Annals of Occupational and Environmental Medicine

Case Report

Challenges in diagnosing occupational allergic contact dermatitis: a case report: Jun Fai Yap, Kim Sui Wan, Muhammad Fadhli Mohd Yusoff, Yin Cheng Lim, Rama Krishna Supramanian; Ann Occup Environ Med 2025;37:e7. Published online March 24, 2025; DOI: https://doi.org/10.35371/aoem.2025.37.e7

Abstract PDF: Background
In Malaysia, occupational allergic contact dermatitis (ACD) is often under-reported. This case report describes a chemical engineer who developed possible ACD, likely due to workplace allergen exposure.
Case presentation
He presented with a 4-month history of intensely itchy rashes on both hands, which improved during work breaks. A dermatological examination revealed lichenified, pruritic papules with well-defined borders on the palmar surfaces of both hands. A skin patch test identified reactions to five allergens, including ‘fragrance mix,’ ‘methyldibromo glutaronitrile,’ ‘clioquinol,’ ‘epoxy resin,’ and ‘textile dye mix.’ However, among these, only ‘bisphenol A diglycidyl ether,’ a component of ‘epoxy resin,’ was listed in the safety data sheet as a confirmed occupational exposure. In accordance with local regulations, this case was reported as ‘occupational dermatitis’ to the Department of Occupational Safety and Health. The patient was prescribed symptomatic topical treatments, including emollients and topical corticosteroids. Additionally, he was advised to switch to hypoallergenic products. On follow-up, his chronic inflammatory skin lesions showed improvement.
Conclusions
Thorough occupational history-taking and patch testing are essential for diagnosing ACD. Personalized health education and regular follow-ups, is crucial in monitoring lesion resolution and evaluating the effectiveness of preventive measures in workplace settings.

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