SOLVING the mystery of an unexplained dermatitis calls not only for informed curiosity on the part of the physician, but also for careful detective work on the part of a well-instructed patient. In this instance, the combination of these two avenues of inquiry led to an awareness of a new vector for skin disease.
Report of a Case
A 21-year-old man presented with a pruritic erythematous eruption of the volar forearms, lower parts of the legs, and eyelids, present with increasing severity for 12 days. It had appeared suddenly within hours of returning from vacation to his work in a wholesale florist supply shop. Severe pruritus had prevented him from working for the past six days.He had worked for six years in this shop, with only one prior attack of dermatitis occurring four months previously. The cause had remained unexplained and he had been treated successfully with intramuscular steroid
Shelley WB, Shelley ED, Welbourn WC. Polypodium Fern Wreaths (Hagnaya): A New Source of Occupational Mite Dermatitis. JAMA. 1985;253(21):3137–3138. doi:10.1001/jama.1985.03350450109032
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