Systemic allergic contact dermatitis to nickel presenting predominantly as severe hand dermatitis, successfully controlled with upadacitinib: A case report.

Systemic allergic contact dermatitis to nickel is a challenging condition often presenting as severe hand dermatitis. This case report details the clinical course of a 33-year-old male truck driver with severe hand dermatitis secondary to systemic allergic contact dermatitis to nickel. Despite significant improvement with avoidance, the patient experienced recurrent flares due to ongoing accidental nickel exposure. Upadacitinib provided an effective salvage strategy. The case underlines challenges of managing systemic allergic contact dermatitis.