ABSTRACT
Occupational skin disease is one of the most common occupational diseases worldwide.
Occupational contact dermatitis is an eczematous eruption caused by irritation or a type IV allergic response to a workplace agent. Occupational contact urticaria that is less common than contact dermatitis is an urticarial response caused by a type I allergic or nonimmunologic response to a workplace agent. Both conditions can be caused by exposure to a variety of proteinic material and chemicals in the workplace that may also cause occupational asthma (OA). Much of the literature on urticaria and dermatitis in the workplace is anecdotal case reports and case series. Many of these cases in the literature are based upon clinical presentations where the urticaria or dermatitis is diagnosed based upon a “probable” occupational exposure and a “probable” allergic or nonallergic mechanism. Occupational contact urticaria can be immunological (caused by proteinic and nonproteinic agents) or nonimmunological. For contact urticaria, diagnostic criteria have been proposed and skin tests can be used. In the case of occupational dermatitis, the diagnosis is based on exposure history, temporal relationships between the disease and exposures, as well as physical examination findings consistent with the diagnosis; patch test results indicating an allergic response to the causative agent are also important. The co-occurrence of skin and respiratory symptoms and disease, and more specifically the possibility that asthma may develop following sensitization via skin exposure, continues to be a topic of investigation.
