Safety of Stainless Steel In Nickel Sensitivity

Abstract

<h3>To the Editor.—</h3> A recent letter by Barranco and Solomon "Eczematous Dermatitis from Nickel," (220:1244, 1972) described a dermatitis in a nickel-sensitive patient from a stainless steel screw used to secure a transferred tendon for a dislocated patella as an example of "internal" allergic contact dermatitis. The authors state that a 4+ reaction was obtained with the stainless steel screw. However, not infrequently, hard metallic objects under a covered patch produce pressure, irritant reactions which are difficult to distinguish from the allergic variety. This is particularly so in individuals who have, or have recently recovered from an eczematous reaction which makes the skin irritable in a nonspecific manner. Furthermore, even though the stainless steel screw contained 14% nickel, this nickel is so firmly bound physically in the alloy, that body fluids or perspiration cannot "leach" out the nickel to make it available to produce an allergic reaction. The presence or