Hyposensitization in nickel allergic contact dermatitis: clinical and immunologic monitoring.
BACKGROUND
In allergic contact dermatitis (ACD) previously sensitized T cells cause skin damage. If an ubiquitous allergen such as nickel is involved, no effective treatment is available. Down-regulation of this allergic response has been described after antigen presentation in the absence of adequate costimulatory signals. UV exposure can enhance such hyposensitization.


OBJECTIVE
The aim of this study was to establish the capability of a hyposensitization procedure to induce antigen-specific tolerance.


METHODS
Twenty-one patients with nickel ACD were randomly assigned to either a hyposensitized or control group. A schedule consisting of UVB treatment and subcutaneous nickel sulfate administration (hyposensitization) or UVB only (control) was applied. During the ensuing 2 years, several clinical and immunologic features were monitored.


RESULTS
During UVB treatment we observed a significant clinical improvement in both groups that persisted in the hyposensitized group. Except for increased slope variances of specific lymphocyte proliferation in time, no clear changes were seen in the immunologic findings.


CONCLUSIONS
Despite significant clinical improvement induced by UVB, hyposensitization did not induce significant changes in the immunologic findings in patients with nickel ACD.
Troost
R J
RJ
Department of Dermatology, Erasmus University, Rotterdam, The Netherlands.
Kozel
M M
MM
van Helden-Meeuwsen
C G
CG
van Joost
T
T
Mulder
P G
PG
Benner
R
R
Prens
E P
EP
D000328:Adult; D002455:Cell Division; D017449:Dermatitis, Allergic Contact / Q000276:immunology / Q000628:therapy*; D003888:Desensitization, Immunologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007108:Immune Tolerance; D016130:Immunophenotyping; D018799:Intercellular Adhesion Molecule-1 / Q000276:immunology; D007509:Irritants / Q000008:administration & dosage / Q000627:therapeutic use; D008213:Lymphocyte Activation / Q000276:immunology; D016169:Lymphocyte Function-Associated Antigen-1 / Q000276:immunology; D009532:Nickel / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000276:immunology; D014467:Ultraviolet Therapy
D007509:Irritants; D016169:Lymphocyte Function-Associated Antigen-1; D018799:Intercellular Adhesion Molecule-1; C029938:nickel sulfate; D009532:Nickel