Low-cobalt diet for dyshidrotic eczema patients. 2008

Joseph Stuckert, and Susan Nedorost
Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.

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

UI MeSH Term Description Entries
D007722 Health Knowledge, Attitudes, Practice Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL). Knowledge, Attitudes, Practice
D009532 Nickel A trace element with the atomic symbol Ni, atomic number 28, and atomic weight 58.69. It is a cofactor of the enzyme UREASE.
D009747 Nutritional Physiological Phenomena The processes and properties of living organisms by which they take in and balance the use of nutritive materials for energy, heat production, or building material for the growth, maintenance, or repair of tissues and the nutritive properties of FOOD. Nutrition Physiological Phenomena,Nutrition Physiology,Nutrition Processes,Nutritional Physiology Phenomena,Nutrition Phenomena,Nutrition Physiological Concepts,Nutrition Physiological Phenomenon,Nutrition Process,Nutritional Phenomena,Nutritional Physiological Phenomenon,Nutritional Physiology,Nutritional Physiology Concepts,Nutritional Physiology Phenomenon,Nutritional Process,Nutritional Processes,Concept, Nutrition Physiological,Concept, Nutritional Physiology,Concepts, Nutrition Physiological,Concepts, Nutritional Physiology,Nutrition Physiological Concept,Nutritional Physiology Concept,Phenomena, Nutrition,Phenomena, Nutrition Physiological,Phenomena, Nutritional,Phenomena, Nutritional Physiological,Phenomena, Nutritional Physiology,Phenomenon, Nutrition Physiological,Phenomenon, Nutritional Physiological,Phenomenon, Nutritional Physiology,Physiological Concept, Nutrition,Physiological Concepts, Nutrition,Physiological Phenomena, Nutrition,Physiological Phenomena, Nutritional,Physiological Phenomenon, Nutrition,Physiological Phenomenon, Nutritional,Physiology Concept, Nutritional,Physiology Concepts, Nutritional,Physiology Phenomena, Nutritional,Physiology Phenomenon, Nutritional,Physiology, Nutrition,Physiology, Nutritional,Process, Nutrition,Process, Nutritional,Processes, Nutrition,Processes, Nutritional
D011146 Eczema, Dyshidrotic A recurrent eczematous reaction characterized by the development of vesicular eruptions on the palms and soles, particularly along the sides and between the digits. It is accompanied by pruritus, a burning sensation, and hyperhidrosis. The disease is self-limiting, lasting only a few weeks. (Dorland, 27th ed) Eczema, Vesicular Palmoplantar,Pompholyx,Vesicular Palmoplantar Eczema,Eczema, Dyshydrotic,Dyshidrotic Eczema,Dyshidrotic Eczemas,Dyshydrotic Eczema,Dyshydrotic Eczemas,Eczemas, Dyshidrotic,Eczemas, Dyshydrotic,Eczemas, Vesicular Palmoplantar,Palmoplantar Eczema, Vesicular,Palmoplantar Eczemas, Vesicular,Vesicular Palmoplantar Eczemas
D003035 Cobalt A trace element that is a component of vitamin B12. It has the atomic symbol Co, atomic number 27, and atomic weight 58.93. It is used in nuclear weapons, alloys, and pigments. Deficiency in animals leads to anemia; its excess in humans can lead to erythrocytosis. Cobalt-59,Cobalt 59
D004032 Diet Regular course of eating and drinking adopted by a person or animal. Diets
D005512 Food Hypersensitivity Gastrointestinal disturbances, skin eruptions, or shock due to allergic reactions to allergens in food. Allergy, Food,Food Allergy,Hypersensitivity, Food,Allergies, Food,Food Allergies,Food Hypersensitivities,Hypersensitivities, Food
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D017410 Practice Guidelines as Topic Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. Clinical Guidelines as Topic,Best Practices,Best Practice

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