e-ISSN 2460-7991

Allergic contact dermatitis due to nickel in household detergent

Font Size:  Small  Medium  Large

Allergic contact dermatitis due to nickel in household detergent

Dewi Utami Putri, Irma Damayanti Roesyanto-Mahadi

Abstract


Allergic contact dermatitis (ACD) is a cutaneous inflammatory reaction caused by contact with specific exogenous allergen to which a person has developed allergic sensitization. Nickel was reported as one of the most common causes of ACD worldwide, particularly affecting females. It is associated with a variety of nickel-containing products, from jewelry to detergent.

A 32-year-old female was presented with pruritic eruption consist of erythematous papules and vesicles on both hands and extensor forearms since 2 weeks before admission. The patient is a housewife who did handwashing clothes and kitchenware with detergent and soap every day. At first, there were erythematous papules on the right extensor forearm, then the patient wore rubber gloves to protect hands when washing. However, the lesions spread to the left extensor forearm and there were also vesicles on both hands. There was history of localized reactions to metal items, the latter one was 3 weeks ago after wearing a metal necklace. The clinical presentation were multiple erythematous papules and vesicles, erythematous and hyperpigmented macules. The patch test using Chemotechnique Diagnostics AB and square chamber showed a 2+ reaction to nickel sulphate. The patient was educated to avoid the causative allergen and treated with oral antihistamine and topical corticosteroid. The patient showed significant clinical improvement after 2 weeks.

 Nickel as metal catalyst used in detergents is found in small concentration, but can lead to ACD in an already sensitized individual. The lesions persist despite the use of gloves because nickel is absorbed through rubber material.

 

Keywords: allergic contact dermatitis, nickel, metal catalyst, household detergent, patch test

 


Full Text: PDF

References


1. Castanedo-Tardan MP, Zug KA. Allergic contact dermatitis. In: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick's dermatology in general medicine. 8th Ed. New York: McGraw-Hill; 2012. p. 152-65
2. Peiser M, Tralau T, Heidler J, Api AM, Arts JHE, Basketter DA, et al. Allergic contact dermatitis: epidemiology, molecular mechanisms, in vitro methods and regulatory aspects. Cell Mol Life Sci. 2012; 69:763-81
3. Hostynek JJ. Aspects of nickel allergy: epidemiology, etiology, immune reactions, prevention, and therapy. In: Hostynek JJ, Maibach HI, editors. Nickel and the skin: absorption, immunology, epidemiology, and metallurgy. Florida: CRC Press; 2002. p. 1-37
4. Hostynek JJ. Sensitization to nickel: etiology, epidemiology, immune reactions, prevention, and therapy. Rev Environ Health. 2006;21(4):253-80
5. Ale IS, Maibach HA. Diagnostic approach in allergic and irritant contact dermatitis. Expert Rev Clin Immunol. 2010;6(2):291-310
6. Jacob SE, Castanedo-Tardan MP. Pharmacotherapy for allergic contact dermatitis. Expert Opin Pharmacother. 2007;8(16):2757-74
7. Lachapelle JM, Maibach HI. Patch testing methodology. In: Lachapelle JM, Maibach HI, editors. Patch testing and prick testing. Berlin: Springer; 2009. p. 45-82
8. Rustemeyer T, van Hoogstraten IM, von Blomberg BM, Gibbs S, Scheper RJ. Mechanisms of irritant and allergic contact dermatitis. In: Johansen JD, Frosch PJ, Lepoittevin JP, editors. Contact dermatitis. Berlin: Springer; 2011. p. 52-99
9. Hand dermatitis due to contactants: special considerations. In: Rietschel RL, Fowler JF, Fisher AA, editors. Fisher's contact dermatitis. 6th ed. Ontario: BC Decker Inc, 2008; p. 319-37
10. European Nickel Institute. Final report the importance of nickel compounds: detergents. Belgium: The Winner Group LLC; 2007. Available from: https://www.nickelinstitute.org
11. Wall LM. Nickel penetration through rubber gloves. Contact Dermatitis. 1980; 6(7):461-3