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Improper piercing may trigger nickel allergy. (Nickel for Your Thoughts).

LAS VEGAS -- An "astounding" increase in the prevalence of nickel allergy between the mid-1980s and mid-1990s appears to correlate with the explosion in popularity of body piercing, according to Dr. David E. Cohen, who is the president-elect of the American Contact Dermatitis Society.

Nickel allergy was "happily chugging along at a fairly stable rate" until about 1985, when the incidence began rising dramatically, he said.

By 1993, 25% more people had nickel allergy than in 1985.

Today, "it's the number one allergen we test to [using patch tests]," Dr. Cohen commented at a dermatology seminar sponsored by the Skin Disease Education Foundation.

His clinical suspicion is that the rise in nickel allergy can be traced to the modern practice of "piercing anywhere you can stick a pin."

He noted that 13% of 8- to 15-year-old girls with pierced ears are allergic to nickel, but only 1% of girls with unpierced ears in that age group demonstrate nickel sensitivity.

Among nickel-allergic women, 95% have pierced ears.

Dr. Cohen emphasized that any piercing should be performed using surgical-grade stainless steel, and whatever object is inserted in the hole made by piercing also should be made of stainless steel or titanium.

Some patients who are sensitized to nickel also have allergies to other common metals, including cobalt, chrome, gold, and palladium, any of which may be found in so-called hypoallergenic jewelry, he said.

Because nickel is so ubiquitous in modern life (see chart), Dr. Cohen often sends his patients home with dimethyl glyoxime so they can hunt down the bioavailable nickel in their own homes and clothing.

Sometimes, the sources can be surprising, noted Dr. Cohen, who is director of occupational and environmental dermatology at New York University, New York.

Although it is largely expected that U.S. nickel coins contain nickel, many people may be unaware that controversial Euro coins have been found to contain 240- to 320-fold more nickel than is allowed by the European Union.

Pediatricians who are frustrated by unresponsive fungal infections in the folds under female teenagers' breasts should consider nickel-containing wires in underwire brassieres as sources of a possible allergic reaction, Dr. Cohen said at the conference.

RELATED ARTICLE: Common Sources Of Nickel

* Belt buckles

* Body-piercing jewelry

* Coins

* Costume jewelry

* Dental instruments

* Door handles

* Drawer pulls

* Eyeglass frames

* Eyelash curlers

* Hair dyes and bleaches

* Handbag handles

* Keys

* Metal arch supports

* Metal lipstick holders

* Scissors

* Umbrellas

* Watchbands/watch backs

* Wires in brassieres

* Zippers

Source: Dr. David E. Cohen

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Author:Bates, Betsy
Publication:Pediatric News
Geographic Code:1USA
Date:Mar 1, 2003
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