Body piercing and metal allergic contact sensitivity

North American Contact Dermatitis Group data from 2007 to 2010

Erin M. Warshaw, Jaime L. Kingsley-Loso, Joel G. DeKoven, Donald V. Belsito, Kathryn A. Zug, Matthew J. Zirwas, Howard I. Maibach, James S. Taylor, Denis Sasseville, Joseph F. Fowler, Charles Gordon Toby Mathias, Vincent A. DeLeo, Melanie D. Pratt, James Marks, Anthony F. Fransway

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: This study aimed to examine the association between piercing and patch test sensitivity to metals (nickel, cobalt, and chromium) in North America. Methods: A retrospective analysis of 9334 patients tested by the North American Contact Dermatitis Group from 2007 to 2010 was conducted. Results: Nickel sensitivity was statistically associated with at least 1 piercing (risk ratio [RR], 2.52; 95% confidence interval [CI], 2.26-2.81; P < 0.0001) and nickel sensitivity rates increased with the number of piercings (16% for 1 piercing to 32% for ≥5 piercings). Prevalence of nickel sensitivity was higher in females (23.2%) than in males (7.1%), but the association with piercing was stronger in males (RR, 2.38; 95% CI, 1.72-3.30; P < 0.0001) than in females (RR, 1.30; CI, 1.13-1.49; P = 0.0002). Crude analysis indicated that cobalt sensitivity was statistically associated with piercing (RR, 1.63; 95% CI, 1.40-1.91; P < 0.0001); however, stratified analysis showed that this relationship was confounded by nickel. After adjusting for nickel sensitivity, the adjusted risk ratio for piercing and cobalt was 0.78 (not significant). Chromium sensitivity was negatively associated with piercing (RR, 0.60; 95% CI, 0.48-0.75; P < 0.0001). Conclusions: Piercing was statistically associated with sensitivity to nickel. This relationship was dose dependent and stronger in males. Cobalt sensitivity was not associated with piercing when adjusted for nickel. Chromium sensitivity was negatively associated with piercing.

Original languageEnglish (US)
Pages (from-to)255-264
Number of pages10
JournalDermatitis
Volume25
Issue number5
DOIs
StatePublished - Jan 1 2014

Fingerprint

Body Piercing
Contact Dermatitis
Nickel
Metals
Odds Ratio
Cobalt
Confidence Intervals
Chromium
Patch Tests
North America

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Dermatology

Cite this

Warshaw, E. M., Kingsley-Loso, J. L., DeKoven, J. G., Belsito, D. V., Zug, K. A., Zirwas, M. J., ... Fransway, A. F. (2014). Body piercing and metal allergic contact sensitivity: North American Contact Dermatitis Group data from 2007 to 2010. Dermatitis, 25(5), 255-264. https://doi.org/10.1097/DER.0000000000000066
Warshaw, Erin M. ; Kingsley-Loso, Jaime L. ; DeKoven, Joel G. ; Belsito, Donald V. ; Zug, Kathryn A. ; Zirwas, Matthew J. ; Maibach, Howard I. ; Taylor, James S. ; Sasseville, Denis ; Fowler, Joseph F. ; Mathias, Charles Gordon Toby ; DeLeo, Vincent A. ; Pratt, Melanie D. ; Marks, James ; Fransway, Anthony F. / Body piercing and metal allergic contact sensitivity : North American Contact Dermatitis Group data from 2007 to 2010. In: Dermatitis. 2014 ; Vol. 25, No. 5. pp. 255-264.
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title = "Body piercing and metal allergic contact sensitivity: North American Contact Dermatitis Group data from 2007 to 2010",
abstract = "Objective: This study aimed to examine the association between piercing and patch test sensitivity to metals (nickel, cobalt, and chromium) in North America. Methods: A retrospective analysis of 9334 patients tested by the North American Contact Dermatitis Group from 2007 to 2010 was conducted. Results: Nickel sensitivity was statistically associated with at least 1 piercing (risk ratio [RR], 2.52; 95{\%} confidence interval [CI], 2.26-2.81; P < 0.0001) and nickel sensitivity rates increased with the number of piercings (16{\%} for 1 piercing to 32{\%} for ≥5 piercings). Prevalence of nickel sensitivity was higher in females (23.2{\%}) than in males (7.1{\%}), but the association with piercing was stronger in males (RR, 2.38; 95{\%} CI, 1.72-3.30; P < 0.0001) than in females (RR, 1.30; CI, 1.13-1.49; P = 0.0002). Crude analysis indicated that cobalt sensitivity was statistically associated with piercing (RR, 1.63; 95{\%} CI, 1.40-1.91; P < 0.0001); however, stratified analysis showed that this relationship was confounded by nickel. After adjusting for nickel sensitivity, the adjusted risk ratio for piercing and cobalt was 0.78 (not significant). Chromium sensitivity was negatively associated with piercing (RR, 0.60; 95{\%} CI, 0.48-0.75; P < 0.0001). Conclusions: Piercing was statistically associated with sensitivity to nickel. This relationship was dose dependent and stronger in males. Cobalt sensitivity was not associated with piercing when adjusted for nickel. Chromium sensitivity was negatively associated with piercing.",
author = "Warshaw, {Erin M.} and Kingsley-Loso, {Jaime L.} and DeKoven, {Joel G.} and Belsito, {Donald V.} and Zug, {Kathryn A.} and Zirwas, {Matthew J.} and Maibach, {Howard I.} and Taylor, {James S.} and Denis Sasseville and Fowler, {Joseph F.} and Mathias, {Charles Gordon Toby} and DeLeo, {Vincent A.} and Pratt, {Melanie D.} and James Marks and Fransway, {Anthony F.}",
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Warshaw, EM, Kingsley-Loso, JL, DeKoven, JG, Belsito, DV, Zug, KA, Zirwas, MJ, Maibach, HI, Taylor, JS, Sasseville, D, Fowler, JF, Mathias, CGT, DeLeo, VA, Pratt, MD, Marks, J & Fransway, AF 2014, 'Body piercing and metal allergic contact sensitivity: North American Contact Dermatitis Group data from 2007 to 2010', Dermatitis, vol. 25, no. 5, pp. 255-264. https://doi.org/10.1097/DER.0000000000000066

Body piercing and metal allergic contact sensitivity : North American Contact Dermatitis Group data from 2007 to 2010. / Warshaw, Erin M.; Kingsley-Loso, Jaime L.; DeKoven, Joel G.; Belsito, Donald V.; Zug, Kathryn A.; Zirwas, Matthew J.; Maibach, Howard I.; Taylor, James S.; Sasseville, Denis; Fowler, Joseph F.; Mathias, Charles Gordon Toby; DeLeo, Vincent A.; Pratt, Melanie D.; Marks, James; Fransway, Anthony F.

In: Dermatitis, Vol. 25, No. 5, 01.01.2014, p. 255-264.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Body piercing and metal allergic contact sensitivity

T2 - North American Contact Dermatitis Group data from 2007 to 2010

AU - Warshaw, Erin M.

AU - Kingsley-Loso, Jaime L.

AU - DeKoven, Joel G.

AU - Belsito, Donald V.

AU - Zug, Kathryn A.

AU - Zirwas, Matthew J.

AU - Maibach, Howard I.

AU - Taylor, James S.

AU - Sasseville, Denis

AU - Fowler, Joseph F.

AU - Mathias, Charles Gordon Toby

AU - DeLeo, Vincent A.

AU - Pratt, Melanie D.

AU - Marks, James

AU - Fransway, Anthony F.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Objective: This study aimed to examine the association between piercing and patch test sensitivity to metals (nickel, cobalt, and chromium) in North America. Methods: A retrospective analysis of 9334 patients tested by the North American Contact Dermatitis Group from 2007 to 2010 was conducted. Results: Nickel sensitivity was statistically associated with at least 1 piercing (risk ratio [RR], 2.52; 95% confidence interval [CI], 2.26-2.81; P < 0.0001) and nickel sensitivity rates increased with the number of piercings (16% for 1 piercing to 32% for ≥5 piercings). Prevalence of nickel sensitivity was higher in females (23.2%) than in males (7.1%), but the association with piercing was stronger in males (RR, 2.38; 95% CI, 1.72-3.30; P < 0.0001) than in females (RR, 1.30; CI, 1.13-1.49; P = 0.0002). Crude analysis indicated that cobalt sensitivity was statistically associated with piercing (RR, 1.63; 95% CI, 1.40-1.91; P < 0.0001); however, stratified analysis showed that this relationship was confounded by nickel. After adjusting for nickel sensitivity, the adjusted risk ratio for piercing and cobalt was 0.78 (not significant). Chromium sensitivity was negatively associated with piercing (RR, 0.60; 95% CI, 0.48-0.75; P < 0.0001). Conclusions: Piercing was statistically associated with sensitivity to nickel. This relationship was dose dependent and stronger in males. Cobalt sensitivity was not associated with piercing when adjusted for nickel. Chromium sensitivity was negatively associated with piercing.

AB - Objective: This study aimed to examine the association between piercing and patch test sensitivity to metals (nickel, cobalt, and chromium) in North America. Methods: A retrospective analysis of 9334 patients tested by the North American Contact Dermatitis Group from 2007 to 2010 was conducted. Results: Nickel sensitivity was statistically associated with at least 1 piercing (risk ratio [RR], 2.52; 95% confidence interval [CI], 2.26-2.81; P < 0.0001) and nickel sensitivity rates increased with the number of piercings (16% for 1 piercing to 32% for ≥5 piercings). Prevalence of nickel sensitivity was higher in females (23.2%) than in males (7.1%), but the association with piercing was stronger in males (RR, 2.38; 95% CI, 1.72-3.30; P < 0.0001) than in females (RR, 1.30; CI, 1.13-1.49; P = 0.0002). Crude analysis indicated that cobalt sensitivity was statistically associated with piercing (RR, 1.63; 95% CI, 1.40-1.91; P < 0.0001); however, stratified analysis showed that this relationship was confounded by nickel. After adjusting for nickel sensitivity, the adjusted risk ratio for piercing and cobalt was 0.78 (not significant). Chromium sensitivity was negatively associated with piercing (RR, 0.60; 95% CI, 0.48-0.75; P < 0.0001). Conclusions: Piercing was statistically associated with sensitivity to nickel. This relationship was dose dependent and stronger in males. Cobalt sensitivity was not associated with piercing when adjusted for nickel. Chromium sensitivity was negatively associated with piercing.

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