title: Patch test results with serial dilutions of nickel sulfate (with and without detergent), palladium chloride, and nickel and palladium metal plates.
abstract: Clinical experience suggests the existence of different degrees of sensitivity in nickel-allergic patients. For quantification of this phenomenon, 462 consecutive patients with previously diagnosed or strongly suspected nickel allergy were tested with serial dilution patch tests with 5 ppm to 5% nickel sulfate in pet. (Ni), and 5 ppm to 1% nickel sulfate in pet. with 1% detergent (Ni/D). Additionally, nickel and palladium metal plates were tested in 103, and cobalt salts, dichromate and palladium chloride (PdCl2) in most patients. 332 patients reacted positively to Ni or Ni/D. The influence of a concomitantly administered detergent was not significant. A significant correlation was found between positive reactions to low concentrations of Ni (or Ni/D), i.e., 0.1% or less (N = 166), and concomitant reactions to nickel metal plates, cobalt salts and PdCl2 and a history of ear piercing with metal intolerance. The clinical relevance of reactions to PdCl2 is at present not clear. A subgroup of nickel-allergic patients with "high sensitivity" can be defined. In future studies further addressing the clinical relevance of high versus low sensitivity, patch testing with 0.01, 0.1, 1.0 and 5% nickel sulfate in pet. is recommended instead of routine tests with 5% only.
authors.affiliation: University Skin Hospital, Göttingen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Uter
authors.forename: T
authors.initials: T
authors.lastname: Fuchs
authors.forename: M
authors.initials: M
authors.lastname: Häusser
authors.forename: H
authors.initials: H
authors.lastname: Ippen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017738:Alkanesulfonic Acids / Q000009:adverse effects; D003035:Cobalt / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D003902:Detergents / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000008:administration & dosage / Q000009:adverse effects*; D010165:Palladium / Q000008:administration & dosage / Q000009:adverse effects*; D010328:Patch Tests; D011192:Potassium Dichromate / Q000009:adverse effects
chemical_list: D017738:Alkanesulfonic Acids; D003902:Detergents; C030641:alkylbenzyl sulfonic acid; D003035:Cobalt; C029938:nickel sulfate; D010165:Palladium; D009532:Nickel; C018021:cobaltous chloride; C026305:cobalt sulfate; C008756:palladium chloride; D011192:Potassium Dichromate