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Low-Nickel Diet Scoring System for Systemic Nickel Allergy

Mislankar, Mona BS*; Zirwas, Matthew J. MD

doi: 10.1097/DER.0b013e3182937e81

Background: Consumption of nickel in the diet leads to spongiotic dermatitis in a dose-related fashion in individuals who are allergic to nickel. Dietary modification to reduce nickel intake leads to resolution of this dermatitis.

Objective: This study aims to create an evidence-based, user-friendly diet to assist patients in reducing dietary nickel intake.

Methods: Food and Drug Administration data on the nickel content of foods were combined with serving size information to calculate the upper limit of nickel per serving for a variety of foods. Based on these calculations, a point system was created that allows patients to reduce their nickel intake below the typical threshold for elicitation of the spongiotic dermatitis.

Conclusions: A simplified point-based diet can help patients with dermatitis due to dietary nickel consumption.

Author Information

From the *College of Medicine, University of Cincinnati; and †Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus.

Address reprint requests to Matthew J. Zirwas, MD, Division of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Pl, Suite 240, Gahanna, OH 43230. E-mail:

The authors have no funding or conflicts of interest to declare.

© 2013 American Contact Dermatitis Society

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