Allergic Contact Dermatitis — SCE Dermatology MCQ

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EasyInflammatory DermatosesAllergic Contact DermatitisSCE Dermatology

A 29-year-old woman presents with an itchy rash on her earlobes and periumbilical area. She has recently had ear piercings and wears a belt with a metal buckle. Patch testing shows a positive reaction to nickel sulfate. Which of the following items is she most likely to need to avoid?

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Correct answer: E — Costume jewellery and jean studs

Nickel is the most common cause of allergic contact dermatitis worldwide, particularly in women. Costume (non-precious) jewellery, jean studs, belt buckles, bra clasps, and nickel-plated items are common sources. The EU Nickel Directive restricts nickel release in items with prolonged skin contact. Stainless steel (especially surgical grade) and titanium typically release negligible nickel. Gold alloys may contain nickel but pure gold does not. The dimethylglyoxime (DMG) spot test can detect nickel release from metallic objects. Sensitised individuals should use nickel-free alternatives.

Reference: BAD 2017 Contact Dermatitis Guidelines; NICE CKS