title: Oral mucosa patch test: a new tool to recognize and study the adverse effects of dietary nickel exposure.
abstract: On contact with the skin, nickel may cause allergic contact dermatitis, which can be diagnosed by an epicutaneous patch test. Nickel exposure via the intestinal mucosa can induce diarrhea, abdominal pain, and swelling. The aim of the present study was to investigate the relationship between these symptoms and nickel intake by means of a novel oral mucosa patch test. Eighty-six patients with intestinal symptoms related to ingestion of nickel-containing foods were submitted to epicutaneous and oral mucosa patch tests for nickel. All patients with positive oral mucosa patch test results were subject to a low-nickel diet and monitored over time. Skin lesions were observed in 33 out of 86 (38.4%) patients evaluated by the epicutaneous patch test. Mucosal lesions were seen in 53 out of 86 (61.6%) patients given the oral mucosa patch test. After 2 months of a low-nickel diet, 52 out of 53 (98.1%) patients showed an improvement of their symptoms. There is a significant correlation between response time of the oral mucosa patch test and the latency of symptoms after ingestion of nickel-containing foods. Consequently, the oral mucosa patch test can be used to recognize and study the adverse effects of dietary nickel exposure that could be defined as allergic contact mucositis. A low-nickel diet is also shown to be an effective treatment for this condition.
authors.affiliation: Center for Research and Study of Celiac Disease--Department of Clinical Sciences, Policlinico Umberto I--Sapienza University, Viale del Policlinico, 155, 00161 Rome, Italy. antonio.picarelli@uniroma1.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Picarelli
authors.forename: Marco
authors.initials: M
authors.lastname: Di Tola
authors.forename: Anna
authors.initials: A
authors.lastname: Vallecoccia
authors.forename: Valerio
authors.initials: V
authors.lastname: Libanori
authors.forename: Mirella
authors.initials: M
authors.lastname: Magrelli
authors.forename: Marta
authors.initials: M
authors.lastname: Carlesimo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Rossi
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects*; D009532:Nickel / Q000008:administration & dosage / Q000009:adverse effects*; D010328:Patch Tests / Q000379:methods*; D055815:Young Adult
chemical_list: D009532:Nickel