Microfragments of silica embedded in the outer layers of the skin were detected by dark-field microscopy of superficial skin biopsies. Transfer from silicon hair curlers handled in the patient's occupation as a hairdresser was facilitated by the fact that daily contacts with alkaline hair sets and waving solutions served to soften the stratum corneum and epidermis. Precise and exactly localizable micropoints of hyperesthesia were identified. Cure was provided by a superficial razor shave biopsy. Prophylaxis must center on avoidance of the new silica rollers.
Shelley WB, Pillsbury DM. FINGERTIP HYPERESTHESIASOLITARY SIGN OF NEW OCCUPATIONAL DERMATOSIS DUE TO SILICA HAIR CURLERS. JAMA. 1959;170(15):1779-1781. doi:10.1001/jama.1959.03010150023006