Metal allergy - common cause of contact dermatitis

Abstract

Background. Metal allergy is a delayed-type hypersensitivity reaction. Various metals can induce allergic reactions, most commonly nickel, chromium and cobalt. Nickel is more commonly implicated in contact dermatitis, 17% of women and 3% of men are allergic to nickel and 1-3% to cobalt and chromium. Objective(s). Presentation of the clinical manifestations and diagnostic peculiarities of nickel allergic contact dermatitis, which is the most commonly implicated in contact dermatitis. Materials and methods. Presentation of a clinical case of allergic contact dermatitis to nickel in a 50-year-old housewife, presenting with urticaria, edema of the face, eczema of the neck, neckline, and hands, apparently idiopathic. The manifestations recur periodically after contact with some jewelry, with frequent exacerbations in the last 2 years. Results. We present the case of a 50-year-old patient with clinical manifestations of dermatitis of the hands after contact with various metals (belt, jewelry, shoes with metal elements, etc?). Present with normal food allergen-specific immunoglobulin E values. Evaluation of contact dermatitis by patch testing is the gold standard. The standard European patch test series for contact dermatitis includes a selection of common allergens including nickel, chromium and cobalt. The patient showed positive skin tests for nickel (+++) and parabens (+). Exposure avoidance and treatment with local corticosteroids improve clinical manifestations. Conclusion(s). Patients with manifestations of contact dermatitis should be investigated by patch testing for contact allergens. Clinical manifestations, history of exposure and positive patch tests for delayed hypersensitivity point towards an accurate diagnosis.