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Nickel Contact Allergy in an Australian Patch Testing Centre Over 2014-2023
Thomas R Brasher1, Amanda Palmer1, Rosemary Nixon1
1Occupational Dermatology Research and Education Centre, Skin Health Institute, Melbourne, Victoria, Australia.
Background:
Nickel is the most common cause of allergic contact dermatitis (ACD). In certain geographical locations, the prevalence of nickel dermatitis (NiACD) has changed over time; however, there is little data on the prevalence of NiACD in Australia.
Objectives:
To investigate the prevalence and trends of both nickel contact allergy and NiACD in Australia.
Methods:
A retrospective audit was performed of 3582 patients patch tested to 5% nickel sulphate between 2014 and 2023. Relevance was assessed by consultant dermatologists. Patch test data was analysed using Pearson's χ2 test and Cochran-Armitage χ2 test for trend.
Results:
573/3582 (16.0%) of patients had nickel contact allergy based on positive patch tests, while 169 (4.7%) of patients were diagnosed with NiACD, where exposure to nickel correlated with their presenting dermatitis. There was a significant trend of decreasing NiACD from 2014 to 2023 (χ2 Trend (1, N = 3582) = 14.1239, PTrend = 0.0002, slope = -0.0045); however, there was no decline in the prevalence of nickel contact allergy (Pearson's χ2 test (9, N = 3582) = 13.426, p = 0.1443). Occupational NiACD was diagnosed in 20/169 (11.8%). There was a high degree of comorbid atopic dermatitis (37.3%), asthma (24.9%), and allergic rhinitis (52.1%).
Conclusions:
We report a declining prevalence of NiACD but a stable prevalence of nickel contact allergy in our patient population between 2014 and 2023.
