Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF
Net letter
2008:74:4;431-431
doi: 10.4103/0378-6323.42887

Contact dermatitis in Wood workers

I Lobo, M Ferreira, E Silva, S Machado, M Selores
 Department of Dermatology, Hospital Geral de Santo António, EPE, Porto, Portugal

Correspondence Address:
I Lobo
Inês Machado Moreira LoboEdifício das consultas Externas do Hospital Geral Santo António, Ex CICAP, Rua D. Manuel II, S/n4100 Porto
Portugal
How to cite this article:
Lobo I, Ferreira M, Silva E, Machado S, Selores M. Contact dermatitis in Wood workers. Indian J Dermatol Venereol Leprol 2008;74:431
Copyright: (C)2008 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Wood and wood dust can cause a wide range of cutaneous reactions, including folliculitis, contact urticaria, and both irritant and allergic contact dermatitis. The majority of wood-induced contact dermatitis occurs in woodworkers [1] and most involved sawdust woods are "exotic" species from tropical regions. [2] Solid wood products such as musical instruments are rarely sensitizing. [3] As exposure in woodworkers occurs with fine dust created during wood processing, the initial clinical picture is typically that of airborne contact dermatitis.

Case 1A healthy 54 year-old Caucasian woodworker (sawyer) presented a history of pruritic eruption on his face after 36 years of professional activity. There were no systemic symptoms and the patient denied any modification on the type of woods he crafted.

The physical examination [Figure - 1] revealed erythema, small vesicles, and scaling on the face (involvement of the eyelids, postauricular and infranasal folds), jaw area, neck and the V of the chest, hands and forearms. These episodes were so severe that they needed repeated visits to emergency service and the need of systemic corticosteroids.

Case 2A healthy 56 year-old Caucasian woodworker (cabinet-marker) had been referred to our department for evaluation of a pruritic eczematous eruption. Like the first patient, the lesions only appeared after 30 years of professional activity and were aggravated during work period. Examination revealed [Figure - 2] erythematous papular lesions and lichenified plaques localized on the exposed areas of the face, neck and forearms.

Patch tests in both patients were performed with the Portuguese Contact Dermatitis Standard Tray, and fresh sawdust samples from 30 wood samples in 1 and 10% petrolatum [Table - 1].

The patches were applied with Finn chambers to the skin on the back, removed after 48 hours and read by 72 hours.

After 72 hours, the first patient revealed positive reactions to colophony and five saw dusts in 10% petrolatum (MDF, agglomerate, pine, Scotch pine and Tabopan) [Table - 2]. The second patient demonstrated positivity to colophony, balsam of peru, fragrance mix and 11 saw dusts incorporated in 1 and 10% petrolatum (MDF, agglomerate, pine, Scotch pine, Agba, chipboard, Pau sangue, ironwood, ebony, Coeur dehors and kambala, [Table - 2].

Considering that many woods have strong irritant properties and that the first patient only revealed positive results to sawdust in 10% petrolatum, patch tests with the same saw dusts were carried out in ten controls. All these controls were negative, negating the hypothesis of irritant contact dermatitis. However, this conclusion was limited by the small number of controls.

As photo-exposed areas were involved in both patients, we carried out photopatch tests. Negativity in these tests permitted us to exclude photo-allergic contact dermatitis.

Woods and wood handling can cause various skin and mucosal adverse symptoms. Almost any wood dust has the potential to be an irritant agent when it comes in contact with the skin. Nevertheless, occupational allergic contact dermatitis is rare. [4] The most recognizable allergic woods include cedar, pine, poplar, oak, rosewood, teak and ebony. [5] Quinones, stibenes, phenols and terpenes are some of the compounds that have been identified as contact allergens in woods. [5]

When wood contact dermatitis is suspected on a clinical basis, patch testing should be performed with fresh sawdust from the same wood species crafted by the patient. [4]

Although 2,6 dimethoxy-1,4 benzoquinone is considered to be a wood allergy marker, we could not perform any test with it because the substance was not available.

The cases described here clearly show that airborne contact dermatitis occurs with the involvement of other woods besides "exotic" types. In the second patient, we can infer that the reaction was allergic, but the negativity to saw dusts in 1% petrolatum in the first patient does not allow us to exclude an irritant reaction. The positive patch test reaction to wood sawdust demonstrates clinical relevance because the patients work with these woods on a daily basis and the dermatitis resolves on its own whenever they avoid wood contact.

It is interesting to note that the clinical manifestations appear for a long time after woodworking activity, apparently with no modification on the type of woods crafted. This may be justified by the multiplicity of some woods′ common names reported by our patients, which made wood identification somewhat difficult. Ideally, woods should be identified by their genus and species names.

Colophony is the natural solid residue that remains after distilling the volatile oil (turpentine) of the pine oleoresin. The positivity in both patients seems to be related with pine dust positivity.

Wood agglomerate, MDF, and Tabopan are produced by agglutinating wood-waste fibrous elements with the gum of formaldehyde. Taking into account that neither of our patients had positive reactions to formaldehyde, the positivity to these wood agglomerates seems to be in agreement with pine dust positivity. In spite of these facts, we cannot exclude the involvement of other unknown wood constituent elements.

Prevention of allergic contact dermatitis to wood dust in sensitized workers is usually difficult. Both our patients needed to leave the woodworking activity to get long-term relief from the wood dust-associated contact dermatitis.

References
1.
Correale CE, Marks JG. Contact dermatitis in a woodworker. Am J Contact Dermat 2002;13:42-4.
[Google Scholar]
2.
Weber LF. Dermatits venenata due to native woods. Arch Dermatol Syphilol 1953;67:388-94.
[Google Scholar]
3.
Scheman AJ, Xu Y, Osborne A. Allergic contact dermatites to Fraximus americanus and Macherium acutifolium. Am J Contact Dermatol 1999;10:233-5.
[Google Scholar]
4.
Estlander T, Jolanki R, Alanko K, Kanerva L. Occupational allergic dermatitis caused by wood dusts. Contact Dermatitis 2001;44:213-7.
[Google Scholar]
5.
Zug K, Marks J. Plants and woods. In: Adams R, editors. Occupational Skin Disease. Philadelphia: Saunders; 1999. p. 567-93.
[Google Scholar]

Fulltext Views
49

PDF downloads
15
Show Sections