Short Repeated Nickel Exposures

February 10, 2020 updated by: Malin Glindvad Ahlström, Herlev and Gentofte Hospital

Evaluation of the Clinical Implication of Short Repeated Nickel Exposures

The former Nickel Directive was introduced in EU in 1994 limiting the release of nickel from items intended for prolonged contact with skin. The nickel regulation entered into full force in 2001 and became a part of REACH (the EU chemicals regulation) in 2009. Since then the prevalence of nickel allergy has declined in some countries, but not in others, following the implementation. Young individuals still become allergic to nickel (2, 3) and a high prevalence of nickel allergy, exceeding 10%, is seen among young women (below 30 years) in the general population.

The EU nickel regulation has been changing over time. The present limits of nickel release for metallic items intended for direct and prolonged contact with the skin is <0.5 μg/cm2/week and <0.2 μg/cm2/week for any post assemblies inserted into pierced holes. In 2014, EU defined prolonged contact with the skin as: at least 30 minutes on one or more occasions within two weeks for items with continuous skin contact, or to at least 10 minutes on three or more occasions within two weeks (7).

The overall objective is to evaluate how well the EU nickel regulation protects individuals against developing nickel dermatitis. More specifically we will:

  1. Study the penetration of nickel in normal and irritated skin after short repeated skin exposure under controlled temperature in nickel sensitized patients and in healthy controls
  2. Reveal the potential of short repeated nickel skin exposure on normal and irritated skin to elicit dermatitis, during controlled climate factors in nickel sensitized patients and controls using the time restrictions of the definition of prolonged skin contact in the nickel regulation.

Study Overview

Study Type

Interventional

Enrollment (Actual)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Hellerup, Denmark, 2900
        • Department of Allergy and Dermatology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

16 years to 73 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

For patients with nickel allergy:

Inclusion Criteria:

  • Positive patch test to nickel sulphate 5% pet. according to European society of contact dermatitis(ESCD) guidelines within the last 5 years at the Department of Dermatology and Allergy, Gentofte Hospital.
  • Age 18-75 years.

Exclusion Criteria:

  • Active eczema in test areas
  • Generalized eczema
  • Scar tissue in test areas.
  • Pregnancy or breast feeding
  • Treatment with topical corticosteroids or other immune-suppressants on/near test areas within four weeks prior to study start
  • Systemic immunomodulatory* treatment within 4 weeks prior to study start
  • UV exposure of test areas within three weeks prior to study start
  • Participation in other clinical studies within four weeks prior to study start
  • Unable to cooperate or communicate with the investigators *Systemic immunomodulatory treatment is drugs taken orally or by injection that modify the response of the immune system by increasing (immunostimulators) or decreasing (immunosuppressives) the production of serum antibodies

For Healthy volunteers:

Inclusion Criteria:

  • Negative patch test result to nickel sulphate 5% pet. according to ESCD guidelines (48) at the Department of Dermatology and Allergy, Gentofte Hospital
  • Age 18-75 years.

Exclusion Criteria:

  • History of contact allergy
  • Generalized eczema
  • Scar tissue in test areas.
  • Pregnancy or breast feeding
  • Treatment with topical corticosteroids or other immune-suppressants on/near test areas within four weeks prior to study start
  • Systemic immunomodulatory treatment within four weeks prior to study start
  • UV exposure of test areas within three weeks prior to study start
  • Participation in other clinical studies within four weeks prior to study start
  • Unable to cooperate or communicate with the investigators

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Patients with nickel allergy
Experimental stimulation with nickel discs

All participants will be exposed to 8 metal discs, 3 cm in diameter, 4 on each arm, placed on the volar side of the forearms (figure 1). Three of the metallic discs consists of >99 wt.% nickel one consist of >99wt.% Aluminium.The latter is used as a negative control. The discs will be applied under occlusion and with initial pressure and friction.

One metallic disc with nickel, and one with aluminium, will be randomized for the earlobes on the patients with nickel allergy

Experimental: Persons without nickel allergy
Experimental stimulation with nickel discs

All participants will be exposed to 8 metal discs, 3 cm in diameter, 4 on each arm, placed on the volar side of the forearms (figure 1). Three of the metallic discs consists of >99 wt.% nickel one consist of >99wt.% Aluminium.The latter is used as a negative control. The discs will be applied under occlusion and with initial pressure and friction.

One metallic disc with nickel, and one with aluminium, will be randomized for the earlobes on the patients with nickel allergy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical evaluation of development of dermatitis after stimulation over time
Time Frame: 24 hours and 78 hours post stimulation with nickel discs
Development of dermatitis after stimulation with nickel discs as a change from baseline skin assessment. The criteria developed by the International Contact Dermatitis Research Group (ICDRG), later modified by Hindsén and Bruze will be used for assessment
24 hours and 78 hours post stimulation with nickel discs
Change of baseline blood flow over time after stimulation
Time Frame: 24 hours and 78 hours post stimulation with nickel discs
measure blood flow with laser doppler technique as a surrogate for inflammation on skin following stimulation with nickel discs over time
24 hours and 78 hours post stimulation with nickel discs
Nickel skin penetration at different time points after stimulation
Time Frame: Immediate deposition and penetration, 24 hours and 78 hours post stimulation of nickel discs
by using the tape stripping technique we will measure the deposition of nickel and the penetration of nickel in the stratum corneum following stimulation
Immediate deposition and penetration, 24 hours and 78 hours post stimulation of nickel discs

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Collaborators

Investigators

  • Principal Investigator: Malin G Ahlström, MD, National Allergy Research Centre, Department of Allergy and Dermatology

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 16, 2017

Primary Completion (Actual)

December 10, 2017

Study Completion (Actual)

December 10, 2017

Study Registration Dates

First Submitted

October 4, 2017

First Submitted That Met QC Criteria

October 12, 2017

First Posted (Actual)

October 13, 2017

Study Record Updates

Last Update Posted (Actual)

February 11, 2020

Last Update Submitted That Met QC Criteria

February 10, 2020

Last Verified

February 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • H-16050296
  • HGH-2017-027 (Other Identifier: Data Protection Agency Region Hovedstaden)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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