Multiple sensitizations and multiple factors contributing to OCD in hairdressers are common. More needs to be done to prevent the development of OCD in hairdressers in our geographical region.

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Occupational contact dermatitis is common amongst hairdressers. In this population-based study, 193 trainee hairdressers and 184 practising hairdressers completed a questionnaire detailing their knowledge of skin hazards, the skills they practised and the frequency of glove use. Knowledge of skin hazards was poor in both groups. While up to 70% of participants correctly identified hairdressing chemicals as potential skin hazards, less than 15% correctly identified the role of wet work. Only a small proportion recognized that hairdressing chemicals could cause allergy. Contrary to findings elsewhere, less-experienced hairdressers often handled chemicals, particularly hair dyes containing p-phenylene diamine. The use of gloves was inadequate, particularly when performing work at the basin, which both junior and senior hairdressers did on a regular basis. Recommended strategies for the prevention of hand dermatitis in hairdressers include improved student education, appropriate glove use and the application of after-work moisturizing creams.

Hairdressers are one of the largest groups affected by occupational contact dermatitis. In this population-based study, 193 trainee hairdressers and 184 practising hairdressers each completed a questionnaire and had their hands examined. Participants were asked about past or present atopy including eczema, asthma or hayfever, which occurred in 59.2%, and were individually correlated with a history of occupational skin problems. Almost 60% of hairdressers and trainees had experienced changes on their hands since commencing hairdressing, while 29% had evidence of abnormal skin on examination on the day of participation. Atopic individuals, who plan to work in a career such as hairdressing with known high rates of occupational contact dermatitis, should be advised to care for and protect their skin from the outset to prevent the development of this condition. There has been little awareness of this issue in Australia, despite longstanding knowledge of the association of hairdressing and contact dermatitis.

We present a case series of 25 paediatric patients with refractory discoid eczema treated with methotrexate. Patients were commenced on either 5 mg or 10 mg of methotrexate per week. Sixteen patients (64%) completely cleared their eczema after an average of 10.5 months of methotrexate therapy. A further three patients (12%) have responded well and are almost clear at the time of writing. Methotrexate was well tolerated by the majority of patients and no serious adverse events were observed. Methotrexate should be considered in moderate to severe paediatric discoid eczema that has failed to respond to conventional therapies.

Dexpanthenol is the alcohol corresponding to pantothenic acid (the water-soluble vitamin B(5)). Although it is a common ingredient in many pharmaceuticals and cosmetics, contact allergy is relatively uncommon. Cocamidopropyl PG dimonium chloride phosphate is a phospholipid complex derived from pure coconut oil, and contact allergy is rare. We report a case of allergic contact dermatitis to panthenol and cocamidopropyl PG dimonium chloride phosphate in a facial hydrating lotion.

A severe cutaneous eruption in an unwell patient can be a major cause of physician anxiety. With numerous differential diagnoses, an early accurate diagnosis can be challenging. infectious causes are the most important to exclude in a timely manner and drug rash and eosinophilia with systemic symptoms (DRESS) is another differential diagnosis that should be considered in children. This hypersensitivity reaction is associated with multisystem involvement. Children with underlying chronic diseases may have impairment of normal metabolic pathways and are also often on multiple medications. Therefore, drugs should always be considered in the aetiopathology of any new symptoms and signs. This case report informs readers of the association of sulfasalazine and DRESS in an 11-year-old with inflammatory bowel disease and discusses its pathogenesis and treatment. Increased awareness of this disorder will hopefully lead to increased reporting and consequently illuminate the syndrome more clearly and help guide its prevention and treatment.

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