A rare case of coexistence of occupational airborne
dermatitis with
rosacea is presented in a 41-year-old female farmer. Her first
dermatitis symptoms appeared at the age of 10 when she started helping her parents on the farm. Uncovered skin areas of the face, neck, décolleté, forearms and the hands gradually became involved. The
dermatitis symptoms were provoked by agricultural dusts (especially of flax and dried herbs). For the subsequent 30 years, the work-related disease remained undiagnosed due to the lack of pre-employment and periodical health check in agriculture. She also suffered from
protein contact dermatitis of the hands from cow epithelium. About 20 years after the onset of airborne
dermatitis,
rosacea developed, possibly secondary to the prolonged treatment. Diagnostic tests carried out at our department confirmed
hypersensitivity to occupational
allergens: type I
allergy to storage mites, moulds, and cow epithelium. A cutaneous late-phase reaction on prick tests and serum
precipitins to the bacterium Pantoea agglomerans (Erwinia herbicola) also were found. Among non-occupational
hypersensitivities, type I allergy to house dust mites and contact
allergy to
methylchloroisothiazolinone/
methylisothiazolinone (
Kathon CG) was found. In connection with these results, the significance of agricultural dusts in farmers' airborne
dermatitis is discussed. Also presented are the problems with obtaining acceptance from the State Sanitary Authority for qualification of this case as an
occupational disease, which was due to the coexistence of the non-occupational
rosacea. Discussed is also the problem of pre-employment exposure to occupational
allergens among farmers' children, and the difficulties with delivering occupational health services to self-employed farmers.