A 40-year-old woman had hand dermatitis. By history alone, a dermatologist diagnosed contact dermatitis from detergents and cleaning solutions. During the next 5 years the patient wore cotton liners under rubber gloves when handling cleaning solutions but continued to have dermatitis. She applied topical corticosteroids regularly and received systemic steroid injections intermittently. After 5 years, she sought the opinion of another dermatologist. This time diagnostic patch tests were employed and revealed an allergy to thiuram mix and carba mix. These results indicated a problem with the rubber gloves she was wearing. She also was found to be sensitive to quatemium-15 in her hand cream. A change to polyvinyl chloride based gloves and a hand cream without quatemium-15 led to resolution of her dermatitis. As this case illustrates, allergic contact dermatitis can be a significant and costly medical problem. Rapid, accurate diagnosis, however, can eliminate a persistent skin problem. The cost to society and industry from occupational skin diseases alone has been estimated to be up to $1 billion per year, 1 more than 90% of which is estimated to result from contact dermatitis. Allergic contact dermatitis also exacts a significant toll in terms of time lost from work and a potentially inappropriate job change, resulting in a lower standard of living. Adding to the patient's burden is the discomfort and disability that results from continued exposure to the offending allergen.