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.
