Nickel allergy is typically diagnosed by patch testing – applying a patch with 2.5% (in North America) or 5% (in Europe) nickel sulfate to the upper back and looking for irritation on the skin. As with other causes of allergic contact dermatitis, patches containing several common allergens are typically applied to the back for 48 hours, removed, then the spots examined for allergic reactions 2 to 5 days later.
SNAS can often mimic IBS and may be more common than is widely appreciated. It therefore should be considered as a differential diagnosis item when a doctor is considering a diagnosis of IBS, and nickel allergy testing is advisable as a means to exclude or confirm SNAS. Even before such testing, some differentiating factors in the medical history are if certain foods prompt the symptoms (for example, peanuts or shellfish), whereas IBS is not specific to those foods.