title: Occupational protein contact dermatitis.
abstract: Occupational contact dermatitis is generally caused by haptens but can also be induced by proteins causing mainly immunological contact urticaria (ICU); chronic hand eczema in the context of protein contact dermatitis (PCD). In a monocentric retrospective study, from our database, only 31 (0.41%) of patients with contact dermatitis had positive skin tests with proteins: 22 had occupational PCD, 3 had non-occupational PCD, 5 occupational ICU and 1 cook had a neutrophilic fixed food eruption (NFFE) due to fish. From these results and analysis of literature, the characteristics of PCD can be summarized as follows. It is a chronic eczematous dermatitis, possibly exacerbated by work, suggestive if associated with inflammatory perionyxix and immediate erythema with pruritis, to be investigated when the patient resumes work after a period of interruption. Prick tests with the suspected protein-containing material are essential, as patch tests have negative results. In case of multisensitisation revealed by prick tests, it is advisable to analyse IgE against recombinant allergens. A history of atopy, found in 56 to 68% of the patients, has to be checked for. Most of the cases are observed among food-handlers but PCD can also be due to non-edible plants, latex, hydrolysed proteins or animal proteins. Occupational exposure to proteins can thus lead to the development of ICU. Reflecting hypersensitivity to very low concentrations of allergens, investigating ICU therefore requires caution and prick tests should be performed with a diluted form of the causative protein-containing product. Causes are food, especially fruit peel, non-edible plants, cosmetic products, latex, animals.
authors.affiliation: Department of Dermatology and Allergology,, EA 7298 Gene-environmental hazards interactions and effects on health "Ingres"
authors.forename: Annick
authors.initials: A
authors.lastname: Barbaud
authors.affiliation: Department of Dermatology and Allergology.
authors.forename: Claire
authors.initials: C
authors.lastname: Poreaux
authors.affiliation: Department of Occupational Diseases, Batiment des spécialités médicales, Brabois Hospitals, Nancy University Hospital, 6 rue du Morvan, 54500 Vandoeuvre les Nancy, France, EA 7298 Gene-environmental hazards interactions and effects on health "Ingres"
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Penven
authors.affiliation: Department of Dermatology and Allergology,, EA 7298 Gene-environmental hazards interactions and effects on health "Ingres"
authors.forename: Julie
authors.initials: J
authors.lastname: Waton
mesh_terms: D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D016273:Occupational Exposure / Q000009:adverse effects*; D011506:Proteins / Q000009:adverse effects* / Q000276:immunology; D012867:Skin / Q000473:pathology*; D012882:Skin Tests
chemical_list: D011506:Proteins
keywords: chronic hand eczema; immunological contact urticaria; neutrophilic fixed food eruption; prick test; protein allergy; protein contact dermatitis