Coverage from the ACAAI conference in Phoenix, November, 2010.
Prolonged cell phone use is leading to nickel sensitivity and reactions on an increasing number of faces, according to a key presenter at the ACAAI conference in Phoenix in November.
“Patients come in with dry, itchy patches on their cheeks, jaw lines and ears and have no idea what is causing their allergic reaction,” Dr. Luz Fonacier, head of the allergy section of Winthrop University Hospital in Mineola, N.Y., told the gathering of about 1,600 allergists.
Nickel contact dermatitis now affects up to 17 per cent of women and 3 per cent of men. Common culprits causing reactions range from nickel-containing coins to eyeglasses, brassiere and jeans fasteners, to watches and jewellery. And now, given the widespread, daily use of portable phones, the cell has been added as major nickel trigger. Dr. Fonacier cited statistics that 6.1 billion minutes per day are racked up on Americans’ cell phones.
“Some researchers suggest that there should be more nickel regulation in the U.S. like there is in some European countries,” noted Dr. Fonacier. (The same issue applies in Canada.)
She has seen patients whose cell phone reactions range from redness, itching and swelling to blistering and skin lesions that sometimes ooze and leave scarring. Those who have eczema are often susceptible to such nickel rashes.
The allergist recommends avoiding phone-to-skin contact. Potential solutions are finding a phone without metal surfaces, using an earpiece cellphone (with plastic covering) or at least getting a plastic cover for an existing cell phone. If you have a rash that may be caused by your cellphone, it’s best to get this looked at by an allergist or dermatologist for diagnosis.
Reactions to Hair Dye, Henna Tattoos
Dr. Fonacier also explained the cause of hair dye reactions and an emerging relationship with allergic responses to temporary tattoos.
The main allergenic culprit in permanent hair dye is paraphenylenediamine, or PPD. Theoretically, Dr. Fonacier said, it shouldn’t cause a reaction when fully oxidized. PPD dye is mixed with a developer (the oxidizer), but the allergist explained that the problem is that PPD in reality is seldom completely oxdized.
This type of hair dye is popular because it looks natural and lasts – it doesn’t wash out with a just a few shampoos. Darker hair dyes contain a greater concentration of PPD, and this is where Dr. Fonacier sees a connection to temporary henna tattoos.
It is the darker tattoos that are increasingly popular that are leading to a majority of the reactions. Dr. Fonacier spoke of lesions forming that heal following treatment with antihistamines or a course of topical (and sometimes oral) corticosteroids.
Importantly, she said that PPD sensitization from tattoos is likely to persist, putting those who react in their youth at risk of responding “adversely to their attempts at hair coloring as they age.”
Expert Speaks Out Against Peanut “Bans”
Also at the 2010 annual meeting of the ACAAI, outgoing president Dr. Sami Bahna took a controversial stand on the issue of accommodating those with peanut allergies.
Dr. Bahna gave a presentation in which he argued that “banning peanuts in schools and on airplanes is unnecessary”.
“Unfortunately, life is not risk-free,” said Dr. Bahna. “A minority of people are severely allergic to peanuts, but it is not reasonable or possible to expect schools or airlines to be peanut-free. Consideration should be also given to the freedom of the vast majority of non-allergic persons. Also, peanut is not the only food that can cause severe allergy.”
While we appreciate that allergy accommodations are a subject with differing and strongly held views, Allergic Living’s editors are disappointed that this presentation was not done as one of the ACAAI’s allergy debates – as there are clearly differing views and interpretations of school and airline safety measures for those at risk of anaphylaxis.
Allergic Living does not believe in “bans” at schools either, but shares the view put forward in an excellent resource developed by the Canadian Society of Allergy and Clinical Immunology and several allergy associations – Allergysafecommunities.ca. This includes guidelines for schools that are build around the notion of “risk reduction,” and presumes that preventing unnecessary reactions in the first place is the best course of action.
In schools where there are peanut allergies, this can entail an anaphylaxis plan in which a principal chooses to restrict peanut consumption on the premises as the easier means of decreasing risk in a large population of active children.
Allergic Living also points out the rationale behind the implementation of Sabrina’s Law in Ontario, and similar legislation in New York, New Jersey and the province of Manitoba again focuses on both self-management and reaction prevention rather than self-management and emergency treatment.
On the airlines issue, Dr. Bahna’s arguments seemed to focus on the recent discussions begun by the Department of Transportation (DOT) on whether a ban on serving peanuts is appropriate on the airlines. At the Phoenix meeting, he referenced the lack of use/availability of epinephrine, and counseled epinephrine auto-injector training for airline staff.
As Allergic Living has shown in its articles on airlines and allergies, many of us in this community put forward the idea of risk reduction on the airlines, given the need to travel, the heightened exposure to peanut and nut products in airlines, and the distance from medical assistance at 35,000 feet in the air.
In closing, it would be a positive thing to see allergy accommodations, particularly when it comes to airlines, discussed and debated at allergists’ conferences. These are complex social issues that deserve a full airing. Judging by the comments after Dr. Bahna spoke, there are definitely different views among the allergy experts of how to handle these risks.
