Allergic Contact Dermatitis to Nickel and Cobalt in a Food Service Worker: Allergic Contact Dermatitis to Nickel and Cobalt in a Food Service Worker
Synopsis
Contact dermatitis (CD) is a pruritic dermo-epidermal inflammatory condition triggered by skin exposure to exogenous allergenic (allergic contact dermatitis – ACD) and/or irritant (irritant contact
dermatitis – ICD) substances. ACD results from a delayed hypersensitivity reaction (type IV) mediated by allergen-specific T lymphocytes and require prior sensitization. CD accounts for approximately 90–95% of occupational dermatoses and frequently leads to work disability. Objective: To describe the diagnostic
approach to occupational ACD, as well as the role of Occupational Medicine in the prevention of contact dermatitis in the workplace. Methods: Case report of a 54-year-old woman who had been working as a counter employee in a pastry shop for 13 years. She presented with erythematous scaly plaques involving the hands and abdominal region. Improvement of the skin lesions was observed during periods away from work. Patch testing showed positive reactions at 72 hours to nickel (++) and cobalt (++). Discussion/Conclusion: ACD to nickel and cobalt may represent an important occupational health problem due to the widespread presence of these metals in multiple work environments, including the food service sector. Prevention of CD requires an integrated approach combining technical, organizational, and behavioral measures, with emphasis on health education and medical surveillance.
