Dermatological toxicity of hexavalent chromium

Hexavalent chromium causes two types of dermatological toxicities: allergic contact dermatitis (ACD) and skin ulcers. This report reviews the etiology, prevalence, pathology, dose-response, and prognosis of both of these reactions. Reports in the literature indicate that repeated exposure to hexavalent chromium in concentrations of 4-25 ppm can both induce sensitization and elicit chromium ACD. Exposure to 20 ppm hexavalent chromium can cause skin ulcers in nonsensitized people. The prevalence of chromium sensitivity in cement workers, exposed to 10-20 ppm hexavalent chromium for years, is approximately 4-5%. Chromium ACD can be a chronic debilitating disease, perhaps because chromium is ubiquitous in foods and in the environment and is difficult to avoid. Due to the high rates of sensitization in populations chronically exposed to chromium and the chronic nature of chromium ACD, some investigators recommend reducing the hexavalent chromium concentrations in consumer products, such as detergents, to less than 5 ppm.