D'Alcamo et al. astutely highlighted a potential immunologic association between nickel allergy, determined by positive epicutaneous patch testing, and the rise of non-celiac wheat sensitivity (NCWS) in the world of gluten-related diseases. Consecutive algorithms including both patch and intradermal testing could provide vital information to more accurately define the patient populations with NCWS, systemic nickel allergy syndrome, and nickel-associated allergic contact dermatitis.
Keywords: intradermal testing; nickel; non-celiac wheat insensitivity; systemic nickel allergy syndrome.