Figure 3 - uploaded by Daniel Bergman
Content may be subject to copyright.
Points Based High Nickel Diet Food Pyramid: Schematic of higher nickel foods with points in superscript. Suggested foods to avoid in nickel sensitized persons, especially with recalcitrant nickel ACD patients. * Note: Nickel can accumulate in tap water, and pipes should be flushed for 5 minutes before drinking.
Source publication
Nickel allergic contact dermatitis (ACD) has become a more widely recognized disease process over the last three decades in the United States. A subpopulation of ACD patients will manifest with systemic contact dermatitis (SCD). Specifically, those cases of widespread recalcitrant nickel ACD with only partial clinical relief after strict nickel avo...
Context in source publication
Context 1
... a dose-response relationship was revealed showing 10% of nickel sensitized patients responding to exposures between 0.55 mg and 0.89 mg. Such low exposures can be easily attained by consuming foods high in nickel content (see Table 1, Figure 2 and Figure 3) [12]. However, many patients sensitized to nickel are unaware that dietary exposure may play a role in their morbidity. ...
Similar publications
Citations
... Nickel is the main known contaminant resulting from the manufacturing process of chocolate, when its hardening is done by hydrogenation of unsaturated fats using nickel as catalyst (Selavpathy and Sarala Devi 1995). Exposure of the general population to dietary intake of nickel does not lead to any health risk (Duran et al. 2009), but a recent study reported that a population of children had exacerbated acute generalized dermatitis after ingestion of chocolates (Bergman et al. 2016). Until 2015, there was no acceptable limit for Ni in food, but the new tolerable daily intake of 2.8 mg/kg adopted by the CONTAM panel (EFSA 2014) has helped in assessing the risk of Ni exposure to the general population. ...
The affordability of candies and chocolates makes their consumption common especially in children. Heavy metal contamination of these candies is well known. This study has estimated health risks associated with heavy metals (HM; Pb, Cd, Cr, Ni, and Zn) in commonly consumed candies in Nigeria. Fifty candies/sweets and chocolates/chewing gums bought from different stores in Port Harcourt and Uyo in Niger Delta, Nigeria, were processed and digested in perchloric acid. The filtrate was analyzed for these heavy metals using atomic absorption spectroscopy (AAS). Pb/Zn and Cd/Zn ratios were calculated. Daily intake, the target hazard quotient (THQ), the hazard index (HI), and the cancer risk were estimated for children. About 80% of the samples exceeded the 0.1 mg/kg permissible lead level in candies. Milk sweet had the highest Pb:Zn and Cd:Zn ratios of 0.99 and 0.40 respectively. For chocolates, the Emperor had the highest Pb:Zn (0.50) ratios and Trident had the highest Cd:Zn (0.57) ratios. The calculated percentage provisional tolerable weekly intake (%PTWI) of cadmium from consumption of chocolates and candies was higher than the Joint Expert Committee for Food Additives (JECFA) standard, and the cancer risk of lead, cadmium, and chromium ranged between 10⁻⁷ and 10⁻³. Consumption of some candies by children in Nigeria may pose significant health risks.
In the last decade, allergic contact dermatitis (ACD) has become an increasingly recognized diagnosis in children presenting with eczematous skin. Although the immunological pathway of a delayed hypersensitivity reaction is specifically distinct, it can be phenotypically difficult to distinguish from the clinical presentations of chronic irritant contact dermatitis (ICD) and atopic dermatitis (AD), even more so when they are concurrent. Furthermore, the barrier disruption inherent to AD appears to increase the risk for developing ACD. The gold standard diagnostic tool for ACD is the epicutaneous patch test. Confirmation of clinically relevant contact allergens is critical in order to direct avoidance and appropriately manage the disease. This chapter discusses the epidemiology, pathophysiology and clinical features of ACD in the context of the available evidence in the literature.
Systemic contact dermatitis (SCD) describes a hypersensitivity reaction following systemic re-exposure of the inciting allergen in previously sensitized individuals. Plants, drugs, and metals are the most common causes of SCD. In individuals with obstinate dermatitis, it is imperative to deliver and history-focused patch testing with subsequent avoidance and elimination of the compound.
