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Article
June 23, 1956

ALLERGIC ECZEMATOUS CONTACT DERMATITIS DUE TO METALLIC NICKEL

JAMA. 1956;161(8):717-721. doi:10.1001/jama.1956.02970080047015
Abstract

• Nickel was found to be the cause of dermatitis in 198 patients seen over a five-year period. Such patients invariably reacted positively to patch tests with 10% nickel sulfate solution, and the only chemical that surpassed nickel as the causative agent of strongly positive patch test reactions was paraphenylenediamine.

As a solution for use in the routine detection of sensitivity to nickel, 5% nickel sulfate was found preferable to more concentrated solutions. Patch testing with nickel coins is reliable if the coins actually contain nickel; this metal was replaced temporarily with silver and manganese during World War II.

Of 40 patients whose reaction to nickel was followed over a period of years, only 4 appeared to lose their sensitivity. The two most frequent sites of dermatitis were the ears (from earrings) and thighs (from garter clasps and metal chairs). Patients who recognized the cause of the dermatitis soon discovered means of avoiding it, either by preventing contact or by replacing the nickel-containing objects with others.

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