Occupational airborne and hand dermatitis to hop (Humulus lupulus) with non-occupational relapses.

We report a case of a 57-years-old female farmer with occupational airborne dermatitis and hand dermatitis to hop (Humulus lupulus). The disease appeared at the age of 46, after 30 years of working with hop without any health problems. The patient had skin erythema of the face, neck and décolleté , oedema of the eyelids, conjunctivitis, as well as acute dermatitis of the hands. The symptoms were provoked both by fresh and dried hop, appeared after half-an-hour of working and persisted over 1-2 days. There were no other skin or allergic problems. Skin tests were carried out with hop leaves (saline extract: prick positive, patch negative; glycerol extract: prick positive, patch negative) and hop cones (saline extract: prick positive, patch negative; glycerol extract: prick negative, patch positive after 48 and 72 hours). Despite discontinuing work, the patient experienced several relapses of her dermatitis. We identified new sources of hop allergens: a beauty cream and a herbal sedative, both containing hop extract. During the next hop cultivation period it also turned out that sleeping in one bed with her husband was provoking relapses of the patient's dermatitis. The husband admitted that sometimes he felt too tired to wash thoroughly after working on the plantation. Our case shows that connubial contacts with husband working in the same workplace may cause relapses of occupational dermatitis. To our knowledge, this is the first report on the concurrent occupational and connubial dermatitis to hop.