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The prevalence of nickel sensitization in patients with chronic allergic-like, non-IgE-mediated skin diseases, and the possible impact of dietary nickel on symptom provocation and persistence has been assessed in the present retrospective study on a case series of 1726 patients referred to our allergy unit for chronic allergic-like skin diseases. IgE-mediated pathogenesis and other differential diagnoses excluded, patients were patch tested. Nickel-positive patients underwent an elimination diet and double-blind placebo-controlled nickel challenge (DBPCNC) test. A total of 339 (20%) tested nickel-positive. Fifty-two patients (15%) recovered by avoiding sources of nickel contact and 29 (10%) dropped out. Out of the remaining nickel-sensitized patients, 277 (80%) achieved complete or near complete recovery with low-nickel content diet, and 185 of them (89%) were positive to DBPCNC. We conclude that nickel sensitization and dietary nickel seem to be the chief trigger for provocation and persistence of symptoms in an important part (~11%) of patients with chronic allergic-like dermatitis syndromes.<\/jats:p>","DOI":"10.2500\/ar.2015.6.0109","type":"journal-article","created":{"date-parts":[[2015,3,6]],"date-time":"2015-03-06T22:42:46Z","timestamp":1425681766000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["Nickel Sensitization and Dietary Nickel are a Substantial Cause of Symptoms Provocation in Patients with Chronic Allergic-Like Dermatitis Syndromes"],"prefix":"10.1177","volume":"6","author":[{"given":"Andrea","family":"Antico","sequence":"first","affiliation":[{"name":"Allergy Unit, Mantova, Asola Hospital, Asola MN, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Soana","sequence":"additional","affiliation":[{"name":"Consultant Dermatologist, Azienda Istituti Ospedalieri \u2018C. 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