Occupational protein contact dermatitis in food handlers

Abstract

The preparation of food in restaurant kitchens carries a high risk of occupational dermatoses. Analysis of 33 cases revealed four different etiological types. Simple irritant dermatitis was rare (2 cases), plain contact dermatitis was more common (6 cases). Fifteen patients had relevant patch tests and scratch tests; ten had positive scratch tests only to explain the cause of their dermatitis. The last type was termed protein contact dermatitis. The major type IV allergens incriminated were metals, onion and garlic. The major proteinaceous allergens indicated by history and test results were fish and shell-fish. Open patch tests with the incriminated foods may cause erythema or oedema on normal skin after 20 minutes. Previously eczematous, now normal looking, skin often responds with a crop of dyshidrotic vesicles preceded by erythema and itching 30 minutes after the application of an open test. Examination for specific IgE is not always positive in such cases. Inhalant allergy was rare. The results indicate that food handlers are sensitized by the protein they touch, and then react to later contact with the proteins. Protein contact dermatitis is similarly common among veterinary surgeons, while the importance in other occupational groups remains to be studied.

Occupational contact dermatitis from protein in sea products: Who is most affected, the fisherman or the chef?

“…Moreover, having been described for the first time in 1976, protein contact dermatitis is still a little-known disease and is hence probably underdiagnosed [1,15]. Additionally, our study is retrospective as it uses the registry for the compensation of occupational diseases.…”

“…Protein contact dermatitis is an allergic dermatitis first described in 1976 by Hjorth and Roed-Petersen [1]. It is likely to be under-recorded, as the diagnosis requires the association of the presence of specific clinical signs (which can appear in different forms) with a proteintype trigger factor examined by a specific dermatoallergological evaluation.…”

A study on correlation between allergen and allergic contact dermatitis

“…In addition to hair dyes PPD is also present in furdyes, leather (used for processing), rubber (vulcanizing), printers ink, photographic work, x-ray fluids and lithography. 6 Occupational exposure to PPD also occurs in the rubber industries, leather processing industries, barbers who are engaged in hair dyeing of their customers. It is recommended that if a patient has a positive patch test reaction to PPD and apparently has no contact with a PPD containing substance, patch test should be performed with other para-amino compounds and azodyes with which PPD is known to cross react.…”

Epicutaneous Testing

“…Howe\'er, in recent years sotne reports have presented evidence that it may be fairly common especially among atopic people (16,18,29,30).…”

“…Immediate hypersensitivity to foods can also be produced by rubbing fresh material on diseased skin, on scratched skin or merely on nortnal-looking skin (7,18,29). In these cases, ordinary epicutaneous tests either remain negative or else yield merely irritant reactions unless delayed type allergies also exist.…”