Peer Reviewed
Feature Article Occupational health

Occupational contact dermatitis: suspect it, treat it, and refer if persistent

Rosemary L Nixon, Mignon Moyle
Occupational contact dermatitis can have considerable impact at work and at home. Accurate and early diagnosis enables optimal management, and there may be multiple causes.
Key Points
  • Occupational contact dermatitis can significantly affect a person’s quality of life. Early diagnosis, appropriate management and timely referral can improve prognosis.
  • Irritant contact dermatitis is more common than allergic contact dermatitis. Both types may coexist and it may be impossible to differentiate them clinically.
  • Young people with a history of eczema should be advised to take appropriate skincare measures as soon as they start work, in order to minimise their risk of contact dermatitis.
  • People with a history of severe eczema affecting the hands should avoid occupations involving wet work, as this increases their risk of developing irritant contact dermatitis.
  • There is no test for irritant contact dermatitis, which is diagnosed subjectively after allergic contact dermatitis has been excluded by patch testing.
  • Immediate hypersensitivity reactions to proteins in latex and foods causes contact urticaria, which may also present as contact dermatitis. Prick testing is used to diagnose contact urticaria, although a radioallergosorbent test (RAST) is preferred if latex allergy is suspected because of the possibility of anaphylaxis with prick testing to latex.
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