Some adverse effects of disulfiram in the treatment of nickel-allergic patients.
A retrospective follow-up study is reported of 58 women and 3 men with nickel allergy and hand eczema, of at least 4 months duration, treated with 50 to 400 mg disulfiram per day for 4 to 56 weeks. 2 patients were given 2 treatment series, making a total of 63 treatment series. 11 patients (20%) developed biochemical evidence of hepatotoxicity. 5 of them developed clinical evidence of hepatitis, which, for 4, was verified by liver biopsy. The patients with hepatotoxcity were significantly older than those who did not have this side effect. No correlation could be seen between the cumulative or maximum dose of disulfiram, the duration of the therapy and whether or not the patients showed evidence of hepatotoxicity. In 29 treatment series the dermatitis healed, while improvement was seen in 19 and no change in 15. There was no difference in the results whether maximum daily doses of 50, 200 or 400 mg were given. Follow-up examinations showed that the eczema recurred within a month after termination of therapy in 50% of the patients who improved during disulfiram therapy. Recurrence was seen within 6 months for another 40% of the patients.