An outbreak of allergic contact dermatitis caused by citral in beauticians working in a health spa

摘要

Single cases of allergic contact dermatitis in beauticians are well recognized, and epidemiological studies have confirmed that individual beauticians have a high risk of developing occupational allergic contact dermatitis (1). Case Report: Over a period of 2 years, 9 beauticians working in the same high-end luxury health spa in the United Kingdom were referred to our contact dermatitis clinic with recent onset of bilateral hand dermatitis. All had been referred separately and independently by their general medical practitioners rather than by their employer. The dermatitis was localized mainly to the dorsum of the hands and fingers, although, in some cases, there was spread to the wrists and forearms. The dermatitis was reported to improve with work avoidance. All were applying a wide variety of beauty treatments, including massages with essential oils, which were applied to clients' skin by direct, ungloved, hand contact. All were female and aged between21 and39years; 7ofthe9 (78%) had a personal history of atopy (asthma, hayfever, or atopic dermatitis) on direct questioning. All had worked at the spa for a minimum of 4 months prior to the onset of their hand dermatitis (range 4-24 months).