Occupational food-related hand dermatoses seen over a 10-year period

Background. Protein contact dermatitis was originally defined in 1976 by Hjorth and Roed-Petersen as a distinct kind of dermatitis seen in patients with occupational food contact. Even though occupational skin diseases are frequent in Denmark, little attention has been paid to protein contact dermatitis, and the frequency is unknown. Objectives. To evaluate the frequency of occupational food-related hand dermatoses and test results in patients occupationally exposed to foods. Materials and Methods. This was a retrospective study based on examinations, including skin prick testing and patch testing, performed at the Department of Dermato-Allergology, Gentofte University Hospital, Denmark between 2001 and 2010. Results. Of all patients (n = 372), 57.0% had irritant contact dermatitis, 22.0% had protein contact dermatitis, 2.4% had contact urticaria, and 1.8% had allergic contact dermatitis. A suggestion for diagnostic criteria is presented. Frequent risk occupations were cooking in restaurants, baking, and kitchen work. Substantially more patients reacted in skin prick testing with fresh foods than with food extracts. Conclusion. Protein contact dermatitis is a frequent disorder among patients who professionally handle foods, and should be considered to be a distinct clinical entity. When diagnosing protein contact dermatitis and in other food-related skin prick testing procedures, it is important to include fresh foods.