Nickel Allergic Hypersensitivity: Prevalence and Incidence by Country, Gender, Age, and Occupation

Consistently, nickel ranks as the most common cause of allergic contact dermatitis (ACD) in the countries where statistics on occurrence of sensitization are recorded, and population as well as patient studies indicate that the prevalence of nickel hypersensitivity may be on a slow but steady increase. For that reason the literature has been scoured for epidemiological studies run over the past century, in order to create an overview of trends and differences in particular populations, ages, occupations, and genders. The female population is particularly affected due to its frequent use of jewelry and accessories. Although not always of overt clinical relevance, the incidence of nickel allergic hypersensitivity (NAH) in patch-tested women rose from 12% in 1967 to 21% in 1976, and in men from 1 to 4% over the same time interval. At present it is seen to reach 22% of the female and 4.7% of the male dermatology patients in the U.S. and Europe. In both female and male cohorts nickel often ranks as the number one contact allergen. Such prevalence of NAH in both women and men is attributed mainly to the use of costume jewelry, often involving perforation of the skin on various parts of the body, and to the prolonged and intimate contact with buttons, rivets, and other types of metallic fasteners on clothes.