D2.37 - Occupational Allergic Dermatoses of the Face: Allergen Distribution and Work-Related Outcomes

Occupational allergic dermatitis of the face is most often related to airborne allergens, whose exposure is increasing in the workplace, raising diagnostic challenges and issues regarding fitness for work. The aim of this study was to describe the allergology profile of occupational allergic facial dermatoses of the face and their impact on medical fitness for work.

A descriptive cross-sectional study including all cases of occupational allergic facial dermatoses managed in the occupational medicine department of La Rabta Hospital in Tunis between 2015 and 2025.

A total of 26 cases were identified, with a male predominance (sex-ratio 1.67) and a mean age of 38.5 ± 12.7 years. Personal history of atopy was reported in eight patients. Manual workers represented the most affected occupational category (20 cases). The mean duration of occupational exposure was 15 ± 11.3 years. The most frequently involved sectors were healthcare (8 cases) and construction (4 cases). Symptoms appeared after employment in all patients, with a mean latency period of 6.6 ± 7.3 years. The most common clinical presentation consisted of poorly demarcated pruritic erythematous and scaly lesions (14 cases). Distant lesions were observed in 15 patients, mainly involving the hands (12 cases). Symptoms occurred on workdays and markedly improved on leaves in 22 cases. All patients underwent patch testing, supplemented by repeated open application testing (one case), specific IgE testing (one case), or avoidance–rechallenge testing (eight cases). The final diagnosis was allergic contact dermatitis in 23 cases and contact urticaria in three cases. The most frequently implicated allergens were metals (9 cases), epoxy resins (3 cases), and formaldehyde (2 cases). These conditions required workplace adjustments in 18 cases and job reassignment in six cases.

Occupational allergic facial dermatoses are associated with a wide range of allergenic exposures and may compromise medical fitness for work. Early diagnosis and appropriate management are essential to promote job retention.