What is the relationship, if any, to metal working fluids?
Some chemicals act as both an irritant and a potential allergen. Metal working fluids can be irritating to the skin and also contain biocides or preservatives which are potential allergens. Often a patient can have both ICD and ACD from metal working fluids. For example a worker who tests positive to a particular biocide can change the MWF to another that does not contain the allergen. The worker may still have ongoing hand dermatitis based on the irritancy of the MWF. The treatment of ACD is really avoidance of the allergen. Once allergic, always allergic and you simply must avoid the allergen. Treatment of ICD is more difficult. Management focuses on protecting the skin from the irritant or changing the way the irritant comes into contact with the skin though a change in handling or processing, decreased exposure, or improving protective equipment. e. Can one distinguish between the rash related to ICD and that related to ACD? As answered above, generally no. There are clues but patc
