Disulfiram is Effective for Nickel Allergic Hand Eczema
Disulfiram, a nickel chelator, has been reported to be useful in treating hand eczema in some individuals who are allergic to nickel. Nine patients with chronic hand eczema and positive patch tests to nickel completed a 2 month, randomized, double-blind, placebo-controlled, crossover study to evaluate the efficacy of disulfiram, 250 mg/d, in controlling their dermatitis. Subjective and objective measurements of itching, fissuring, and percentage of hand involvement, as well as overall evaluation, were made on a scale of 0 to 4. Eight of the nine patients were noted to improve while on the drug, although the other patient showed no overall change. In contrast, on placebo, four patient's conditions were unchanged and five became worse (P< .02). In addition, the average of the total scores improved in each parameter studied while on the drug and worsened in each parameter while on placebo. Only one patient had a transient elevation of liver function tests, which returned to normal while the patient continued to take the medication. This study confirms previous work that has suggested that disulfiram has a beneficial effect in individuals with a positive nickel patch test and hand eczema.