Nickel cobalt and chromium sensitivity in patients with pompholyx (dyshidrotic eczema)

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Abstract
Patients [16] with negative routine patch tests were challenged orally in a controlled trial with 2.5 mg Ni, 1 mg Co and 2.5 mg Cr given as salts of the respective metals. All of the patients had symmetrical, vesicular hand dermatitis and in some cases also foot involvement. The dermatitis of 2 patients flared after challenge with Co; in 2 patients flare occurred following Cr ingestion. Prior to the oral challenge all the patients were patch tested with NiSO4, CoCl2 and Cr2K2O7 after adhesive tape stripping. Solutions of the same metal salts were used for intradermal testing. The intradermal test sites were read after 20 min and 48 h, the patch tests after 48 h. Skin test reactivity correlated poorly to the results of the oral challenge, possibly due to nonspecific skin test reactivity. Oral challenge is a valuable adjunctive diagnostic procedure in patients with pompholyx [dyshidrotic eczema] who have negative routine patch tests. [Allergic contact dermatitis caused by Ni, Co or Cr is frequently the cause of permanent occupational disability].

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