Beruflich bedingtes dyshidrotisches Handekzem durch Euro-Münzen?

Abstract

Nickel ist the most prevalent allergen in western world. In patients who are sensitized to nickel, cupro-nickel coins may elicit or maintain allergic contact dermatitis of the hands. Two cashiers presented work-related dyshidrotic eczema. Patch tests showed positive reactions to nickel sulfate 5% pet in both patients as well as to the 1- and 2-Euro coins. The patch test reactions to the coins were, however, doubtful in the first case. In the second patient, occupational hand eczema was probably elicited from handling of the new Euro coins. However, sensitization from nickel in the Euro coins was unlikely because intolerance of nickel-containing jewellery was present since childhood in this patient. The new European cupro-nickel coins have a nickel release of23.2 up to 65.1 μg/cm 2 /week after immersion in artificial sweat. A factor contributing to this high release is corrosion due to the bimetallic structure of the coins, which generates a galvanic potential of 30 to 40 mV in human sweat. However, according to the European Union nickel directive, limits for objects in direct and prolonged contact with the skin should not be greater than 0,5 μg/cm 2 /week. Nickel-containing coins have been shown to elicit similar responses in nickel-sensitized subjects as those obtained with standardized patch tests. Considering the literature and our cases, it appears to be possible that a sensitized person develops hand eczema after contact with such coins. However, sensitization to nickel via the new Euro has not yet be demonstrated.