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Occupational protein contact dermatitis — SCE Dermatology MCQ

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HardCutaneous allergyOccupational protein contact dermatitisSCE Dermatology

A baker develops urticated hand swelling within minutes of handling dough, later eczematous fissuring, and work-related wheeze. Baseline patch testing is negative. Which investigation best addresses the suspected mechanism?

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Correct answer: E — Skin-prick testing to relevant flour proteins

The immediate contact reaction and respiratory symptoms indicate IgE-mediated protein contact dermatitis with possible occupational asthma. Skin-prick testing or specific IgE to wheat, rye and relevant enzymes evaluates immediate sensitisation; conventional patch testing evaluates delayed type IV allergy.

Reference: https://academic.oup.com/bjd/pages/bad-guidelines