D2.35 - Occupational Protein Contact Dermatitis to Latex Compromising Fitness for Work in a Nurse

Introduction: Protein contact dermatitis (PCD) is an underrecognized entity in healthcare workers. It may mimic allergic contact dermatitis or contact urticaria, making diagnosis challenging. We report a case of occupational latex-induced PCD in a nurse.

Case description: A 38-year-old nurse, employed for seven years in a medical intensive care unit of a hospital in Tunis, developed symptoms following each use of latex gloves. Within minutes, she experienced transient pruritic erythematous papular wheals on the hands, forearms, and face, associated with mild eyelid edema. Within 24 hours, secondary pruritic erythematous vesicular lesions evolving to scaling appeared on the hands.For the past year, similar symptoms also occurred when latex gloves were handled by nearby colleagues. In addition, wearing a surgical gown and cap induced pruritic erythematous vesicular lesions on the forehead and wrists, reproducing the distribution of the elastic bands of these protective equipment. She had also experienced anaphylactic shock during childbirth two years earlier, attributed to latex hypersensitivity.Specific IgE testing for latex was positive. Patch testing with the European baseline series revealed sensitization to nickel and colophony. Patch testing with rubber additives series was negative. The diagnosis of occupational latex-induced PCD was established, associated with allergic contact dermatitis to nickel and colophony, notably present in adhesive tapes and metallic medical instruments. As occupational avoidance of latex was impossible due to its ubiquity and potential airborne exposure in the intensive care setting, medical fitness assessment led to job reassignment to a non–latex-exposed position outside the intensive care unit.

Conclusion: Latex is a widely prevalent allergen in healthcare settings. Latex-induced protein contact dermatitis may significantly compromise medical fitness for work among healthcare professionals.