Dermatitis of the hands in caterers

Area of Science:

• Dermatology
• Occupational Health
• Allergology

Background:

• Hand eczema is a common occupational skin disease, particularly among food handlers.
• Identifying causative agents, whether irritants or allergens, is crucial for effective management.
• The role of atopy in the development of occupational hand eczema requires further investigation.

Purpose of the Study:

• To investigate the causes of hand eczema in a cohort of 50 caterers.
• To differentiate between irritant and allergic contact dermatitis.
• To explore the association between atopy and sensitization to Type I and Type IV allergens.

Main Methods:

• A cohort of 50 caterers with hand eczema was studied.
• Patch testing was performed to identify specific allergens.
• Dilutions of garlic and onion in arachis oil were evaluated as potential patch test materials.

Main Results:

• 47 out of 50 cases of hand eczema were attributed to occupational factors, primarily irritants.
• Atopy showed a correlation with Type I sensitisation (commonest: fish) but not Type IV sensitisation (commonest: garlic).
• 50% dilutions of garlic and onion in arachis oil were found to be non-irritant and effective patch test materials.

Conclusions:

• Irritants play a more significant role than sensitisers in occupational hand eczema among caterers.
• Atopic individuals may be more prone to Type I allergies relevant to their occupation.
• The prognosis for hand eczema in this group is generally poor, even after job changes, highlighting the need for preventative strategies.