title: Nickel Allergy and Our Children's Health: A Review of Indexed Cases and a View of Future Prevention.
abstract: Nickel is the leading cause of allergic contact dermatitis (ACD) from early childhood through adolescence. Studies have shown that skin piercings and other nickel-laden exposures can trigger the onset of nickel ACD in those who are susceptible. Nickel ACD causes a vast amount of cutaneous disease in children. Cases of nickel ACD in children have been reported in peer-reviewed literature from 28 states. Common items that contain inciting nickel include jewelry, coins, zippers, belts, tools, toys, chair studs, cases for cell phones and tablets, and dental appliances. The diagnosis of nickel ACD has been routinely confirmed by patch testing in children older than 6 months suspected of ACD from nickel. Unlike in Europe, there are no mandatory restrictions legislated for nickel exposure in the United States. Denmark has demonstrated that regulation of the nickel content in metals can lower the risk of ACD and the associated health care-related costs that arise from excess nickel exposure. To further awareness, this article reviews the prominent role of nickel in pediatric skin disease in the United States. It discusses the need for a campaign by caretakers to reduce nickel-related morbidity. Lastly, it promotes the model of European legislation as a successful intervention in the prevention of nickel ACD.
authors.affiliation: Loma Linda University, Loma Linda, California.
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Jacob
authors.affiliation: University of California at San Diego, San Diego, California.
authors.forename: Alina
authors.identifier: http://orcid.org/0000-0001-8397-6727
authors.initials: A
authors.lastname: Goldenberg
authors.affiliation: Eastern Maine Medical Center, Bangor, Maine.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Pelletier
authors.affiliation: Department of Clinical Medicine, State University of New York at Stony Brook, Stony Brook, New York.|Allergy and Immunology Training Program, Winthrop University Hospital, Mineola, New York.
authors.forename: Luz S
authors.initials: LS
authors.lastname: Fonacier
authors.affiliation: University of Texas Health Science Center, San Antonio, Texas.
authors.forename: Richard
authors.initials: R
authors.lastname: Usatine
authors.affiliation: Icahn School of Medicine at Mt. Sinai, Mt. Sinai St. Luke's-Roosevelt Hospital Center, New York, New York.
authors.forename: Nanette
authors.initials: N
authors.lastname: Silverberg
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D000067576:Child Health; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D009532:Nickel / Q000009:adverse effects* / Q000276:immunology; D010328:Patch Tests / Q000379:methods; D011322:Primary Prevention / Q000458:organization & administration*; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D014481:United States
chemical_list: D009532:Nickel