We describe the clinical presentation and management of an anesthesiologist who developed a severe
allergic contact dermatitis resulting from occupational exposure to tincture of
benzoin aerosol spray. A previously healthy male anesthesiologist with a small
laceration between his right thumb and forefinger used a tincture of
benzoin aerosol spray to improve adhesion of a small
bandage immediately before performing a spinal
anesthetic. He had previously used
benzoin for skin reinforcement on several occasions during weight-lifting. The anesthesiologist experienced severe
pruritus in the affected hand 48 h after
benzoin exposure. A well-demarcated, bright red erythematous confluent vesicular
dermatitis with and without painful hemorrhagic
bullae erupted on the palmar and dorsal surfaces, respectively, of his hand, accompanied by pronounced
edema. The palmar
bullae were drained with several small incisions and the anesthesiologist was treated with intravenous
methylprednisolone. He was unable to work for 10 days while the
dermatitis gradually resolved. The case emphasizes that occupational exposure to
benzoin represents a potential risk for operating room personnel who may be susceptible to cutaneous
delayed hypersensitivity-mediated
allergic reactions as a result of previous exposure to
benzoin or chemically related cross-reacting substances.