title: Dose-response testing with nickel sulphate using the TRUE test in nickel-sensitive individuals. Multiple nickel sulphate patch-test reactions do not cause an 'angry back'.
abstract: The aim of this study was to employ the TRUE test assay to confirm the presence or absence of the 'angry back' phenomenon, i.e. that a strong positive patch-test reaction heightens adjacent patch-test response. In addition, we wished to establish the dose-response relationship for nickel sulphate patch tests among nickel-sensitive patients. Seventy-two nickel-sensitive patients, 36 in Odense and 36 in Stockholm, were tested with a 10-step nickel sulphate dilution series (TRUE test) and two placebo patches. The position of the patches was rotated, to provide a balanced spatial distribution of the different concentrations. Readings were performed blind. The results were analysed by means of polynomial multiple-regression methods and a logistic dose-response model. Half the patients (38/72) had a threshold patch-test concentration for nickel sulphate in the range of 3-0.3 microgram/cm2. The 'angry back' phenomenon was not apparent in this study, as the spill-over effect was not statistically significant. Strong reactions to high concentrations of nickel sulphate did not enhance the response to adjacent lower concentrations of nickel sulphate.
authors.affiliation: Department of Dermatology, Odense University Hospital, Denmark.
authors.forename: K E
authors.initials: KE
authors.lastname: Andersen
authors.forename: C
authors.initials: C
authors.lastname: Lidén
authors.forename: J
authors.initials: J
authors.lastname: Hansen
authors.forename: A
authors.initials: A
authors.lastname: Vølund
mesh_terms: D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007509:Irritants; D009532:Nickel / Q000009:adverse effects*; D010328:Patch Tests; D012044:Regression Analysis; D012867:Skin / Q000187:drug effects*
chemical_list: D007509:Irritants; C029938:nickel sulfate; D009532:Nickel