Pre‐treatment of nickel test areas with sodium lauryl sulfate detects nickel sensitivity in subjects reacting negatively to routinely performed patch tests

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Abstract
A fair % of patients with a clinical history of nickel allergy show negative patch test results. To improve the response rate to NiSO4 5% pet, patch tests, a testing procedure utilizing pre‐treatment of I he lest area by a 24‐h application of sodium lauryl sulfate (SLS) was introduced 46 women with a clinical history of nickel sensitivity who exhibited negative reactions to nickel sulfate 5% pet, patch tests. were studied, Patients underwent d patch tests on adjacent sites on the volar surface of the forcarms. 4 patch tests were performed with a 72‐h application of 40 mg nickel sulfate 5% pet. While I of these patch tests served as control. 3 test areas underwent 24‐h pretreatment with 40 μl SLS. 1 with 0.1% and 2 with 0.5% solution. To evaluate differences in the reactivity to SLS plus nickel sulfate related to the site on the forearm, 0.5% SLS pre‐treatment was performed both on a proximal and on a distal lest site. At the 72‐h evaluation. 19 subjects out of 46 showed positive reaction to nickel sulfate 5%. At skin sites pre‐t railed with SLS. Whereas 23 patients reacted positively at 0.5% SLS pre‐treated ureas. Echographic values of skin thickness and of hypo‐echogeme dermal areas al positive pre‐treated nickel lest. Next higher than al control Jest areas, confirming the clinical evidence of an increased response to NiSO4 after SLS pre‐treatment. The inflammatory reaction, is evaluated clinically and echographically, was much higher al distal skin areas (0.l% SLS and distal (0.5%.) SLS than at proximal 0.5% SLS ones.