Patch Testing

One of our patients has kindly given consent for us to show you some of his pictures and show how our Dermatology team helped to diagnose his skin problems using Patch Testing.

Case Report

He was seen by our Dermatology Team having developed areas of itch dermatitis on the head and neck and arms (Figure 1) one month after starting a new job. Two more episodes occurred over the next 9 months each one was more severe than the previous. During the final flare he had severe acute dermatitis of the face, neck and ears with marked swelling especially around the eyes which were 75% closed and the ears which were very painful and tender. Epoxy resin was present in the workplace and despite efforts to minimise contact, sensitisation was suspected.

Patch Testing using the TRUE Test standard series was performed 2 weeks later and demonstrated a +++ reaction to epoxy resin at 96 hours confirming the clinical suspicion.

He is to be relocated at work to a different area with no epoxy resin exposure.

Epoxy resin is a common type of thermosetting plastic resin used in structural applications, paints and coatings. It is cured / hardened after which it is unlikely to cause allergy but a small proportion may initially remain uncured and so sensitise the individual causing allergic dermatitis. The commonest affected sites are the face, forearms and hands. Allergy tends to occur early often within 3 months of the initial contact. Strict avoidance of further contact with uncured epoxy resin is needed to prevent further episodes. This can be difficult as epoxy resin can penetrate plastic and rubber gloves. Heavy duty vinyl gloves and silicone-based barrier creams can be protective. Regular cleaning and maintenance of epoxy-resin-contaminated equipment and workplaces is essential. Education is important, however work products may contain undisclosed epoxy resins.