Hand dermatitis as an unsuspected presentation of textile dye contact sensitivity

The aim of this study was to evaluate disperse dye sensitization in patients with hand dermatitis. From January 1996 to December 2000, we identified 130 patients with hand dermatitis reacting to one of the 7 dyes included in our standard series. In 82 subjects the dermatitis was localized to the hands alone, whereas 48 patients had lesions both on the hands and on other skin sites. Disperse Blue dyes, and Disperse Orange 3 were the most common sensitizers. Among the 13 subjects allergic to disperse dyes alone, we found 3 cases of occupational allergic contact dermatitis, 1 child with atopic dermatitis worsening after the use of synthetic fibre garments, 4 subjects affected by clothing dermatitis, and 5 individuals occupationally exposed to irritants with a dermatitis involving the hands alone. In the latter, the hands may represent a 'locus minoris resistentiae', and both induction and elicitation of contact sensitization could be caused by impaired barrier function at a skin site repeatedly exposed to sensitizing garments.