Aetiology

The commonest cause of allergic contact eczema in women is nickel, whilst chrome, usually from cement or leather is the most frequent precipitating factor in men. Other patients at high risk are those with chronic skin conditions such as leg ulcers who tend to become sensitised to medicaments.

Other causes include: (1,2)

• dichromates
• rubber chemicals
• wool alcohols - lanolin - cosmetics and creams
• topical drugs - neomycin - benzocaine
• paraphenylenediamine - hair dye - clothing
• preservatives in cosmetics and creams - parabens
• colophony - sticking plaster - colodion
• balsam of Peru - citrus fruit - perfumes
• plants such as the Compositae family eg. chrysanthemums
• epoxy resins and their hardening agents, acrylic resins and formaldehyde are common occupational agents

References:

1. DeKoven JG, Warshaw EM, Reeder MJ, et al. North American Contact Dermatitis Group patch test results: 2019-2020. Dermatitis. 2023 Mar-Apr;34(2):90-104.
2. English JS. Current concepts of irritant contact dermatitis. Occup Environ Med. 2004 Aug;61(8):722-6.