Permanent disability from hand dermatitis in females sensitive to nickel, chromium and cobalt

Among 564 Danes applying for permanent disability pension due to skin diseases, 222 had allergic contact eczema. Psoriasis was the next most common disorder. Nickel allergy was found in 99 cases, of whom 91 were women with hand eczema. In 43 the primary eczema was on the hands, in 38 under costume jewellery, suspenders, ect. Besides nickel the patients were often sensitive to cobalt, rubber and formaldehyde. Within Denmark there were geographical differences, as only few applicants came from the rural areas. Ten were atopics. 63 were chrome sensitive, including 21 women who all had hand eczema. Like the nickel sensitive they often had additional allergies to cobalt, rubber and formaldehyde. In 53% of the nickel sensitive the hand eczema started in occupations with a high nickel exposure. 39% had frequent changes in occupation, often to a new job with occupational nickel contact. As the patients in the present study were all selected on the basis of their poor prognoses, we have tried to establish prognostic criteria through comparison with unselected material from within the same geographical area.