000312 - Hand dermatitis in a painter, who is to blame?

Epoxy resins are polymers used in the paint, plastics and electromechanical engineering industries and have been known to cause allergic contact dermatitis. Phenyl glycidyl ether is an organic compound used as a diluent for epoxy resins to improve their  viscosity. 

A 58-year-old man without medical history or known allergies, who works as a painter, in renovations and car painting. He was referred to our Allergology Department for more than 5 years of erythematous-eczematous and pruritic lesions, with cracks on his both hands. In the last year, they became more intense, requiring topical and systemic corticosteroids on several times with short-term improvement. In his work he manipulates epoxy resins and their diluents. 

Epicutaneous tests were performed with the standard protocol of Spanish Research Group on Contact Dermatitis and Cutaneous Allergy (GEIDAC, acronyms in spanish) extended, which includes: Nickel, Wool Alcohols, Neomycin, Potassium dichromate, Cain III blend, Fragrance I blend, Rosin, Paraben blend, Peruvian balsam, Cobalt chloride, p-tert-butylphenol formaldehyde resin, Epoxy resin (Bisphenol A), Carba blend, N-isopropyl-p-phenylenediamine, Kathon, Methyldibromo glutaronitril, P-phenylenediamine, Formaldehyde, Mercapto mixture, Thiuram mixture, Diazolidinyl urea, Thixocortol-21-pivalate, Imidazolinidyl urea, Budesonide, Mercaptobenzothiazole, Sesquiterpene lactose mixture, Textile dye mixture, Methylisothiazolinone, Propolis, Lyral, Perfume mixture II, Hydroxymethylacrylate, Sodium metabisulfite, Benzylisothiazolinone, Decyl glucoside; which were all negative at 48 and 96 hours.

Taking into account the patient's work, epicutaneous tests were also performed with plastics and glues protocol, which includes: Abietic acid, Hydroabietil alcohol, Benzoyl peroxide, Bisphenol A, Butyl acrylate, Resorcinol monobenzoate, Dibutyl phthalate, Diethylenetriamine, Diethyl phthalate, Diphenyl thiourea, Dimethyl phthalate, Dimethyl-p-toluidine, Dioctyl phthalate  Butyl glycidyl ether, Phenyl glycidyl ether, Dromethizole, Phenylindole, Phenyl salicylate, Phenol formaldehyde resin, Hydroquinone, Butyloacrylate, 4-Tert-butylcatechol, P-tert-butylphenol, Octylisothiazolinone, Toluene 4-sulfonamide, Ethyl cyanoacrylate, Tricresyl phosphate, Diethylthiourea, Triphenyl phosphate , Triglycidyl isocyanurate; which were positive at 48 hours and 96 hours only for phenyl glycidyl ether (++). 

We describe a case of allergic contact dermatitis due to phenyl glycidyl ether, with typical distribution on hands, in a painter handling epoxy resin diluents, so its positivity is clinically relevant in this case. The patient was advised to avoid contact with epoxy resins containing phenyl glycidil ether.