Abstract
Dr Kucenic and I thank Drs Dickel and John for their interest in our article and their thoughtful comments. Indeed, we completely agree that the results of our study may have been influenced by selection bias because many of our patients were referred to our tertiary dermatologic center. Throughout the third paragraph of our discussion, we stressed this possible bias. Nonetheless, our findings are in sharp contrast to those from the Centers for Disease Control and Prevention (CDC) which, in 1986, reported that 80% of occupational contact dermatitis (OCD) was irritant and 20% was allergic.1 The principal point of our paper was that occupational allergic contact dermatitis (OACD) may be significantly more frequent than the previous estimates of 20% and that “patch tests with a wider array of allergens than those currently available in the United States are needed.”
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