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Case Report
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Challenges in diagnosing occupational allergic contact dermatitis: a case report
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Jun Fai Yap, Kim Sui Wan, Muhammad Fadhli Mohd Yusoff, Yin Cheng Lim, Rama Krishna Supramanian
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Ann Occup Environ Med 2025;37:e7. Published online March 24, 2025
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DOI: https://doi.org/10.35371/aoem.2025.37.e7
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Abstract
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- 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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Original Article
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Investigation of Occupational Dermatological Problem with Additives in Polypropylene Manufacturing Process
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Seung Ho Jeon, Kyong Min Lee, Kan Woo Yoon, Do Myung Paek, Jong Yeop Yoo, Hee Chul Eun
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Korean Journal of Occupational and Environmental Medicine 2003;15(3):252-260. Published online September 30, 2003
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DOI: https://doi.org/10.35371/kjoem.2003.15.3.252
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Abstract
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- OBJECTIVES
To investigate the causative agents for the dermatological problems associated with the polypropylene manufacturing process.
METHODS
The study subjects consisted of 44 male workers involved in the polypropylene manufacturing process. Twenty-seven of them had been exposed to additives, and the remaining 17 had not. Among the 27 exposed, 10 had been exposed previously, and 17 are currently being exposed through their duties. Patch test were performed with three different concentrations, 0.1%, 1% and 10% of 10 different additives that was diluted with Vaseline.
RESULTS
18 subjects (41%) had positive reactions to the patch tests. Exposed group had a higher reaction rate (51.9%) than the control group (23.5%). When the positive reactions were further classified, 7, 6 and 5 were compatible with probably irritant, probably allergic, and multiple hypersensitivity reactions respectively. The most frequent reactions were from Ultranox-626 followed by Millad 3988, Armoslip-E and Songstab Sc-100.
CONCLUSIONS
When considering the significantly higher probability of an allergic reaction rate among the currently exposed group compared to non- or previously-exposed groups, the nature of dermatological problems in a polypropylene plant is probably allergic. Ultranox-626, Millad3988, Armoslip-E and Songstab Sc-100 were the main causatives agents found in the process.
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