Allergic Contact Dermatitis from Black Rubber Mix
For 8 months, a 50-year-old woman had had an erythematous, pruritic rash on her palms. When her hands were exposed to water, the rash worsened and fissures developed. Recently, she noticed that the fissures had begun to bleed. Application of clobetasol, 0.05%, for 1 month provided no relief.
For 8 months, a 50-year-old woman had had an erythematous, pruritic rash on her palms. When her hands were exposed to water, the rash worsened and fissures developed. Recently, she noticed that the fissures had begun to bleed. Application of clobetasol, 0.05%, for 1 month provided no relief.
The patient uses industrial cleaning solutions, rubber gloves, and a squeegee with a black rubber tip at her job, where she has worked for years.
A 24-panel thin-layer rapid use epicutaneous (TRUE) test was applied to the patient's back. She was told to refrain from using antihistamines for the next few days. After 48 hours, a strong positive (+2) reaction to black rubber mix was noted. The +2 reaction remained at the 72-hour follow-up visit.
Christine Cook, Carla DiBenedetto, PA-C, Patricia Hood, PA-C, and Jonathan Crane, DO, of Wilmington, NC, write that this patient had allergic contact dermatitis that most likely resulted from prolonged contact with the black rubber tools she used at work.
The patient's work gear was evaluated. Black rubber was also found on the handles of some of her tools. She was advised to read the labels of all products before use and avoid those that contain black rubber mix or latex.
