Acrylate Allergy — SCE Dermatology MCQ

Correct answer: A — Nail technicians, dentists, and orthopaedic surgeons (from exposure to acrylate-based products)

The correct answer is A, nail technicians, dentists, and orthopaedic surgeons (from exposure to acrylate-based products). (Meth)acrylate monomers, including HEMA, are potent skin sensitisers when uncured, and these three occupational groups have the heaviest direct occupational contact: nail technicians through gel and acrylic nail systems, dentists through composite resins and bonding agents, and orthopaedic surgeons through PMMA bone cement used in joint replacement. The British Association of Dermatologists has highlighted a UK acrylate allergy epidemic driven largely by gel and acrylic nails, with occupational sensitisation concentrated in nail beauticians and related trades. Standard nitrile gloves do not reliably block (meth)acrylate penetration, so repeated skin contact in these roles drives sensitisation rates well above the general population. Once sensitised, patients react to trace acrylate exposure in nail products, dental materials, or orthopaedic cement, explaining cross-reactivity across these seemingly unrelated professions. Why the other options are wrong: E. Teachers: no recognised occupational exposure to acrylate monomers; classroom materials do not involve uncured (meth)acrylate resins. B. Office workers: exposure is limited to cured, polymerised products (e.g. adhesives, laminates) which are essentially non-allergenic compared with uncured monomer. C. Chefs: kitchen exposures are to food, heat, and cleaning agents, not acrylate monomers; no plausible sensitisation pathway exists. D. Retail workers: handle finished, cured consumer goods rather than reactive monomer, so occupational acrylate sensitisation is not described in this group. Key point: uncured (meth)acrylate monomer is the sensitising agent, so risk tracks with occupations handling it directly (nail technicians, dentists, orthopaedic surgeons), not those exposed only to cured, polymerised acrylate products.

Reference: British Association of Dermatologists, "Dermatologists issue warning about UK artificial nail allergy epidemic", bad.org.uk