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In a household appliance plant, several rinse-free lubricating fluids have been used instead of neat mineral oils since 1994: mixtures of isoparaffinic hydrocarbons with 9 to 14 carbons per molecule. As such they denature keratin, irritate and defat the skin, and remove water from it. Work gloves have been worn over plastic gloves and separate, reusable, cotton inner gloves have been added to absorb sweat since skin problems were first recognized in 1994. All 74 males (mean ± SD, 38.8 ± 8.0 years) who work with the fluids were interviewed and given cutaneous examinations when indicated. While 4 cases of severe dermatitis and 31 cases of mild dermatitis were identified, 28 individuals gave a history of similar problems since the use of lubricating fluids. Their symptoms were typical of primary skin irritation. The hands were the commonly affected region (63 of 63 cases: 100%), followed by the thighs (15.9%) and trunk (11.1%). The work-related skin symptoms identified were less common in workers who immediately removed the liquid with soap and water, when it is spilled on the hands, than in those who did not, but the difference was not statistically significant (7/23 (30.4%) vs. 28/51 (54.9%), p=0.051 by chi-square test). Since skin contact with metalworking fluids (MWF) is often unavoidable, good personal hygiene is important in minimizing potential adverse health effects. Health education thus remains the most important preventive measure against irritant contact dermatitis among workers handling MWFs.

A bullous eruption is now recognized as a specific complication of systemic lupus erythematosus (SLE). We described a 22-year-old woman with SLE whose vesiculobullous eruptions exacerbated with a flare of visceral manifestations of the disease and resolved when the systemic disease was controlled by oral prednisolone.

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