Kawahara-Nanamori Hikaru, Sawada Yu
Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2022;44(3):307-311. doi: 10.7888/juoeh.44.307.
A 42-year-old man working at a steel mill recognized itching and erythema on the dorsal surfaces of his hands for 2 weeks prior to his first visit to our department. Lichenized erythematous plaques were observed on the dorsal surfaces of his fingers and hands. A patch testing of the rubber part of the gloves showed a positive reaction. We also conducted a patch testing of metals to exclude a possibility of contact dermatitis mediated by metals as occupational materials. The patch testing of metals showed a positive reaction to zinc, which is not an occupational material in his steel mill, but his rubber gloves contained zinc in the rubber accelerators, which might have been the trigger that caused his allergic contact dermatitis. Contact dermatitis is the most common occupational skin disease, and various materials are the causative agents. Allergic reactions to rubber (latex) are classified into type I allergy and type IV allergy. Type IV allergic reaction is observed in rubber accelerators such as thiuram; however, our case showed that zinc allergy could be a possible causative agent in patients with contact dermatitis due to rubber gloves.
一名在钢铁厂工作的42岁男性,在首次就诊于我们科室前两周,就发现双手背出现瘙痒和红斑。其手指和手背可见苔藓化红斑斑块。对其手套的橡胶部分进行斑贴试验显示阳性反应。我们还对金属进行了斑贴试验,以排除金属作为职业材料介导接触性皮炎的可能性。金属斑贴试验显示对锌呈阳性反应,锌并非他所在钢铁厂的职业材料,但他的橡胶手套在橡胶促进剂中含有锌,这可能是引发其过敏性接触性皮炎的诱因。接触性皮炎是最常见的职业性皮肤病,多种材料都可能是致病因素。对橡胶(乳胶)的过敏反应分为I型过敏和IV型过敏。在诸如秋兰姆等橡胶促进剂中可观察到IV型过敏反应;然而,我们的病例表明锌过敏可能是因橡胶手套导致接触性皮炎患者的一种潜在致病因素。