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Contact dermatitis is an eczematous skin reaction that is caused by repeated and direct exposure to an allergen: The prevalence of contact dermatitis to nickel is estimated at 17% in women and 3% in men, and 1-3% of the general population has allergic contact dermatitis to cobalt and chromium. Nickel, which is the leading cause of occupational dermatitis, shows reactivity to other metals; mainly chromium and cobalt.A 47-year old man, with previous sensitization to nickel in childhood, is a worker in the metal industry, with occupational exposure to nickel and cobalt, and showed dermatosis predominantly in the upper limbs.The risk of new sensitizations to metals (such as cobalt) has been increased by his previous sensitization to nickel that happened in childhood and his work in the metal industry.Antecedentes: La dermatitis por contacto es una reacción eccematosa en piel causada por la exposición repetida y directa de un alérgeno; se estima que la prevalencia de dermatitis de contacto al níquel es de 17 % en mujeres y 3 % en hombres y que 1 a 3 % de la población general presenta dermatitis de contacto alérgica a cobalto y cromo. El níquel es la causa más importante de dermatitis ocupacional y presenta reactividad a otros metales, principalmente cromo y cobalto. Caso clinico: Hombre de 47 años, con previa sensibilización a níquel en la infancia, trabajador de la industria metalúrgica, con exposición laboral a níquel y cobalto, quien presentó dermatosis de predominio en miembros superiores. Conclusión: La sensibilización previa a níquel en la infancia y el trabajo en la industria metalúrgica incrementó el riesgo de nuevas sensibilizaciones a metales, como cobalto.

Background: Allergic Contact Dermatitis is a classic delayed hypersensitivity reaction. Aim: To study the reactivity and evolution in Chilean patients by gender, using the standard European patch test. Materials and Methods: The results of the European standard patch test applied to 4,022 patients aged 1 to 93 years (64% female) with Allergic Contact Dermatitis, diagnosed between January 1995 and August 2011, were retrospectively analyzed. Results: From a total of 4,022 patients, 2,439 (60.6%) had a positive reaction. Among reactive patients, 1,854 (76.04%) were female and 584 (23.96%) male. The most common positive allergens were nickel (35.3%), cobalt (15.1%), fragrance mix (14%), chromium (8.7%) and balsam of Peru (8.5%). In females, nickel was the most common reactive antigen (34.28%), and in males, fragrance mix (15.7%). During the period 2003-2011, an increased reactivity to nickel (26.6%) and a decreased reactivity to p-phenylenediamine (29.6%) and fragrance (42.8%), was observed. Conclusions: Fragrance mix is the most common reactive allergen in males and the third for females. Nickel is the leading allergen in the female group and the second of importance for males, making it the most significant allergen for the Chilean population. We also observed that the reactivity of some allergens evolves and varies over time.