Allergic contact sensitivity to mydriatic agents on a nurse's fingers

We report a case of contact sensitivity to a cycloplegic mydriatic agent (Mydrin-P) on the fingers of a nurse whose work included the instillation of eyedrops into patients undergoing routine funduscopic examination in a hospital ophthalmology department. The lesion showed well-demarcated brownish erythema with scaling on the second and third fingers of her left hand, which are used for opening the eyes of patients and are subjected routinely to contact with leaking mydriatic eyedrops. The results of a patch test to Mydrin-P and to its pharmacologic components tropicamide and phenylephrine hydrochloride were positive. These chemicals seem to be weak antigens since reports of allergic reactions to them are rare. This case exemplifies a unique occupational contact dermatitis.