Allergic contact dermatitis and electronic cigarettes: Is nickel to blame?

Introduction:
This text discusses a case report of a patient with allergic contact dermatitis (ACD) caused by an electronic cigarette (e-cigarette) and its liquid (e-liquid). The patient was sensitized to nickel, and the e-cigarette device tested negative for nickel with a dimethylglyoxime (DMG) nickel spot test. However, the patient had spilled the e-liquid, Cigavapor, on her hands, and further patch testing revealed a positive reaction to the e-liquid "as is" and menthol flavouring. The text highlights the potential role of e-cigarettes and e-liquids as sources of contact sensitization.

Key Points:

* The patient was a 38-year-old female with a 6-month history of hand dermatitis, not known to be allergic to nickel, with no personal or familial history of atopy.
* Clinical examination showed erythematous, scaly dermatitis with lichenification on both hands.
* Patch testing revealed a positive reaction to nickel 5% pet. and further testing with personal products revealed a positive reaction to vaping liquid Cigavapor "as is."
* Further testing of individual ingredients of the e-liquid did not reveal any positive reactions, except for menthol 2% pet. from the bakery series.
* The patient had spilled the e-liquid, Cigavapor, on her hands around the time of onset of the hand dermatitis.
* The distributional pattern supported the diagnosis of ACD caused by the e-liquid, and among the ingredients of the e-liquid Cigavapor, menthol was identified as the probable culprit agent.
* Clinicians should be aware of e-liquids as potential allergens and the potential sources of nickel in e-cigarettes.

Main Message:
The main message of this text is that e-cigarettes and e-liquids can be potential sources of contact sensitization, and clinicians should be aware of this possibility. The text highlights the importance of recognizing e-cigarettes as potential sources of nickel and the potential role of e-liquids as allergens. With the increasing popularity of e-cigarettes, it is crucial to consider their potential impact on public health and the potential risks they pose for contact sensitization. The text emphasizes the need for further research to better understand the risks associated with e-cigarettes and e-liquids and to develop appropriate regulations to protect public health.

Azevedo, Alexandra, Inês Lobo, and Manuela Selores. “Allergic Contact Dermatitis and Electronic Cigarettes: Is Nickel to Blame?” Contact Dermatitis 81, no. 2 (August 2019): 135–36. https://doi.org/10.1111/cod.13257.