Worldwide use of mobile phones is rising and along with this, allergic reactions to mobile phones. A group of researchers from California, Arizona and Denmark conducted a comprehensive online literature review to study how mobile phone usage links to allergic reactions. The review summarizes major findings from published case studies on Allergic Contact Dermatitis (ACD) caused by mobile phone and its accessories. It was found the number of mobile phone-associated ACD cases reported have increased rapidly since 2000. The case reports highlight mobile phone-associated ACD in pediatric and adult population and revealed that metal allergens, mainly nickel and chromium, were frequently associated with mobile phone ACD. It has been reported nickel release seems to be characteristic of both cheap and expensive mobile phones.
The review of the literature, conducted through the National Library of Medicine with appropriate medical subject headings and keywords, found thirty-seven cases of mobile phone-related ACD and six studies evaluating allergen release from mobile phones. The nickel dimethylglyoxime spot test (DMG) was used to evaluate nickel release in amounts that are sufficient to elicit ACD in nickel-sensitized individuals. The major goals of the review were as follows:
- Present published cases of mobile phone-related dermatitis
- Identify and summarize the studies which investigated nickel and cobalt release from mobile phones through screening spot tests
- Provide a basic understanding of etiology, clinical presentation and mobile phone ACD prevalence to dermatology, immunology or pediatric specialists
The study’s highlights are as follows:
- Majority of the mobile phone ACD cases reported from 2000 to 2008 were related to nickel exposure. Seven additional nickel-induced dermatitis case reports were published from 2009 to 2011 examining reactions in 15 patients in which all patients had a positive patch test to nickel or their mobile phone, a positive DMG spot test, or both. It was found that the dermatitis got resolved on discontinuation of the use of mobile phones. Out of the 37 patients reported with mobile phone dermatitis, 10 patients had positive chromium patch test results. There were case reports which implicated iridium, cobalt and plastics/glues as the causes for ACD.
- Excessive nickel release was identified in 18 to 45.5% of the tested products while considering four identified studies of DMG testing of mobile phones. Data on cobalt release from mobile phones was found to be inconsistent. Even after adding mobile phones to the EU Nickel Directive in 2009, rates of DMG test positive phones remained unchanged between 2008 and 2011 in Denmark. The studies suggest that, as the use of mobile phone increase among all economic groups, nickel exposure induced by mobile phones will continue to rise and putting consumers at ACD risk
- Out of the 34 patients whose age was reported in the review, 14 were aged 18 years or younger. It is estimated that patch test reactivity to nickel affects up to 17% of women and 3% of men while nickel sensitization is common in children with ACD prevalence ranging from 17% to 33%. Though nickel is the most common allergy found in patch-tested children, mobile phone dermatitis cases are likely underreported among pediatric patients. It is expected that a greater number of younger adults will develop mobile phone ACD with the increased use of smartphones
Since the review highlights several presenting symptoms and characteristic distributions such as face (especially preauricular and cheek), hands, thighs and chest/breasts, the researchers point out that clinicians should suspect mobile phone dermatitis in patients with dermatitis in these distributions, especially when the patients have unusual mobile phone habits, occupational mobile phone use, or a new mobile phone. With the exponential rise in mobile phone usage, allergy transcription services can help meet physician documentation needs as they focus on their core task of patch and spot testing for proper diagnosis and treatment.