title: Complementary and alternative remedies: an additional source of potential systemic nickel exposure.
abstract: BACKGROUND
  Systemic contact dermatitis from nickel has been reported from a number of sources including medical devices and following experimental oral exposure.
  
  
  OBJECTIVE
  To identify other potential sources of systemic nickel exposure.
  
  
  METHODS
  The internet and published medical literature were searched for complementary and alternative remedies which contain nickel.
  
  
  RESULTS
  We identified and evaluated sources of nickel exposure in 4 homeopathic preparations, which are advertised to treat common skin diseases, as well as in a number of other homeopathic remedies, several herbal products and multivitamin mineral complexes.
  
  
  CONCLUSIONS
  Complementary and alternative remedies are an additional source of systemic nickel exposure and at highest doses the potential risk for systemic contact dermatitis in nickel allergic patients should be considered.
authors.affiliation: Section of Industrial Dermatology, Department of Dermatology (A-61), Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Luciana M
authors.initials: LM
authors.lastname: de Medeiros
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Fransway
authors.forename: James S
authors.initials: JS
authors.lastname: Taylor
authors.forename: Marcia
authors.initials: M
authors.lastname: Wyman
authors.forename: Jodith
authors.initials: J
authors.lastname: Janes
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Fowler
authors.forename: Robert L
authors.initials: RL
authors.lastname: Rietschel
mesh_terms: D000284:Administration, Oral; D000529:Complementary Therapies / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D003875:Drug Eruptions / Q000209:etiology*; D004365:Drugs, Chinese Herbal / Q000009:adverse effects; D006705:Homeopathy; D006801:Humans; D008419:Materia Medica / Q000009:adverse effects; D009532:Nickel / Q000008:administration & dosage / Q000009:adverse effects* / Q000032:analysis; D008517:Phytotherapy / Q000009:adverse effects; D028321:Plant Preparations / Q000009:adverse effects; D014815:Vitamins / Q000009:adverse effects
chemical_list: D004365:Drugs, Chinese Herbal; D008419:Materia Medica; D028321:Plant Preparations; D014815:Vitamins; D009532:Nickel