Type IV sensitization to
nickel (II)
sulfate is common in the general population.
Nickel can be found in different metals leading to occupational exposition in industrial professions. The individual clinical relevance of
nickel allergy can easily be identified but it can be difficult to assess if
nickel allergy was acquired privately or occupationally. The problem if
nickel allergy fulfills the criteria of an occupational
skin disease is presented in three case reports. The occupational relevance of a type IV sensitization to
nickel in a chemical laboratory assistant, a flight attendant and a cashier are discussed. Important conditions for acquiring
nickel allergy are contact with
nickel-plated and
nickel-releasing materials, the kind of skin contact, the status of the epidermal barrier, and the individual working conditions with an increased bioavailability of
nickel. In cases of type IV sensitization to
nickel, the affected person cannot continue to work in
metal plating or with contact to
nickel-plated metals. The causal relationship between the type IV sensitization to
nickel and the occupation needs to be clarified in each individual case. In general, occupationally caused
nickel allergy is rare and the occupational relevance of
nickel allergy is often overestimated.