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Contact dermatitis due to nickel allergy in patients suffering from non-celiac wheat sensitivity

  • Autori: D'Alcamo, A.; Mansueto, P.; Soresi, M.; Iacobucci, R.; La Blasca, F.; Geraci, G.; Cavataio, F.; Fayer, F.; Arini, A.; DI STEFANO, L.; Iacono, G.; Bosco, L.; Carroccio, A.
  • Anno di pubblicazione: 2017
  • Tipologia: Articolo in rivista (Articolo in rivista)
  • Parole Chiave: Cutaneous symptoms; Irritable bowel syndrome; Nickel allergy; Non-celiac wheat sensitivity; Food Science
  • OA Link: http://hdl.handle.net/10447/221799

Abstract

Background: Non-celiac wheat sensitivity (NCWS) is a new clinical entity in the world of gluten-related diseases. Nickel, the most frequent cause of contact allergy, can be found in wheat and results in systemic nickel allergy syndrome and mimics irritable bowel syndrome (IBS). Objective: To evaluate the frequency of contact dermatitis due to nickel allergy in NCWS patients diagnosed by a double-blind placebo-controlled (DBPC) challenge, and to identify the characteristics of NCWS patients with nickel allergy. Methods: We performed a prospective study of 60 patients (54 females, 6 males; mean age 34.1 ± 8.1 years) diagnosed with NCWS from December 2014 to November 2016; 80 age- and sex-matched subjects with functional gastrointestinal symptoms served as controls. Patients reporting contact dermatitis related to nickel-containing objects underwent nickel patch test (Clinicaltrials.gov registration number: NCT02750735). Results: Six out of sixty patients (10%) with NCWS suffered from contact dermatitis and nickel allergy and this frequency was statistically higher (p = 0.04) than observed in the control group (5%). The main clinical characteristic of NCWS patients with nickel allergy was a higher frequency of cutaneous symptoms after wheat ingestion compared to NCWS patients who did not suffer from nickel allergy (p < 0.0001). Conclusions: Contact dermatitis and nickel allergy are more frequent in NCWS patients than in subjects with functional gastrointestinal disorders; furthermore, these patients had a very high frequency of cutaneous manifestations after wheat ingestion. Nickel allergy should be evaluated in NCWS patients who have cutaneous manifestations after wheat ingestion.