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Reactivity to patch tests with nickel sulfate and fragrance mix in infants


Klaus E. Andersen
Department of Dermato-venereology
Odense University Hospital
DK-5000 Odense
Tel: +45 6611 3333
Fax: +45 6612 3819


The pattern of patch test reactivity to nickel sulfate and fragrance mix was studied with respect to patch test performance, reproducibility and clinical relevance in a population of unselected infants followed prospectively from birth to 18 months of age. TRUE Test™ patches with nickel sulfate in 3 concentrations, 200, 66 and 22 µg/cm2, and fragrance mix 430 µg/cm2 were used. A likely case of nickel sensitivity was defined as a reproducible positive reaction with at least homogeneous erythema and palpable infiltration occurring at least 2× and present at both the 12 and 18 months follow-up. 543 infants (268 girls and 275 boys) were tested at least 1×, 304 were tested at both 12 and 18 months. The prevalence of a reproducible positive reaction to nickel was 8.6% (20 girls and 6 boys). A transient positive reaction was observed in 111 children. Clinical relevance of nickel sensitivity was found in only 1 child. No reproducible positive reaction to fragrance mix was found. The high proportion of transient patch test reactivity to nickel sulfate 200 µg/cm2 indicates that this standard concentration used for adults cannot be applied to infants. The interpretation of a single positive nickel patch test in infants must be assessed with caution and it is probably of non-specific or irritant nature.