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Nickel sensitization and dietary nickel are a substantial cause of symptoms provocation in patients with chronic allergic-like dermatitis syndromes

机译:镍致敏和饮食中的镍是引起慢性过敏性皮炎综合症患者症状激化的重要原因

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摘要

Data in literature seem to show that, in patients with contact allergic dermatitis, dietary nickel might be a cause of systemic dermatitis, but little information exists in literature about the role of nickel sensitization and dietary nickel in patients with allergic-like chronic dermatitis syndromes. The prevalence of nickel sensitization in patients with chronic allergic-like, non-IgE-mediated skin diseases, and the possible impact of dietary nickel on symptom provocation and persistence has been assessed in the present retrospective study on a case series of 1726 patients referred to our allergy unit for chronic allergic-like skin diseases. IgE-mediated pathogenesis and other differential diagnoses excluded, patients were patch tested. Nickel-positive patients underwent an elimination diet and double-blind placebo-controlled nickel challenge (DBPCNC) test. A total of 339 (20%) tested nickel-positive. Fifty-two patients (15%) recovered by avoiding sources of nickel contact and 29 (10%) dropped out. Out of the remaining nickel-sensitized patients, 277 (80%) achieved complete or near complete recovery with low-nickel content diet, and 185 of them (89%) were positive to DBPCNC. We conclude that nickel sensitization and dietary nickel seem to be the chief trigger for provocation and persistence of symptoms in an important part (∼11%) of patients with chronic allergic-like dermatitis syndromes.
机译:文献中的数据似乎表明,在接触性变应性皮炎患者中,饮食中的镍可能是全身性皮炎的病因,但文献中关于变态反应性慢性皮炎综合征患者中镍敏化和饮食中镍的作用的文献很少。在本回顾性研究中,对涉及1726例患者的一系列病例进行了回顾性研究,评估了其对慢性过敏样,非IgE介导的皮肤病患者的镍致敏程度以及饮食中镍对症状激发和持久性的可能影响。我们用于慢性过敏性皮肤病的过敏科。排除IgE介导的发病机制和其他鉴别诊断,对患者进行斑贴测试。镍阳性的患者应消除饮食并进行双盲安慰剂对照镍激发试验(DBPCNC)。总共339(20%)测试的镍呈阳性。 52名患者(15%)通过避免镍接触而recovered愈,29名(10%)退学。在剩下的对镍敏感的患者中,有277名(80%)通过低镍含量饮食实现了完全或接近完全的恢复,其中185名(89%)对DBPCNC呈阳性。我们得出结论,在慢性过敏性皮炎综合症患者的重要部分(约11%)中,镍致敏和饮食中的镍似乎是引起挑衅和症状持续的主要诱因。

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