Many chemical agents such as poison ivy, rubber accelerators, epoxy resins, certain solvents, certain perfumes, and some metals and soluble salts of metals (e.g., nickel, chromium, cobalt, gold, mercury) are able to cause ACD. A broad range of skin symptoms ranging from dryness, chapping, and inflammation to eczema and blisters characterizes this condition. Discomfort is caused by skin inflammation and itching.
|Nickel ACD from nickel releasing necklace clasp.
Nickel sensitization is not an inherited condition. It is related to intimate and prolonged skin contact (i.e., exposure) by nickel-containing and releasing materials, nickel metal, or nickel soluble salts. Nickel ACD was first noticed in occupational settings where soluble forms of nickel came into contact with worker’s skin. Individuals working in electroplating shops, in battery manufacturing, and with nickel catalysts were the most susceptible to exposure. Work related nickel dermatitis is now relatively rare due to preventative occupational hygiene measures.
Non-occupational nickel sensitization is well documented. It was first observed in individuals who had skin contact with clothing items releasing nickel, such as nickel-coated buckles, zippers, and clasps. The prevalence increased with the increasing use of nickel-plated jewelry. A common cause of nickel sensitization and nickel ACD is now body piercing, which may involve inserting nickel-releasing studs into the wound to pre-vent closure during healing. Once healed, with the stud removed, additional contact with nickel in the pierced area may occur by wearing jewelry or posts in piercings that release a significant amount of nickel ions.