Tulip fingers

Tulip fingers, an allergic contact dermatitis from handling tulip bulbs, is a common occupational problem among workers in the European tulip industry. We describe five of nine workers who sort and package flower bulbs at a central Pennsylvania bulb distribution center; all five had tulip fingers confirmed by positive patch tests to pieces of tulip bulbs and to tuliposide A, the allergen in tulips. The diagnosis of tulip fingers should be considered in any patient with a hand dermatitis who works in the flower industry, especially those who frequently handle bulbs.