From the Journals

Nickel allergy common in children, significantly higher in girls


Key clinical point: This U.S. study reinforces other recent investigations citing high occurrence of pediatric nickel-associated allergic contact dermatitis.

Major finding: Almost one-quarter (23.7%) of almost 2,000 children patch tested were found to have nickel sensitivity.

Study details: Retrospective, cross-sectional study of 1,894 pediatric patients.

Disclosures: The research was funded by the Minneapolis Veterans Affairs Medical Center, and in part by the Nickel Producers Environmental Research Association. Three of the researchers have ties to various pharmaceutical companies and other organizations. Dr. Warshaw and the remaining researchers had no relevant financial disclosures.

Source: Warshaw EM et al. J Am Acad Dermatol. 2018 Apr 14. doi: 10.1016/j.jaad.2018.02.071.



Nickel sensitivity appears to be common in children, and more frequent in girls than boys, said Erin M. Warshaw, MD, MS, of the University of Minnesota, Minneapolis, and her associates.

“Although nickel sensitivity is reported to be problematic in children, the pediatric population is often underrepresented in large-scale epidemiologic studies,” they added.

Girl with a piercing under her lip

In this retrospective, cross-sectional study of 1,894 children aged 18 years or younger tested by the North American Contact Dermatitis Group (NACDG) between 1994 and 2014, 23.7% of those patch tested were found to be sensitive to nickel. This included 6.5% who were 5 years or younger, 34.2% who were 6-12 years, and 59.4% who were 13-18 years.

Among all three patient groups, jewelry was the most common source of nickel sensitivity (36.4%), and this sensitivity was found to increase with age (5 years and younger, 20.7%; 6-12 years, 28.3%; and 13-18 years, 42.9%; P = .0006).

More than two-thirds of positive patch test reactions to nickel were found to be extreme or strong, Dr. Warshaw and her colleagues reported in the Journal of the American Academy of Dermatology.

Notably, girls were significantly more likely to exhibit nickel sensitivity than boys, a result the authors credit to “trends and social norms. ”

Citing a separate study conducted recently by NACDG on the correlation between piercing and nickel sensitivity across all ages, researchers found that females were significantly more likely to have piercings than were males, and with age, they speculated, “girls may be more likely to encounter high nickel release through piercing jewelry, bracelets, necklaces, hair clips, etc., resulting in higher proportions of girls than boys with nickel allergy.”

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