(23) Nickel dermatitis—a follow-up study

Nickel dermatitis has become the most frequent allergic contact dermatitis in the region of Erfurt (Germany).
Between 1982 and 1986 the incidence in our patch test clinic increased from 13·7% (18·3% female, 5·7% male) to 21·5% (27·4% female, 80% male). Eighty per cent of the female patients were under 30 years of age and 42% under 20 years of age. Primary nickel sensitization was due to fancy jewellery and wrist watches in 62% and dressing buckles in 14%. Nickel sensitivity was occupationally acquired in 25%; half of the workers were galvanizers.
Three years after initial patch testing all cases of 2 + and 3 + reactions to nickel sulphate in 5% petrolatum remained positive. Twenty out of 32 patients were free of skin lesions. Eight still had mild eczema of the hands. Twenty-three have changed their job because of the nickel allergy and are now working as secretary, referee, textile shop assistant, telephone operator, woodworker and textile manufacturer.
A positive patch test to nickel can become negative but this is rare. Normally rehabilitation is possible by avoidance of numerous and intensive contacts and is easier than in chromate dermatitis. Polysensitization renders or prevents healing and occupational rehabilitation.