Low-cobalt diet for dyshidrotic eczema patients

STUCKERT, JOSEPH
NEDOROST, SUSAN

¹Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA, and ²Department of Dermatology, University Hospitals Case Medical Center, Cleveland, OH 44106, USA

Address: Dr Susan Nedorost Department of Dermatology University Hospitals Case Medical Center 11100 Euclid Ave Cleveland, OH 44106 Tel: +1-216-844-8200 Fax: +1-440-250-2451 email: [email protected]

Accepted for publication 18 July 2008

Contact Dermatitis 59(6):p 361-365, December 2008.

Background

Dyshidrotic eczema is a type of chronic intermittent dermatitis characterized by vesicles, dystrophic fingernail changes, and rarely bullae that affects the hands and feet. Many exogenous factors may trigger a flare including dermatophyte infections, contact irritants, and metal hypersensitivity. Although metal hypersensitivity does not play a role in all cases of dyshidrotic eczema, high oral ingestion of nickel and/or cobalt should be considered, regardless of patch test results.

Objective

We updated and simplified existing published guidelines for low-cobalt diets. A recent review of the literature showed that dietary cobalt restriction, a safe yet burdensome treatment option for dyshidrosis, is referenced to dated sources.

Methods

We have analysed current data for the cobalt content in common food items.

Conclusion

We propose a revised, point-based diet that will eliminate much of the dietary cobalt (and nickel) and reduce dyshidrotic eczema flares.