Low-cobalt diet for dyshidrotic eczema patients.
BACKGROUND
Dyshidrotic eczema is a type of chronic intermittent dermatitis characterized by vesicles, dystrophic fingernail changes, and rarely bullae that affects the hands and feet. Many exogenous factors may trigger a flare including dermatophyte infections, contact irritants, and metal hypersensitivity. Although metal hypersensitivity does not play a role in all cases of dyshidrotic eczema, high oral ingestion of nickel and/or cobalt should be considered, regardless of patch test results.


OBJECTIVE
We updated and simplified existing published guidelines for low-cobalt diets. A recent review of the literature showed that dietary cobalt restriction, a safe yet burdensome treatment option for dyshidrosis, is referenced to dated sources.


METHODS
We have analysed current data for the cobalt content in common food items.


CONCLUSIONS
We propose a revised, point-based diet that will eliminate much of the dietary cobalt (and nickel) and reduce dyshidrotic eczema flares.
Stuckert
Joseph
J
Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Nedorost
Susan
S
D003035:Cobalt / Q000633:toxicity*; D004032:Diet; D011146:Eczema, Dyshidrotic / Q000178:diet therapy* / Q000209:etiology*; D005512:Food Hypersensitivity / Q000178:diet therapy* / Q000209:etiology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009532:Nickel / Q000633:toxicity; D009747:Nutritional Physiological Phenomena; D017410:Practice Guidelines as Topic; D014481:United States
D003035:Cobalt; D009532:Nickel