P04 Cashiers’s disease due to euro coins – a case report

A 37‐year‐old female cashier working in a drugstore developed a dyshidrotic hand eczema in summer 2001. Positive patch test results were obtained against nickel and cobalt. When the new euro coins were introduced in January 2002, the skin symptoms disappeared. Five months later the work‐related hand eczema flared up with massive aggravation. Money‐triggered hand eczema has occasionally been reported. Its low incidence is probably due to the absence of wet or irritant work. Coins are not mentioned in the EU nickel directive as “products intended to come into direct and prolonged contact with the skin”. Nestle et al. (Nature, Vol 419, p 132, 2002) found that 1‐ and 2‐ euro coins released more nickel than pure nickel itself in vitro. A factor contributing to this high release of nickel is corrosion due to the bimetallic structure of these coins, which generates a galvanic potential of 30–40 mV in human sweat. A current can enhance galvanic corrosion and thereby cause more nickel release. In a thin irregular electrolyte layer such as a sweat deposit, galvanic corrosion occur primarily near the bimetallic junction owing to the high resistance to lateral current flow in the thin layer.