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July 2014

Fingertip Purpura in a Dental Student: An Unusual Manifestation of Methyl Methacrylate Dermatitis

Author Affiliations
  • 1Department of Dermatology, Massachusetts General Hospital, Boston
JAMA Dermatol. 2014;150(7):784-785. doi:10.1001/jamadermatol.2013.8520

Methyl methacrylate (MMA) is a well-known sensitizer commonly found in dental resins, bonding agents, prosthetics, artificial nail adhesive, and industrial glues. Allergic contact dermatitis due to MMA is often seen in individuals with occupational exposure, such as those in the dental profession.

A healthy dental student in her 20s with allergies to silver, nickel, and wool presented with pruritus, pain, blistering, swelling, and numbness of the first 3 digits on her left hand. One month earlier, she had presented to her primary care physician for intense pruritus and vesicles on the left hand. Despite treatment with topical steroids for presumed eczema, her symptoms worsened, forcing her to reschedule her practical examination and present to an outside emergency department (ED) where she was treated for presumed herpetic whitlow with a 7-day course of acyclovir. Her symptoms ultimately resolved.