Occupational hand eczema caused by nickel and evaluated by quantitative exposure assessment.

BACKGROUND: EU legislation has reduced the epidemic of nickel contact allergy affecting the consumer, and shifted the focus towards occupational exposure. The acid wipe sampling technique was developed to quantitatively determine skin exposure to metals.
OBJECTIVES: To assess the clinical usefulness of the acid wipe sampling technique as part of the diagnostic investigation for occupational nickel allergy-associated hand dermatitis. PATIENTS AND METHODS: Six patients with vesicular dermatitis on the hands were included. Acid wipe sampling of skin and patch testing with a nickel sulfate dilution series were performed.
RESULTS: Nickel was detected in all samples from the hands. In all patients, the nickel content on the hands was higher than on the non-exposed control area.
CONCLUSIONS: Occupational exposure to nickel-releasing items raised the nickel content on exposed skin as compared with a non-exposed control site. Nickel-reducing measures led to complete symptom relief in all cases. In cases of a positive nickel patch test reaction and hand eczema, patients should perform the dimethylglyoxime (DMG) test on metallic items at home and at work. The acid wipe sampling technique is useful for the diagnosis of occupational hand eczema following screening with the inexpensive DMG test.