P53 Hand contact dermatitis in jewellwery 2 cases

The production of jewellery is currently mostly industrial and the jewellers perform only one or two stages in the manufacturing process. The jewellers make jewellery by hand in small workshops and are more polyvalent: they shape the metal with pliers or hand tools or cast it in moulds, assemble the individual parts with glues, carve metal, diamonds and other stones, clean metals with soaps and ultrasonic baths. The occupational dermatitis is of irritant nature (acid and alkalis in metal cleaners, soaps, detergents, metal dust, abrasions from polishing wheels and emery paper, heat, adhesives, etc) and allergic nature (potassium dichromate, 2-mercaptobenzothiazole, ammoniated mercury, carba mix, epoxy resin, mercapto mix, formaldehyde, nickel, colophony). We report the cases of two jewellers working in workshops. A 47 year old atopic woman already known for a sensitivity to metals (nickel, potassium dichromate and cobalt) developed recurrent vesiculo-pustular erythematous lesions of both palms with occasional infections treated with systemic antibiotics and topical steroids. Patch tests were performed for the European standard series, woods, and personal series. There were positive + reactions at 96 h to colophony, palladium, and personal waxes. Information obtained through the manufacturer revealed colophony in the waxes frequently used by jewellers to fix the precious stones to woods and metal allowing the stones to be carved. A 47 years old atopic man working as a jeweller for 32 years developed recurrent eczematous lesions of the fingers of the right hand. Patch tests were performed for the European standard series, preservatives, plastics, acrylates and personals series and were positive + + at 96 h for urea formaldehyde, diethylenetriamine, araldite hardener and the soap used to clean the jewels. Uncommonly this contact allergy is not due to the epoxy resins themselves but to the hardener. The urea formaldehyde and the diethylenetriamine are in fact used as epoxy resins hardeners. There were no reactions to the araldite resin but there was one to its hardener. In conclusion we report two unusual cases of hand contact dermatitis in jewellers. Because jewellers are exposed to a variety of substances, to detect the allergens the inquiry must be accurate and extensive patch testing may be required. Common allergens are compounds of uncommon substances and tools and uncommon allergens are compounds of well-known sensitizers.