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Nickel Hypersensitivity: A General Review on Clinical Aspects and PotentialCo-Morbidities

Calogiuri GF, Bonamonte D Foti C and Al-Sowaidi

Allergic contact hypersensitivity to metals is a delayed-type allergy. Although various metals are able to induce anallergic reaction, nickel is the most frequent cause of metal allergy worldwide. The high prevalence of skinsensitization to that metal is the result of an ubiquitous exposure, being contained in different everyday things, suchas detergents, cheap jewelry, cosmetics, coins, buttons, zippers, eyeglasses, buckles, clasps, inks, dental prosthesisand foods even. However, nickel is able to induce a wide range of morphological and clinical patterns, ranging fromsimple allergic contact dermatitis to systemic contact dermatitis and systemic nickel allergy syndrome. The latterseems to be promoted by nickel rich-foods or through endogenous route caused by metal implants which seem toelicit mainly in loco symptoms, sometimes with catastrophic consequences as aseptic bone necrosis following theimplantation of hip prosthesis