Allergic contact dermatitis to rubber accelerators in a surgical assistant and the challenge of finding a suitable indicator underglove

Abstract

Contact sensitizations to rubber accelerators are common in healthcare worker due to usage of protective gloves causing allergic contact dermatitis of the hands. We report the case of a 63-year-old woman who has worked as a surgical assistant for more than 35 years and suffered from work related hand eczema for the past 3 years. Two outpatient patch tests revealed positive reactions to thiurams, 1,3-diphenylguanidine and a protective glove used at work which did not result in complete substitution of gloves. Due to the hand eczema's chronic course, the patient took part in a tertiary individual prevention program (TIP) in our department. Another patch test was performed confirming sensitizations to 1,3-diphenylguanidine and thiurams. We diagnosed work-related hand eczema caused by irritant contact dermatitis and allergic contact dermatitis due to occupational use of 1,3-diphenylguani-dine-containing sterile surgical gloves and dithiocarbamate-containing sterile indicator gloves. During the TIP, new accelerator free gloves were selected. Finding suitable indi-cator gloves was particularly challenging. After returning to work, the patient devel-oped a mild relapse which was attributed to irritant contact dermatitis, but she was able to continue working.