D3.303 - Contact Dermatitis and Rhinoconjunctivitis due to Palisander Wood Exposure in a Cabinetmaker

Contact dermatitis due to exposure to exotic woods is uncommon but relevant in occupational settings. Palisander wood (Dalbergia genus, Fabaceae family) has been reported as a potential sensitizer. We present a case of allergic contact dermatitis and rhinoconjunctivitis associated with professional exposure to Palisander wood in a cabinetmaker.

A 46-year-old male, an active smoker (5-6 cigarettes/day) with no history of allergies, reported a two-week history of pruritic erythematous micropapular lesions initially affecting the axillae, arms, and trunk before spreading to the face. His symptoms included angioedema of the upper lip and eyelids, conjunctival irritation, eyelid eczema, mucous membrane involvement, nasal congestion, and mild rhinorrhea. He associated symptom onset with recent exposure to rosewood, despite having tolerated other types of wood throughout his 29-year career as a cabinetmaker. Additionally, he had domestic exposure to a cat within the last month, though without respiratory symptoms. On physical examination, he presented with bipalpebral conjunctival eczema, fine eyelid desquamation, mucous discharge, conjunctival injection, nasal congestion, rhinorrhea, and erythematous plaques on the flexural areas, trunk, arms, and legs, along with discrete angioedema of the upper lip.

Prick tests with wood dust provided by the patient was performed for different types of woods: Iroko, Sapelly, Oak, Elondo, Pine, MDF, Beech, Palisander. Epicutaneous patch testing was performed. Serum IgE levels and specific IgE to common aeroallergens and cat epithelia were measured.

• Patch testing with Palisander wood: Positive (+++).
• Patch testing with other woods (Iroko, Sapelly, Oak, Elondo, Pine, MDF, Beech): Negative.
• TRUE Test: Positive reactions to nickel sulfate (+), fragrance mix (+), and gold sodium thiosulfate (+)
• Total IgE: 31 kUA/L. Specific IgE to aeroallergens, cat epithelium, and grass pollens: Negative.
• Notable clinical improvement occurred following avoidance of Palisander wood exposure accompanied by treatment with oral corticosteroids, oral antihistamines and topical corticosteroids. Symptoms recurred mildly upon resuming work but resolved completely after work cessation.

This case highlights an occupational allergic contact dermatitis and rhinoconjunctivitis due to Palisander wood. The complete resolution of symptoms after discontinuation of exposure reinforces the diagnosis. Workplace protective measures, such as the use of gloves, masks, and immediate post-exposure hygiene, should be recommended for at-risk professionals.