Nickel release and surveying in surgical clip alopecia

We read with interest the article by Ono et al. in which a woman experienced onset of redness, itching, and focal hair loss 3 weeks after clipping surgery of her cerebral aneurysm.[3] It was noted that the four metal pins of the Sugita head holder contain allergens such as cobalt, nickel, chromium, and mercury. It was later determined that the woman had a history of contact dermatitis to metal jewelry, supporting the nickel in the etiology.