch tested to nickel. The prevalence of nickel allergy has been relatively stable in North America since 2005. Although Ni-ACD historically was identified as an occupational disease of the hands in male nickel platers, the epidemiology of nickel allergy has shifted. Today, most cases are nonoccupational and affect women more often than men, in part due to improved industrial hygiene, pervasive incorporation of nickel in consumer items, and differences in cultural practices such as piercings. Piercings in particular have been implicated as important sources of nickel exposure, as this practice disrupts normal skin barrier function and is a potentially sensitizing event. Multiple studies including a large-scale epidemiologic analysis from 2017 have found piercings to be associated with an increased frequency of Ni-ACD (24.4% with piercing vs 9.6% without piercing). Interestingly, the degree of nickel sensitivity also was found to increase with the number of piercings (14.3% with 1 piercing vs 34.0% with 5 piercings).

• #24 Nickel allergy – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nickel-allergy/symptoms-causes/syc-20351529

  Nickel allergy: Epidemiology, pathomechanism, clinical patterns, treatment and prevention programs. […] Nickel allergy is a common cause of allergic contact dermatitis an itchy rash that appears where your skin touches a usually harmless substance. […] The exact cause of nickel allergy is unknown. […] Your immune system’s sensitivity to nickel may develop after your first exposure or after repeated or prolonged exposure. […] Certain factors may increase your risk of developing nickel allergy, including: Having ear or body piercings. […] If you work in an occupation that constantly exposes you to nickel, your risk of developing an allergy may be higher than it is for someone who doesn’t work with the metal. […] Females are more likely to have a nickel allergy than are males. […] You may have inherited a tendency to develop a nickel allergy if other people in your family are sensitive to nickel.

• #25 Nickel allergy – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nickel-allergy/symptoms-causes/syc-20351529

  Nickel allergy: Epidemiology, pathomechanism, clinical patterns, treatment and prevention programs. […] Nickel allergy is a common cause of allergic contact dermatitis an itchy rash that appears where your skin touches a usually harmless substance. […] The exact cause of nickel allergy is unknown. […] Your immune system’s sensitivity to nickel may develop after your first exposure or after repeated or prolonged exposure. […] Certain factors may increase your risk of developing nickel allergy, including: Having ear or body piercings. […] If you work in an occupation that constantly exposes you to nickel, your risk of developing an allergy may be higher than it is for someone who doesn’t work with the metal. […] Females are more likely to have a nickel allergy than are males. […] You may have inherited a tendency to develop a nickel allergy if other people in your family are sensitive to nickel.

• #26 Pediatric Contact Dermatitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/911711-overview

  The incidence of contact dermatitis in the pediatric age group is debated, but allergic contact dermatitis affects approximately 20% of all children at some time. Approximately 20-35% of healthy children react to one or more allergens on standard patch tests. […] Children of parents who experience contact dermatitis are 60% more likely to have positive patch test results. […] Both allergic and irritant reactions are twice as common in females as in males. […] The recent trend of piercing ears in infants and body piercing by adolescents can be expected to lower the average age at which nickel allergy occurs.

• #27

  https://medicaljournalssweden.se/actadv/article/view/42425

  Nickel allergy is common among children. The present study investigated prevalence trends of self-reported nickel allergy, risk factors, and atopic comorbidity among children. Self-reported nickel allergy decreased from 7.7% (2006) to 6.1% (2017; p=0.024) and was significantly more common among girls. Among children with atopic dermatitis, no significant decrease was seen over the years 1996 to 2017. Ear piercing and female sex were risk factors for self-reported nickel allergy in 2006 and 2017, respectively. Self-reported nickel allergy was significantly more prevalent among children with atopic dermatitis than without in 2006 (12.3% vs 6.4%; p0.001) and 2017 (11.5% vs 5.1%; p0.001), and among children with allergic rhinitis in 2017 (8.6% vs 4.7%; p=0.015). In conclusion, we found a decreasing prevalence of self-reported nickel allergy, but not among children with atopic dermatitis. Our findings also suggest that nickel allergy is associated with atopic dermatitis and allergic rhinitis.

• #28

  https://medicaljournalssweden.se/actadv/article/view/42425

  Nickel allergy is common among children. The present study investigated prevalence trends of self-reported nickel allergy, risk factors, and atopic comorbidity among children. Self-reported nickel allergy decreased from 7.7% (2006) to 6.1% (2017; p=0.024) and was significantly more common among girls. Among children with atopic dermatitis, no significant decrease was seen over the years 1996 to 2017. Ear piercing and female sex were risk factors for self-reported nickel allergy in 2006 and 2017, respectively. Self-reported nickel allergy was significantly more prevalent among children with atopic dermatitis than without in 2006 (12.3% vs 6.4%; p0.001) and 2017 (11.5% vs 5.1%; p0.001), and among children with allergic rhinitis in 2017 (8.6% vs 4.7%; p=0.015). In conclusion, we found a decreasing prevalence of self-reported nickel allergy, but not among children with atopic dermatitis. Our findings also suggest that nickel allergy is associated with atopic dermatitis and allergic rhinitis.

• #29

  https://medicaljournalssweden.se/actadv/article/view/42425

  Nickel allergy is common among children. The present study investigated prevalence trends of self-reported nickel allergy, risk factors, and atopic comorbidity among children. Self-reported nickel allergy decreased from 7.7% (2006) to 6.1% (2017; p=0.024) and was significantly more common among girls. Among children with atopic dermatitis, no significant decrease was seen over the years 1996 to 2017. Ear piercing and female sex were risk factors for self-reported nickel allergy in 2006 and 2017, respectively. Self-reported nickel allergy was significantly more prevalent among children with atopic dermatitis than without in 2006 (12.3% vs 6.4%; p0.001) and 2017 (11.5% vs 5.1%; p0.001), and among children with allergic rhinitis in 2017 (8.6% vs 4.7%; p=0.015). In conclusion, we found a decreasing prevalence of self-reported nickel allergy, but not among children with atopic dermatitis. Our findings also suggest that nickel allergy is associated with atopic dermatitis and allergic rhinitis.

• #30 Irritable Bowel Syndrome and Nickel Allergy: What Is the Role of the Low Nickel Diet?

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm16027

  Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain or discomfort accompanied by abnormal bowel movements. In sensitized subjects, ingested nickel (Ni) may induce gastrointestinal symptoms similar to IBS, in addition to typical systemic cutaneous lesions (systemic nickel allergy syndrome [SNAS]). A low nickel diet could improve the systemic manifestations. We evaluated prevalence of nickel allergy in IBS and effects of low Ni diet on (1) gastrointestinal symptoms control, (2) intestinal barrier function, (3) quality of life, and (4) psychological status of patients with IBS and Ni-sensitized patients. […] Our data demonstrate that: (1) Ni allergy is highly prevalent in patients affected by IBS, with a higher frequency in females; (2) a low Ni diet determines a clear improvement on both gastrointestinal symptoms and state of general physical health in IBS patients with concomitant Ni allergy; and (3) the change of IP after low Ni diet is influenced by skin reactivity to Ni and IBS subtypes.

• #31 High Prevalence of Nickel Allergy in an Overweight Female Population: A Pilot Observational Analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0123265

  Prevalence of Nickel allergy in overweight female was 59.7%, compared with a prevalence rate of 12.5% in the general population. […] This pilot observational analysis showed a substantially higher prevalence of Nickel allergy among overweight females, especially those with metabolic syndrome and fatty liver disease. […] The patch test showed a considerable higher prevalence of Nickel allergy in overweight patients compared to the general population. […] In particular, the prevalence of Nickel allergy among overweight women and males was 59.7% (43/72) (95% CI: 47.5% -71.1%; P0.001) and 13.3% (2/15) (95% CI: 031.0%; P0.1) respectively, in contrast to a prevalence rate of Nickel allergy of 815% in women and 13% in males in the general population. […] When a normocaloric diet, formulated to be low only in Nickel (100 g/daily), was prescribed to allergic overweight females as the established therapy for their allergy, they manifested a reduction in body mass index and waist circumference in the first three months of diet, and this reduction was maintained stable at six months of follow up. […] This pilot observational analysis showed a substantially higher prevalence of Nickel allergy among overweight females, especially those with metabolic syndrome and fatty liver disease.

• #32 The Human Nickel Microbiome and its relationship to Allergy and Overweight in Women | bioRxiv

  https://www.biorxiv.org/content/10.1101/546739v1.full-text

  Introduction Nickel exposure usually presents as Allergic Contact Dermatitis. However, Nickel not only causes dermatitis, but an excess of dietary Nickel is reported to be responsible for overweight, metabolic disorders and imbalance of gut microflora. […] The prevalence of Nickel allergy in overweight women is 63%, compared with a prevalence rate of 12% in the general population, and a normocaloric diet formulated to be low only in Nickel is effective in reducing BMI and waist circumference in overweight females. These findings have been recently confirmed in a larger cohort of 1128 obese people, where a Nickel allergy is more frequent in presence of weight excess and is associated with worse metabolic parameters. […] In this study, we aimed to expand preliminary evidences of the presence of nickel resistant bacteria in human gut and study and their correlation with nickel allergy severity and overweight especially in females that are the gender mostly affected by chronic exposure to nickel.

• #33 Irritable Bowel Syndrome and Nickel Allergy: What Is the Role of the Low Nickel Diet?

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm16027

  Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain or discomfort accompanied by abnormal bowel movements. In sensitized subjects, ingested nickel (Ni) may induce gastrointestinal symptoms similar to IBS, in addition to typical systemic cutaneous lesions (systemic nickel allergy syndrome [SNAS]). A low nickel diet could improve the systemic manifestations. We evaluated prevalence of nickel allergy in IBS and effects of low Ni diet on (1) gastrointestinal symptoms control, (2) intestinal barrier function, (3) quality of life, and (4) psychological status of patients with IBS and Ni-sensitized patients. […] Our data demonstrate that: (1) Ni allergy is highly prevalent in patients affected by IBS, with a higher frequency in females; (2) a low Ni diet determines a clear improvement on both gastrointestinal symptoms and state of general physical health in IBS patients with concomitant Ni allergy; and (3) the change of IP after low Ni diet is influenced by skin reactivity to Ni and IBS subtypes.

• #34 Systemic nickel hypersensitivity and diet: myth or reality? – European Annals of Allergy and Clinical Immunology

  https://www.eurannallergyimm.com/systemic-nickel-hypersensitivity-and-diet-myth-or-reality/

  Nickel is a very common metal contained in many everyday objects and is the leading cause of ACD (Allergic Contact Dermatitis). […] The relationship between ACD and contact with nickel is undisputed and widely confirmed in literature. […] The situation is different for systemic nickel allergy syndrome (SNAS). […] A rigorous demonstration of the relationship between SCD and nickel is extremely difficult. […] In particular, further and larger studies are needed to assess the reality and the prevalence of nickel urticaria. […] Conclusion: an evaluation of the data presented by medical literature about SNAS and its relationship with oral nickel does not allow to draw final conclusions. In the absence of genuine certainty we can only conclude that further and broader studies, more rigorously conducted, are needed.

• #35 Systemic Nickel Allergy Syndrome (SNAS) – Research Article

  https://www.gavinpublishers.com/article/view/systemic-nickel-allergy-syndrome-taking-stock-of-medical-nutrition-therapy-snas-and-nutrition

  Nickel is a ubiquitous metal present in different products such as soil, food, and water. […] SNAS prevalence in patients with ACD is largely unknown. In one recent study, up to 6% of patients in Europe were identified as being allergic to Nickel while diagnosed with SNAS, implying that it may be under-identified in the population affected by dermatitis. […] On the contrary, a high prevalence of Nickel Allergy has been observed globally. The highest number of cases has been registered in Asia and in North America, underlying an increasing trend from 15.5% in 2009-2010 to 18.5% in 2011-2012. […] Nickel allergy mainly affects adults (approximately 8% to 19% of the general population) and children and adolescents (8% to 10%). […] According to data published by the European Contact Allergy Surveillance System (ESSCA), Italy is the first country in Europe regarding the prevalence of Nickel allergy (32.1%), while Denmark is the last, with a 9.7% prevalence rate.

• #36

  https://link.springer.com/article/10.1007/s40521-014-0029-6

  Allergic contact dermatitis (ACD) has an approximate prevalence of 20 %. […] The median nickel allergy prevalence was noted to be 8.6 %. […] Unfortunately, no epidemiological data exist for SCD in the general population. […] However, a meta-analysis of 17 studies of oral nickel exposure estimated that 1 % of nickel-sensitive patients may react systemically to everyday nickel exposure (0.22 0.35 mg nickel), and 10 % may react to a diet composed of foods rich in nickel (0.551.33 mcg nickel). […] Of 1,696 patients referred to allergy units in Italy, 98 (5.78 %) were diagnosed with SNAS.

• #37 Validation of Self-testing as a Method to Estimate the Prevalence of Nickel Allergy | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1120

  The aim of this study was to investigate the validity of self-patch testing for nickel allergy, in order to determine a cost-effective method for surveillance of the prevalence of nickel allergy. […] Continuous epidemiological surveillance is necessary to determine the prevalence of contact allergy and to evaluate interventions. […] The present study has validated a tool for epidemiological surveillance of nickel allergy. It is of importance to follow the prevalence of contact allergy in the general population. […] All methods available for estimation of the occurrence of nickel allergy have limitations, practical, economic, or regarding validity. In the present study self-testing appears to be a reasonable alternative method for estimation of the prevalence of nickel allergy. However, the positive predictive value is critically dependent on the population chosen and the prevalence of disease within that population. This means that the positive predictive value may not be transferable from the patient population in the present study to the general population. Further testing in the general population will be needed to determine the usefulness of self-testing as an epidemiological tool to follow the prevalence of nickel allergy.

• #38 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel is unrivaled as the most common cause of contact allergy worldwide. Nickel continues to be the most common cause of contact allergy worldwide. Data from the 2015-2016 North American Contact Dermatitis Group patch test cycle (N=5597) showed nickel sulfate to be positive in 17.5% of patients patch tested to nickel. The prevalence of nickel allergy has been relatively stable in North America since 2005. Although Ni-ACD historically was identified as an occupational disease of the hands in male nickel platers, the epidemiology of nickel allergy has shifted. Today, most cases are nonoccupational and affect women more often than men, in part due to improved industrial hygiene, pervasive incorporation of nickel in consumer items, and differences in cultural practices such as piercings. Piercings in particular have been implicated as important sources of nickel exposure, as this practice disrupts normal skin barrier function and is a potentially sensitizing event. Multiple studies including a large-scale epidemiologic analysis from 2017 have found piercings to be associated with an increased frequency of Ni-ACD (24.4% with piercing vs 9.6% without piercing). Interestingly, the degree of nickel sensitivity also was found to increase with the number of piercings (14.3% with 1 piercing vs 34.0% with 5 piercings).

• #39 Epidemiology of Contact Allergy in Europe: Current Situation and Outlook for the Future | Actas Dermo-Sifiliográficas

  http://www.actasdermo.org/en-epidemiology-contact-allergy-in-europe-articulo-S1578219011707466

  Epidemiology of Contact Allergy in Europe: Current Situation and Outlook for the Future […] Decrease in nickel sensitization in a Danish schoolgirl population with ears pierced after implementation of a nickel-exposure regulation. Br J Dermatol, 146 (2002), pp. 636-642Medline […] Decrease in nickel allergy in Germany and regulatory interventions. Contact Dermatitis, 49 (2003), pp. 107-108Medline […] Nickel allergy is still frequent in young German females – probably due to insufficient protection from nickel-releasing objects. Contact Dermatitis. 2010. In press. […] The European standard series in 9 European countries, 2002/2003 – First results of the European Surveillance System on Contact Allergies. Contact Dermatitis, 53 (2005), pp. 136-145 […] The European Surveillance System of Contact Allergies (ESSCA): results of patch testing the standard series, 2004. J Eur Acad Dermatol Venereol, 22 (2008), pp. 174-181 […] The European baseline series in 10 European Countries, 2005/2006results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis, 61 (2009), pp. 31-38

• #40 Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/es-translated-article-four-year-epidemiological-surveillance-articulo-S0001731024000929

  Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends […] The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. […] A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. […] Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained.

• #41 Nickel Allergy: Epidemiology, Pathomechanism, Clinical Patterns, Treatment and Prevention Programs – PubMed

  https://pubmed.ncbi.nlm.nih.gov/31994473/

  Nickel is the most common cause of contact allergy in the general population and the most frequently detected allergen in patients patch tested for suspected allergic contact dermatitis (ACD). […] Nickel allergy is a relevant issue of public health with significant personal, social, and economic impact. […] A recent EU nickel directive, regulating the content and release of nickel from products, has caused a decrease of nickel contact allergy in some European countries.

• #42 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel content has been regulated in parts of the European Union (EU) since the 1990s, but regulation in the United States is lacking. In an attempt to reduce the prevalence of nickel allergy, the EU limits the level of nickel release from consumer items intended to be in direct and prolonged contact with the skin. These limits were first introduced in Denmark in 1990, followed closely by the EU Nickel Directive in 1994, which has resulted in consistent patterns of decreasing prevalence of Ni-ACD in multiple European countries. Notably, a Danish study comparing the prevalence of sensitization between girls with ears pierced before vs after implementation of nickel regulation found a decrease in prevalence from 17.1% to 3.9%. Additionally, this initiative has greatly reduced the economic burden of nickel dermatitis. It is estimated that Denmark alone has saved US $2 billion over a 20-year period in both direct and indirect health care costs.

• #43 Nickel Allergy – ECARF

  https://www.ecarf.org/en/information-portal/allergies-overview/nickel-allergy/

  True symptoms in the form of allergic eczema triggered by nickel or other substances develop in 8.0% of German adults over the course of their lifetime. This was revealed in an extensive patient survey conducted by the Robert Koch Institute between 2008 and 2011 in which 12.7% of women in Germany indicated that they had once received a contact allergy diagnosis. For men, the figure was 3.4%. For children, 5.6% had contact eczema. […] The EU nickel directive stipulates that nickel-containing products intended for direct and prolonged contact with the skin may release no more than 0.5 g Ni/cm2/week. For post assemblies inserted into piercings, the rate of nickel release is restricted to no more than 0.2 g/cm/week. The release of nickel from toys is also restricted by the EU REACH regulation to 0.5 g/cm2/week. […] Research is currently underway to investigate immunotherapy options for nickel allergy.

• #44 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel content has been regulated in parts of the European Union (EU) since the 1990s, but regulation in the United States is lacking. In an attempt to reduce the prevalence of nickel allergy, the EU limits the level of nickel release from consumer items intended to be in direct and prolonged contact with the skin. These limits were first introduced in Denmark in 1990, followed closely by the EU Nickel Directive in 1994, which has resulted in consistent patterns of decreasing prevalence of Ni-ACD in multiple European countries. Notably, a Danish study comparing the prevalence of sensitization between girls with ears pierced before vs after implementation of nickel regulation found a decrease in prevalence from 17.1% to 3.9%. Additionally, this initiative has greatly reduced the economic burden of nickel dermatitis. It is estimated that Denmark alone has saved US $2 billion over a 20-year period in both direct and indirect health care costs.

• #45 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel content has been regulated in parts of the European Union (EU) since the 1990s, but regulation in the United States is lacking. In an attempt to reduce the prevalence of nickel allergy, the EU limits the level of nickel release from consumer items intended to be in direct and prolonged contact with the skin. These limits were first introduced in Denmark in 1990, followed closely by the EU Nickel Directive in 1994, which has resulted in consistent patterns of decreasing prevalence of Ni-ACD in multiple European countries. Notably, a Danish study comparing the prevalence of sensitization between girls with ears pierced before vs after implementation of nickel regulation found a decrease in prevalence from 17.1% to 3.9%. Additionally, this initiative has greatly reduced the economic burden of nickel dermatitis. It is estimated that Denmark alone has saved US $2 billion over a 20-year period in both direct and indirect health care costs.

• #46 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel content has been regulated in parts of the European Union (EU) since the 1990s, but regulation in the United States is lacking. In an attempt to reduce the prevalence of nickel allergy, the EU limits the level of nickel release from consumer items intended to be in direct and prolonged contact with the skin. These limits were first introduced in Denmark in 1990, followed closely by the EU Nickel Directive in 1994, which has resulted in consistent patterns of decreasing prevalence of Ni-ACD in multiple European countries. Notably, a Danish study comparing the prevalence of sensitization between girls with ears pierced before vs after implementation of nickel regulation found a decrease in prevalence from 17.1% to 3.9%. Additionally, this initiative has greatly reduced the economic burden of nickel dermatitis. It is estimated that Denmark alone has saved US $2 billion over a 20-year period in both direct and indirect health care costs.

• #47 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  However, a policy is only effective if it is enforced, and it has been reported in the EU that 8% to 32% of tested jewelry exceeds the limit placed on nickel release, with imported jewelry being especially problematic. Also of interest, the 1 and 2 euro coins are known to release more nickel than pure nickel itself, releasing 240 to 320 times more than is allowed under the EU Nickel Directive. Although coins are not explicitly mentioned as items having prolonged contact with the skin, they can and do exacerbate allergic contact dermatitis of the hands, especially in occupational groups such as cashiers. However, the EU regulation is considered a public health success overall, and the trends of Ni-ACD and economic burden are opposite of the United States, where legislation has yet to be adopted.

• #48 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  However, a policy is only effective if it is enforced, and it has been reported in the EU that 8% to 32% of tested jewelry exceeds the limit placed on nickel release, with imported jewelry being especially problematic. Also of interest, the 1 and 2 euro coins are known to release more nickel than pure nickel itself, releasing 240 to 320 times more than is allowed under the EU Nickel Directive. Although coins are not explicitly mentioned as items having prolonged contact with the skin, they can and do exacerbate allergic contact dermatitis of the hands, especially in occupational groups such as cashiers. However, the EU regulation is considered a public health success overall, and the trends of Ni-ACD and economic burden are opposite of the United States, where legislation has yet to be adopted.

• #49 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  However, a policy is only effective if it is enforced, and it has been reported in the EU that 8% to 32% of tested jewelry exceeds the limit placed on nickel release, with imported jewelry being especially problematic. Also of interest, the 1 and 2 euro coins are known to release more nickel than pure nickel itself, releasing 240 to 320 times more than is allowed under the EU Nickel Directive. Although coins are not explicitly mentioned as items having prolonged contact with the skin, they can and do exacerbate allergic contact dermatitis of the hands, especially in occupational groups such as cashiers. However, the EU regulation is considered a public health success overall, and the trends of Ni-ACD and economic burden are opposite of the United States, where legislation has yet to be adopted.

• #50 Validation of Self-testing as a Method to Estimate the Prevalence of Nickel Allergy | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1120

  The aim of this study was to investigate the validity of self-patch testing for nickel allergy, in order to determine a cost-effective method for surveillance of the prevalence of nickel allergy. […] Continuous epidemiological surveillance is necessary to determine the prevalence of contact allergy and to evaluate interventions. […] The present study has validated a tool for epidemiological surveillance of nickel allergy. It is of importance to follow the prevalence of contact allergy in the general population. […] All methods available for estimation of the occurrence of nickel allergy have limitations, practical, economic, or regarding validity. In the present study self-testing appears to be a reasonable alternative method for estimation of the prevalence of nickel allergy. However, the positive predictive value is critically dependent on the population chosen and the prevalence of disease within that population. This means that the positive predictive value may not be transferable from the patient population in the present study to the general population. Further testing in the general population will be needed to determine the usefulness of self-testing as an epidemiological tool to follow the prevalence of nickel allergy.

• #51 Validation of Self-testing as a Method to Estimate the Prevalence of Nickel Allergy | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1120

  The aim of this study was to investigate the validity of self-patch testing for nickel allergy, in order to determine a cost-effective method for surveillance of the prevalence of nickel allergy. […] Continuous epidemiological surveillance is necessary to determine the prevalence of contact allergy and to evaluate interventions. […] The present study has validated a tool for epidemiological surveillance of nickel allergy. It is of importance to follow the prevalence of contact allergy in the general population. […] All methods available for estimation of the occurrence of nickel allergy have limitations, practical, economic, or regarding validity. In the present study self-testing appears to be a reasonable alternative method for estimation of the prevalence of nickel allergy. However, the positive predictive value is critically dependent on the population chosen and the prevalence of disease within that population. This means that the positive predictive value may not be transferable from the patient population in the present study to the general population. Further testing in the general population will be needed to determine the usefulness of self-testing as an epidemiological tool to follow the prevalence of nickel allergy.

• #52 Validation of Self-testing as a Method to Estimate the Prevalence of Nickel Allergy | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1120

  The aim of this study was to investigate the validity of self-patch testing for nickel allergy, in order to determine a cost-effective method for surveillance of the prevalence of nickel allergy. […] Continuous epidemiological surveillance is necessary to determine the prevalence of contact allergy and to evaluate interventions. […] The present study has validated a tool for epidemiological surveillance of nickel allergy. It is of importance to follow the prevalence of contact allergy in the general population. […] All methods available for estimation of the occurrence of nickel allergy have limitations, practical, economic, or regarding validity. In the present study self-testing appears to be a reasonable alternative method for estimation of the prevalence of nickel allergy. However, the positive predictive value is critically dependent on the population chosen and the prevalence of disease within that population. This means that the positive predictive value may not be transferable from the patient population in the present study to the general population. Further testing in the general population will be needed to determine the usefulness of self-testing as an epidemiological tool to follow the prevalence of nickel allergy.

• #53 Allergic Contact Dermatitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1049216-overview

  The National Health and Nutrition Examination Survey (NHANES) estimated the prevalence of contact dermatitis to be 13.6 cases per 1000 population, using physical examinations by dermatologists of a selected sample of patients. NHANES underreported the prevalence compared with the physical examination findings. […] A Swedish study found that prevalence of allergic contact dermatitis of the hands was 2.7 cases per 1000 population. A Dutch study found that prevalence of allergic contact dermatitis of the hands was 12 cases per 1000 population.

• #54 Allergic Contact Dermatitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1049216-overview

  The National Health and Nutrition Examination Survey (NHANES) estimated the prevalence of contact dermatitis to be 13.6 cases per 1000 population, using physical examinations by dermatologists of a selected sample of patients. NHANES underreported the prevalence compared with the physical examination findings. […] A Swedish study found that prevalence of allergic contact dermatitis of the hands was 2.7 cases per 1000 population. A Dutch study found that prevalence of allergic contact dermatitis of the hands was 12 cases per 1000 population.

• #55 Systemic nickel hypersensitivity and diet: myth or reality? – European Annals of Allergy and Clinical Immunology

  https://www.eurannallergyimm.com/systemic-nickel-hypersensitivity-and-diet-myth-or-reality/

  Nickel is a very common metal contained in many everyday objects and is the leading cause of ACD (Allergic Contact Dermatitis). […] The relationship between ACD and contact with nickel is undisputed and widely confirmed in literature. […] The situation is different for systemic nickel allergy syndrome (SNAS). […] A rigorous demonstration of the relationship between SCD and nickel is extremely difficult. […] In particular, further and larger studies are needed to assess the reality and the prevalence of nickel urticaria. […] Conclusion: an evaluation of the data presented by medical literature about SNAS and its relationship with oral nickel does not allow to draw final conclusions. In the absence of genuine certainty we can only conclude that further and broader studies, more rigorously conducted, are needed.

• #56 Systemic nickel hypersensitivity and diet: myth or reality? – European Annals of Allergy and Clinical Immunology

  https://www.eurannallergyimm.com/systemic-nickel-hypersensitivity-and-diet-myth-or-reality/

  Nickel is a very common metal contained in many everyday objects and is the leading cause of ACD (Allergic Contact Dermatitis). […] The relationship between ACD and contact with nickel is undisputed and widely confirmed in literature. […] The situation is different for systemic nickel allergy syndrome (SNAS). […] A rigorous demonstration of the relationship between SCD and nickel is extremely difficult. […] In particular, further and larger studies are needed to assess the reality and the prevalence of nickel urticaria. […] Conclusion: an evaluation of the data presented by medical literature about SNAS and its relationship with oral nickel does not allow to draw final conclusions. In the absence of genuine certainty we can only conclude that further and broader studies, more rigorously conducted, are needed.

• #57 Systemic nickel hypersensitivity and diet: myth or reality? – European Annals of Allergy and Clinical Immunology

  https://www.eurannallergyimm.com/systemic-nickel-hypersensitivity-and-diet-myth-or-reality/

  Nickel is a very common metal contained in many everyday objects and is the leading cause of ACD (Allergic Contact Dermatitis). […] The relationship between ACD and contact with nickel is undisputed and widely confirmed in literature. […] The situation is different for systemic nickel allergy syndrome (SNAS). […] A rigorous demonstration of the relationship between SCD and nickel is extremely difficult. […] In particular, further and larger studies are needed to assess the reality and the prevalence of nickel urticaria. […] Conclusion: an evaluation of the data presented by medical literature about SNAS and its relationship with oral nickel does not allow to draw final conclusions. In the absence of genuine certainty we can only conclude that further and broader studies, more rigorously conducted, are needed.

• #58 The Human Nickel Microbiome and its relationship to Allergy and Overweight in Women | bioRxiv

  https://www.biorxiv.org/content/10.1101/546739v1.full-text

  Nickel resistant bacteria were isolated in both allergic and control subjects. However, while in control subjects bacteria stop their grow at 5 mM NiSO4, bacteria isolated from allergic patients were able to tolerate higher concentrations of NiSO4, up to 50mM in obese allergic. […] This study, although simple and technically basic, confirms how an excess of Nickel can influence the gut microbiota in obese Nickel allergic females.

• #59 High Prevalence of Nickel Allergy in an Overweight Female Population: A Pilot Observational Analysis | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0123265

  Prevalence of Nickel allergy in overweight female was 59.7%, compared with a prevalence rate of 12.5% in the general population. […] This pilot observational analysis showed a substantially higher prevalence of Nickel allergy among overweight females, especially those with metabolic syndrome and fatty liver disease. […] The patch test showed a considerable higher prevalence of Nickel allergy in overweight patients compared to the general population. […] In particular, the prevalence of Nickel allergy among overweight women and males was 59.7% (43/72) (95% CI: 47.5% -71.1%; P0.001) and 13.3% (2/15) (95% CI: 031.0%; P0.1) respectively, in contrast to a prevalence rate of Nickel allergy of 815% in women and 13% in males in the general population. […] When a normocaloric diet, formulated to be low only in Nickel (100 g/daily), was prescribed to allergic overweight females as the established therapy for their allergy, they manifested a reduction in body mass index and waist circumference in the first three months of diet, and this reduction was maintained stable at six months of follow up. […] This pilot observational analysis showed a substantially higher prevalence of Nickel allergy among overweight females, especially those with metabolic syndrome and fatty liver disease.

• #60 Nickel Allergy – ECARF

  https://www.ecarf.org/en/information-portal/allergies-overview/nickel-allergy/

  True symptoms in the form of allergic eczema triggered by nickel or other substances develop in 8.0% of German adults over the course of their lifetime. This was revealed in an extensive patient survey conducted by the Robert Koch Institute between 2008 and 2011 in which 12.7% of women in Germany indicated that they had once received a contact allergy diagnosis. For men, the figure was 3.4%. For children, 5.6% had contact eczema. […] The EU nickel directive stipulates that nickel-containing products intended for direct and prolonged contact with the skin may release no more than 0.5 g Ni/cm2/week. For post assemblies inserted into piercings, the rate of nickel release is restricted to no more than 0.2 g/cm/week. The release of nickel from toys is also restricted by the EU REACH regulation to 0.5 g/cm2/week. […] Research is currently underway to investigate immunotherapy options for nickel allergy.

• #61 Validation of Self-testing as a Method to Estimate the Prevalence of Nickel Allergy | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1120

  The aim of this study was to investigate the validity of self-patch testing for nickel allergy, in order to determine a cost-effective method for surveillance of the prevalence of nickel allergy. […] Continuous epidemiological surveillance is necessary to determine the prevalence of contact allergy and to evaluate interventions. […] The present study has validated a tool for epidemiological surveillance of nickel allergy. It is of importance to follow the prevalence of contact allergy in the general population. […] All methods available for estimation of the occurrence of nickel allergy have limitations, practical, economic, or regarding validity. In the present study self-testing appears to be a reasonable alternative method for estimation of the prevalence of nickel allergy. However, the positive predictive value is critically dependent on the population chosen and the prevalence of disease within that population. This means that the positive predictive value may not be transferable from the patient population in the present study to the general population. Further testing in the general population will be needed to determine the usefulness of self-testing as an epidemiological tool to follow the prevalence of nickel allergy.

• #62 Contact Allergy to Nickel: Still #1 After All These Years | MDedge

  https://medauth2.mdedge.com/content/contact-allergy-nickel-still-1-after-all-these-years

  Nickel allergy remains common, found in up to 17.5% of patch tested patients. Despite regulation in the EU, nickel continues to have high prevalence of positive patch test reactions around the world. Nickel is not only found in jewelry and belt buckles but also in personal care products, electronics, and food. Allergen avoidance is key and requires knowledge of common items containing nickel and a low nickel diet for select patients.

• #63 Allergic contact dermatitis pattern in Kuwait: nickel leads the pack. In-depth analysis of nickel allergy based on the results from a large prospective patch test series report

  https://www.termedia.pl/Allergic-contact-dermatitis-pattern-in-Kuwait-nickel-leads-the-pack-In-depth-analysis-of-nickel-allergy-based-on-the-results-from-a-large-prospective-patch-test-series-report,7,29962,1,1.html

  The maximum number of nickel allergic patients was found in the age group of 15-25 years (51.09%) followed by the age group of 26-35 years. […] Contact dermatitis to nickel represents a significant morbidity that can lead to inability to work, a decreased quality of life, and noteworthy healthcare expenses. […] Nickel was the most common positive patch test allergen in all patch tested patients (23.9%) in this study. […] The reason for the relatively high prevalence of nickel ACD could be the use of nickel in consumer items that come in direct and prolonged contact with the skin. […] The highest incidence and prevalence of nickel ACD has been noted by the North American Contact Dermatitis Group in the age group of 10 to 19 years. […] Nickel sensitization is a major community health problem due to the high frequency, and extensive existence of nickel in daily life.

• #64 Allergic contact dermatitis pattern in Kuwait: nickel leads the pack. In-depth analysis of nickel allergy based on the results from a large prospective patch test series report

  https://www.termedia.pl/Allergic-contact-dermatitis-pattern-in-Kuwait-nickel-leads-the-pack-In-depth-analysis-of-nickel-allergy-based-on-the-results-from-a-large-prospective-patch-test-series-report,7,29962,1,1.html

  The maximum number of nickel allergic patients was found in the age group of 15-25 years (51.09%) followed by the age group of 26-35 years. […] Contact dermatitis to nickel represents a significant morbidity that can lead to inability to work, a decreased quality of life, and noteworthy healthcare expenses. […] Nickel was the most common positive patch test allergen in all patch tested patients (23.9%) in this study. […] The reason for the relatively high prevalence of nickel ACD could be the use of nickel in consumer items that come in direct and prolonged contact with the skin. […] The highest incidence and prevalence of nickel ACD has been noted by the North American Contact Dermatitis Group in the age group of 10 to 19 years. […] Nickel sensitization is a major community health problem due to the high frequency, and extensive existence of nickel in daily life.

• #65 Validation of Self-testing as a Method to Estimate the Prevalence of Nickel Allergy | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-1120

  The aim of this study was to investigate the validity of self-patch testing for nickel allergy, in order to determine a cost-effective method for surveillance of the prevalence of nickel allergy. […] Continuous epidemiological surveillance is necessary to determine the prevalence of contact allergy and to evaluate interventions. […] The present study has validated a tool for epidemiological surveillance of nickel allergy. It is of importance to follow the prevalence of contact allergy in the general population. […] All methods available for estimation of the occurrence of nickel allergy have limitations, practical, economic, or regarding validity. In the present study self-testing appears to be a reasonable alternative method for estimation of the prevalence of nickel allergy. However, the positive predictive value is critically dependent on the population chosen and the prevalence of disease within that population. This means that the positive predictive value may not be transferable from the patient population in the present study to the general population. Further testing in the general population will be needed to determine the usefulness of self-testing as an epidemiological tool to follow the prevalence of nickel allergy.

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