This concise guidance aims to provide physicians who work in primary and secondary medical care with a standardised approach to managing contact dermatitis in patients of working age. The document summarises three key sets of recently published or updated guidance and covers both the clinical and the occupational aspects of case management.
Key recommendations
- Take a full occupational history, asking the patient about:
- their job
- the materials with which they work
- the location of the rash
- any temporal relationship with work.
- Arrange for diagnosis of occupational CD to be confirmed objectively by patch tests and/or prick tests in a specialist contact dermatitis clinic.
- Treat established symptoms with topical steroids, soap substitutes and emollients.
- Advise patients of their increased risk from exposure to irritants and sensitising agents at work, and counsel them to:
- avoid exposure or protect their skin with suitable gloves
- use soap substitutes and emollients during and after work.
- Consider advising temporary adjustments to duties (or brief absence from work) to facilitate recovery if a patient’s CD is severe and deteriorates because of work. GPP
- Refer patients with steroid-resistant CD to a dermatologist for consideration of second-line treatments.
- Refer patients with occupational CD to a physician who has expertise in occupational skin disease for advice about workplace adjustments and liaison with their employer.
