Background: Nickel-sensitive patients may experience persistent dermatitis even if they avoid cutaneous contact with nickel-plated items.

Objective: The purpose of the study was to determine whether reduced nickel intake in food reduces the activity of dermatitis in selected nickel-sensitive persons.

Methods: Ninety nickel-sensitive patients who had a flare of dermatitis after oral challenge with 2.5 mg of nickel but had no reaction to a placebo were instructed to adhere to a low-nickel diet.

Results: Fifty-eight of the 90 patients benefited in the short term from the diet, whereas 15 others had possible benefit. Seventeen patients did not benefit in the short term. Fifty-five patients who adhered to the diet for at least 4 weeks, and whose dermatitis had cleared or improved at the end of this time, responded to a questionnaire follow-up 1 to 2 years later. Forty of these patients had long-term improvement of their dermatitis. Patients with strongly positive patch tests to nickel had less benefit from the diet than patients with moderately positive patch tests.

Conclusion: Reduction of the dietary intake of nickel may benefit some nickel-sensitive patients.