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A 14-year-old girl with dermatitis on her earlobe

A 14-year-old girl recently had her ears pierced. She purchased earrings that she had worn for less than 24 hours when the following dermatitis was noted on her earlobe (see Figure).

image (89)Figure.

What is the likely component in the earring resulting in this presentation?

  • gold
  • silver
  • mercury
  • nickel
The correct answer is:

Nickel

 

Educational Objective:

Describe the diagnosis and etiology of nickel dermatitis.

Explanation:

Dermatitis developing from contact with jewelry and metal items on clothing is likely due to nickel dermatitis. A frequent site of presentation for nickel sensitivity is on the earlobes from nickel-containing earrings. It is best to delay ear piercing until after a child is 10 years of age or older to reduce the likelihood of nickel sensitivity.

Reference:

Dickey BZ, Chiu YE. Eczematous disorders. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 20th ed., 2015:3150-3155.

 

This question appears in Med-Challenger Emergency Medicine Review with CME

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