A questionnaire was sent to 143 patients who had shown a positive patc
h test reaction to nickel sulfate more than 10 years earlier. 91 patie
nts returned the questionnaire, revealing that after the testing, 73 h
ad suffered from dermatitis, 61 especially from hand dermatitis. 37 of
these patients were clinically examined and patch tested with standar
d series and in addition, 12 patients were tested with nickel sulfate
and nickel chloride with different occlusion times. At the clinic visi
t, 23 patients had dermatitis, 16 hand dermatitis, and 11 were symptom
-free. 26 of the patients had metal items close to their skin and 21 o
f them had current dermatitis, 14 hand dermatitis. Of the 11 patients
who had no metal exposure, 9 were symptom-free. The association of der
matitis with exposure to metal objects was statistically significant (
p<0.001). Those patients who had current dermatitis had also developed
multiple allergies and reacted to nickel with shorter application tim
es in patch tests, as compared to those who were symptom-free. It seem
ed possible that the prognosis for nickel dermatitis could be improved
if nickel-allergic patients would strictly avoid metal contact, espec
ially in clothing and jewelry.