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VBeam Perfecta Laser: Versatile Dermatology Treatment
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Last month I saw an attorney with a curios itchy rash just below the belly button. He said that it had been there for a while. He was well dressed in a suit and tie. When I examined him he had a red circular patch about the size of a dime. He thought that it was odd that he experienced more itching and that the spot was more red on Monday and Tuesday and as the week wore on it would get better. It was becoming an annoying cycle. I really had to scratch my head on this one. I prescribed a topical corticosteroid cream and advised him to return in two weeks.
The night before his follow up visit I had a thought and called him asking him to bring in the jeans he usually wears on the weekends. The next day when I saw him in the office he reported some improvement but the rash was not gone. I asked him to take off his fancy suit and put on his jeans. When he put the jeans on we both noticed that the metal button from his jeans matched up perfectly with where the rash was. The diagnosis was made in an instant. He had an allergic contact dermatitis reaction to nickel.
Allergic Contact Dermatitis is a common problem in dermatology. The most commonly seen are reactions to plants such as poison oak. Nickel is the most common metal to cause an allergic contact dermatitis and it is estimated that 18% of people in North America are allergic to nickel. If you are allergic to nickel your best bet is to avoid nickel. One of the challenges in patients with nickel dermatitis is how prevalent nickel is. People most commonly will contact nickel in jewelry such as rings, earrings, and watch backs. People are usually surprised when I tell them that their “gold” jewelry is causing a nickel allergy. This is because most jewelry is made of metal alloys or mixtures of metals with nickel added. If you have a nickel allergy it is important to only purchase nickel free jewelry.
The best way to treat any allergic contact dermatitis is to avoid exposure. For those with a nickel allergy they can ask their jeweler for nickel free jewelry. For someone with a flare the treatment is usually with a topical prescription cream containing a corticosteroid. For severe reactions oral steroids are sometimes needed. The great thing about realizing that you have a nickel allergy is that if you avoid nickel you will not have the problem. Our attorney ended up switching from his favorite old faded jeans to newer ones that did not contain nickel. This made his wife very happy because she never liked the old jeans that her husband would never take off on the weekends. It was very satisfying for me to cure the rash and strengthen the marriage.
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