Occupational Contact Dermatitis

  • Nlandu Roger Ngatu


Occupational contact dermatitis (OCD) is a skin disorder characterized by a red, sore, or inflamed skin after a direct contact with a substance. It is either of allergic (ACD) or irritative (ICD) nature, and they account for over 90% of all work-related skin disorders. The most frequent causes of occupational ACD are metals (nickel, chrome, cobalt), resins (epoxy resin, acrylic resin), rubber-based materials, agrichemicals, and plants; it is mostly characterized by scaly red (erythema) to pink areas of elevated skin that can be papules and/or plaques, vesicles (or blisters), and pruritus (itch). ICD, the most common occupational skin disorder (OSD), is five times more frequent than ACD and is characterized by scaling, erythema, and a mild edema at the site of contact with the irritant substance. The differential diagnosis between ACD and ICD is made mainly based on the clinical features and, eventually, patch testing (when positive, ACD will be the diagnosis). If pruritus appears as the dominant symptom in ACD, however, ICD patients often have burning feeling and pain. Another clinical feature that may facilitate the diagnosis consists of the status of the border of the skin lesions (erythema). In case of ICD, borders are less distinct, whereas distinct lines, angles, and borders are characteristics of ACD. In occupational settings with risk of OCD, a number of preventives measures can be implemented to reduce the risk; they include pre-employment screening which can help to identify predisposed subjects, the use of personal protective devices and creams (appropriate gloves, mask, barrier cream, after-work cream, etc.), and technical measures and work organization in order to reduce exposure to the sensitizer or irritant substance. Regarding OCD treatment, therapy based on corticosteroids is the first choice. Ultraviolet B (UVB) therapy based on UVB (medium wave length) and psoralen plus UVA (PUVA) is reported to be beneficial particularly for hand dermatitis, whereas a systemic treatment can be recommended for very severe and recalcitrant OCD.


Allergic contact dermatitis Contact dermatitis Irritant contact dermatitis Scoring of atopic dermatitis 

List of Abbreviations


Allergic contact dermatitis


Irritant contact dermatitis


Occupational contact dermatitis


Occupational safety and health


Psoralen plus ultraviolet A




  1. Behrens V, Seligman P, Cameron L, et al. The prevalence of back pain, hand discomfort, and dermatitis in the US working population. Am J Public Health. 1994;84(11):1780–5.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Belsito DV. Occupational contact dermatitis: etiology, prevalence, and resultant impairment/disability. J Am Acad Dermatol. 2005;532:303–13.CrossRefGoogle Scholar
  3. Berard F, Marty JP, Nicolas JF. Allergen penetration through the skin. Eur J Dermatol. 2003;13(4):324–30.PubMedGoogle Scholar
  4. Bordel-Gomez MT, Miranda-Romero A, Castrodeza-Sanz J. Epidemiology of contact dermatitis: prevalence of sensitization to different allergens and associated factors. Actas Dermosifiliogr. 2010;1012:196.CrossRefGoogle Scholar
  5. Brasch J, Becker D, Aberer W, et al. Guideline contact dermatitis. S1-Guidelines of the German Contact Allergy Group (DKG) of the German Dermatology Society (DDG), the Information Network of Dermatological Clinics (IVDK), the German Society for Allergology and Clinical Immunology (DGAKI), the Working Group for Occupational and Environmental Dermatology (ABD) of the DDG, the Medical Association of German Allergologists (AeDA), the Professional Association of German Dermatologists (BVDD) and the DDG. Allergo J Int. 2014;23(4):126–38.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Broberg A, Kalimo K, Lindbald B, et al. Parental education in the treatment of childhood atopic eczema. Acta Derm Venereol (Stockh). 1990;70:495–9.Google Scholar
  7. Chen YX, Cheng HY, Li LF. Prevalence and risk factors of contact dermatitis among clothing manufacturing employees in Beijing: a cross-sectional study. Medicine. 2017;96(12):e6356.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Clark SC, Zirwas MJ. Management of occupational dermatitis. Dermatol Clin. 2009;27(3):365–83.CrossRefPubMedGoogle Scholar
  9. Codruta-Dana P, Alexandru T. Prevalence of contact dermatitis among occupational and work-related diseases. Correlation between atopy and allergic or irritative contact dermatitis. Acta Medica Marisiensis. 2015;61(4):320–3.CrossRefGoogle Scholar
  10. Coenraads PJ, Goncalo M. Skin diseases with high public health impact. Contact dermatitis. Eur J Dermatol. 2007;17(6):1128–34.Google Scholar
  11. Dobashi K, Akiyama K, Usami A, et al. Japanese guidelines for occupational allergic diseases 2017. Allergol Int. 2017;66(2):265–80.CrossRefPubMedGoogle Scholar
  12. English JSC. Current concepts of irritant contact dermatitis. Occup Environ Med. 2004;61:722–6.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Garcia-Gavin J, Armario-Hita JC, Fernandez-Redondo V, et al. Epidemiology of contact dermatitis in Spain. Results of the Spanish surveillance system on contact allergies for the year 2008. Actas Dermosifiliogr. 2011;102(2):98–105.CrossRefPubMedGoogle Scholar
  14. Geraut C, Geraut L, Jover H, et al. Occupational diseases due to cooling fluids. Eur J Dermatol. 2011;21(2):162–9.PubMedGoogle Scholar
  15. Liccardi G, Dente B, Triggiani M, et al. A multicenter evaluation of the CARLA system for the measurement of specific IgE antibodies vs. other different methods and skin prick tests. J Invest Allergol Clin Immunol. 2002;12(4):235–41.Google Scholar
  16. Mathias CG, Maibach HI. Dermatotoxicology monographs I. Cutaneous irritation: factors influencing the response to irritants. Clin Toxicol. 1978;13(3):333–46.CrossRefPubMedGoogle Scholar
  17. Morris-Jones R, Robertson SJ, White IR, et al. Dermatitis caused by physical irritants. Br J Dermatol. 2002;147(2):270–5.CrossRefPubMedGoogle Scholar
  18. Niang SO, Cisse M, Gaye FM, et al. Occupational allergic contact dermatitis in Dakar. Mali Med. 2007;22(3):34–7.PubMedGoogle Scholar
  19. Niklasson B, Bjorkner B, Sundberg K. Contact allergy to a fatty acid ester component of cutting fluids. Contact Dermatitis. 1993;28(5):265–7.CrossRefPubMedGoogle Scholar
  20. Nosbaum A, Vocanson M, Rozieres A, et al. Allergic and irritant contact dermatitis. Eur J Dermatol. 2009;19(4):325–32.PubMedGoogle Scholar
  21. Petering H, Breuer C, Herbst R, et al. Comparison of localized high-dose UVA1 irradiation versus topical cream psoralen-UVA for treatment of chronic vesicular dyshidrotic eczema. J Am Acad Dermatol. 2004;50:68–72.CrossRefPubMedGoogle Scholar
  22. Qin R, Lampe HP. Review of occupational contact dermatitis-Top allergens, best avoidance measures. Curr Treat Options Allergy. 2015;2(4):349–64.CrossRefGoogle Scholar
  23. Rademaker M. Occupational epoxy resin allergic contact dermatitis. Australas J Dermatol. 2000;41(4):222–4.CrossRefPubMedGoogle Scholar
  24. Rui F, Bovenzi M, Prodi A, et al. Nickel, cobalt and chromate sensitization and occupation. Contact Dermatitis. 2010;62(4):225–31.CrossRefPubMedGoogle Scholar
  25. Sadagopan K, Kalappan D, Sivaprakasam N, et al. Patch test results from an occupational and contact dermatitis clinic in a tertiary care hospital of southern India: a retrospective study. J Clin Diagn Res. 2017;11(8):WC11–4.PubMedPubMedCentralGoogle Scholar
  26. Sasseville D. Occupational contact dermatitis. Allergy Asthma Clin Immunol. 2008;4(2):59–65.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Stege H. Ultraviolet therapy for hand chronic dermatitis (published in German). Hautarzt. 2008;59:696–702.CrossRefPubMedGoogle Scholar
  28. Taylor JS, Amado A. Contact dermatitis and related conditions. Center for Continuing Education Report. 2010. Accessed 10 Dec 2017.
  29. Thyssen JP. Nickel and cobalt allergy before and after nickel regulation-evaluation of a public health intervention. Contact Dermatitis. 2011;65:1): 1–68.PubMedGoogle Scholar
  30. Tosti A, Guerra L, Vincenzi C, et al. Occupational skin hazards from synthetic plastics. Toxicol Ind Health. 1993;9(3):493–502.CrossRefPubMedGoogle Scholar
  31. US Department of Labor. Workplace injuries and illnesses in 2008. 2010. Accessed 12 Dec 2017.
  32. Usatine RP, Riojas M. Am Fam Physician. 2010;82(3):249–55.PubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Nlandu Roger Ngatu
    • 1
    • 2
  1. 1.Graduate School of MedicineInternational University of Health and Welfare (IUHW)ChibaJapan
  2. 2.Graduate School of Public HealthInternational University of Health and Welfare (IUHW)TokyoJapan

Personalised recommendations