Occupational autoeczematization or atopic eczema precipitated by occupational contact dermatitis?

Authors

  • Jason Williams,

    1. Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc, Melbourne, VIC 3053, Australia
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  • Jennifer Cahill,

    1. Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc, Melbourne, VIC 3053, Australia
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  • Rosemary Nixon

    Corresponding author
    1. Occupational Dermatology Research and Education Centre, Skin and Cancer Foundation Inc, Melbourne, VIC 3053, Australia
    2. Department of Medicine, The University of Melbourne, Melbourne, Australia
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Dr Rosemary Nixon
Occupational Dermatology Research and Education Centre
Skin and Cancer Foundation Inc.,
Melbourne
PO Box 132
Carlton South
VIC 3053
Australia
Tel.: +61 3 96399633
Fax: +61 3 96399644
e-mail: rnixon@occderm.asn.au

Abstract

Autoeczematization is characterized by the sudden dissemination of a previously localised form of eczema. While widely described, most cases reported have followed chronic, localized stasis dermatitis. In this study, we describe the clinical scenario of occupational contact dermatitis (OCD) triggering endogenous-like eczema in atopic individuals, who often have not had eczema since childhood, if at all. These cases appear similar to previously described cases of autoeczematization. To show this clinical scenario, a series of 6 patients is presented from the Occupational Dermatology Clinic in Melbourne, Australia. These workers initially developed OCD, usually affecting the hands, which then precipitated a flare of more generalized eczema. This appeared clinically consistent with atopic eczema (AE), and often became recurrent, and sometimes persistent. OCD can precipitate a flare of more generalized eczema, in a pattern consistent with AE, which may then persist. The clinical scenario is similar to that described for autoeczematization. It is possible that the pathophysiology, when clarified, will prove to be similar. Workers’ compensation issues may become complicated for these patients, as the relationship between their generalized eczema and their occupational exposures may not be readily apparent. As a result, the work relatedness of their condition may not be recognized.

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