Low-Nickel Diet Scoring System for Systemic Nickel Allergy

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.