Abstract
Contact dermatitis of the hands makes up the majority of work-related skin disease. Eighty per cent of these reactions are irritant in nature, whereas 20% are due to a type IV delayed ACD. Both clinically and histologically, irritant and allergic reactions can be indistinguishable. The diagnostic test of choice for allergic contact dermatitis is patch testing. Atopics with a history of childhood eczema are significantly at risk for the development of occupational ICD and should avoid wet work jobs, such as housekeeping, food preparation, nursing, or machinists, as adults. Though chronicity is extremely common and job change does not improve overall prognosis, early diagnosis, treatment, and preventive efforts are crucial.
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