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Contact dermatitis from a nickel‐containing bindi

A 33-year-old woman presented with a 2-year history of recurrent eczema localized to her central forehead where she typically wore her bindi. She typically developed symptoms of pruritus followed by palpable erythema 8h after application of the bindi. She had worn a bindi 3days before her patch test appointment. She gave a history of sensitivity to inexpensive jewelry. She had a family history of atopy, no personal history of atopy and was otherwise well, with no known allergies. On examination, there was a circular area of red scaly skin on her central forehead She was patch tested to the European standard series, her bindi and its plastic adhesive backing, and on D2 and D4 was positive to nickel sulfate 5% pet. (π π) and the metal bindi (π π). A positive dimethylglyoxime test on the bindi confirmed nickel release. The patient was treated with a moderately potent topical corticosteroid and has been been advised to avoid bindis made of inexpensive metals.