Dyshidrotic eczema as an occupational dermatitis in metal workers.

Metalworkers exposed to metalworking fluids often encounter dermatological problems. In an epidemiological study of 286 metalworkers, 14% had dermatitis. Of these, 21 (54%) presented with the clinical appearance of dyshidrotic eczema. 3 out of these 21 operators had positive patch test reactions, 1 to nickel and 2 to formaldehyde and formaldehyde releasers, while 1 other was diagnosed as atopic. According to the literature, dyshidrotic eczema is strongly related to an atopic constitution and to contact sensitization, especially to nickel. However, our findings suggest that dyshidrotic eczema in metalworkers is a predominantly irritant dermatitis, mainly induced by exposure to soluble oils and unrelated to atopy.