Case report: pediatric nickel dermatitis caused by belt buckles

(HealthDay)—Nickel dermatitis has been observed in a number of children whose symptoms resolved after avoiding contact with dimethylglyoxime (DMG)-positive belt buckles. These observations have been published as a case report online Aug. 3 in Pediatrics.

Alina Goldenberg, M.D., from the University of California-San Diego, and colleagues describe allergic contact dermatitis in 12 children with peri-umbilical nickel dermatitis attributed to DMG-positive belt buckles.

The researchers found that the patients ranged from 9 to 15 years old, and included five males and seven females. Nine of the patients had a history of atopic dermatitis. Eleven of the patients were positive for nickel allergy on confirmatory patch testing. None of the jeans snaps from 11 patients tested positive for nickel with the DMG test, but DMG testing of patients' belt buckles identified the source. Patients were instructed to avoid contact with the belt buckles by switching to brass buckles. Dramatic resolution of dermatitis was reported within one to five weeks by 10 patients who adhered to instructions and replaced their belt buckles.

"In recent years, detection and reporting of nickel allergy in children has been on the rise," the authors write. "It is important to continue considering metallic-appearing accessories as potential nickel exposure sources and, whenever possible, recommending avoidance of prolonged skin contact to metal with nickel-releasing content."

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