Nickel dermatitis. An update.

Several reports indicate that the prevalence of nickel sensitivity among females in the general population is around 10 per cent and probably is increasing, especially in schoolchildren. It has been claimed that there is such a high correlation between a positive history of nickel hypersensitivity and patch-test results that testing is unnecessary if there is a history of hypersensitivity. This is not true. Nickel hypersensitivity itself is not a serious health problem for the individual. However, when hand eczema also is present, the situation is quite different. Concerns about medical metal implants in nickel-sensitive persons appear to have been exaggerated, and nickel intake in food probably is not a serious difficulty, although some persons may be unusually sensitive. In dealing with the clinical problems of nickel dermatitis, we must not overlook prophylaxis. It seems important to introduce safe methods of ear piercing (a primary source of nickel hypersensitivity) and to spread information about the health hazard potential of the seemingly harmless sensitivity to nickel.