Uter W, Fuchs T, Häusser M, Ippen H
University Skin Hospital, Göttingen, Germany.
Contact Dermatitis. 1995 Mar;32(3):135-42. doi: 10.1111/j.1600-0536.1995.tb00802.x.
Clinical experience suggests the existence of different degrees of sensitivity in nickel-allergic patients. For quantification of this phenomenon, 462 consecutive patients with previously diagnosed or strongly suspected nickel allergy were tested with serial dilution patch tests with 5 ppm to 5% nickel sulfate in pet. (Ni), and 5 ppm to 1% nickel sulfate in pet. with 1% detergent (Ni/D). Additionally, nickel and palladium metal plates were tested in 103, and cobalt salts, dichromate and palladium chloride (PdCl2) in most patients. 332 patients reacted positively to Ni or Ni/D. The influence of a concomitantly administered detergent was not significant. A significant correlation was found between positive reactions to low concentrations of Ni (or Ni/D), i.e., 0.1% or less (N = 166), and concomitant reactions to nickel metal plates, cobalt salts and PdCl2 and a history of ear piercing with metal intolerance. The clinical relevance of reactions to PdCl2 is at present not clear. A subgroup of nickel-allergic patients with "high sensitivity" can be defined. In future studies further addressing the clinical relevance of high versus low sensitivity, patch testing with 0.01, 0.1, 1.0 and 5% nickel sulfate in pet. is recommended instead of routine tests with 5% only.
临床经验表明，镍过敏患者存在不同程度的敏感性。为了量化这一现象，对462例先前诊断为镍过敏或高度怀疑镍过敏的连续患者进行了系列稀释斑贴试验，使用含5 ppm至5%硫酸镍的凡士林（Ni），以及含5 ppm至1%硫酸镍和1%去污剂的凡士林（Ni/D）。此外，对103例患者测试了镍和钯金属板，对大多数患者测试了钴盐、重铬酸盐和氯化钯（PdCl₂）。332例患者对Ni或Ni/D呈阳性反应。同时使用去污剂的影响不显著。在对低浓度Ni（或Ni/D）（即0.1%或更低浓度，N = 166）呈阳性反应与对镍金属板、钴盐和PdCl₂的伴随反应以及有金属不耐受的穿耳史之间发现了显著相关性。目前，对PdCl₂反应的临床相关性尚不清楚。可以定义一组“高敏感性”的镍过敏患者亚组。在未来进一步探讨高敏感性与低敏感性临床相关性的研究中，建议使用含0.01%、0.1%、1.0%和5%硫酸镍的凡士林进行斑贴试验，而不是仅进行5%的常规试验。
