Introduction:

Contact dermatitis can have an irritating or allergic background and are the most frequently encountered occupational dermatosis. Allergic Contact Dermatitis can be of occupational origin and most often affects the hands, wrists and forearms. The occupational and clinical history is critical for its diagnosis. The relationship between the symptoms and work, identifying substances that may cause the dermatosis is important to perform epicutaneous tests. The initial stage of treatment consists of evicting the agent, which may include removing the worker from his workplace. Early and appropriate treatment is important to prevent further deterioration and persistence of skin lesions.

Case Report:

47-year-old man, a plumber for thirty years, and no relevant personal background. About seventeen years ago, he started erythematous, scaly, and fissured lesions on the dorsum of both hands and in the interdigital spaces, which he associated with his professional activity. Initially, he did not wear gloves when working with plastic pipes, glues, sealants, and other rubber and steel materials. With the appearance of the injuries, he began to use them, without improvement. However, he kept the injuries. Dermatology followed it, where it performed the first epicutaneous tests with positivity for the agent Isopropyl-N-Phenyl 4 Phenylenediamine, present in rubbers. Due to continued exposure to the agent present in his workplace, with consequent worsening of the skin lesions, he returned to the consultation. He carried out new epicutaneous tests that revealed new positivities: Paraphenylenediamine, Mixture of Thiurans and Colophony. These agents are present in his work, and the diagnosis of Occupational Allergic Contact Dermatitis was assumed.

Discussion/ Conclusion:

Occupational Allergic Contact Dermatitis is associated with high personal and professional suffering, loss of earning capacity and decreased productivity. Given the multiplicity of sensitized agents, this case was a challenge for Occupational Health, as it was present in various work materials and protective equipment. In this case, it was not possible to leave the workplace, which was not the option accepted by the worker, so the management of the case involved minimizing contact, giving preference to other types of materials, by reducing the time and intensity of exposure, using safer individual protection material, as well as using inner cotton gloves and outer vinyl gloves, in addition to concomitant pharmacological treatment. This case is also positive for other agents due to cross-reactivity, as well as the multiplicity of reactions that was partly caused by the continuous injury to the skin.

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