MOMMY RN DERMATITIS

INTRODUCTION: The COVID-19 pandemic has highlighted the importance of hand hygiene and led to the increased use of sanitizing gels and wipes. Here we describe a case of contact dermatitis due to sanitizing gels and wipes which was misdiagnosed as eczema for 3 years. CASE DESCRIPTION: A 40-year-old Guyanese female presented for evaluation of pruritic rash. She has seen several dermatologists and diagnosed with eczematous dermatitis. She has been prescribed topical 0.1% triamcinolone and a course of oral steroids with temporary improvement in symptoms. She had tried oral antihistamines with no improvement. On interview, she reported a rash predominantly on her hands which began in early 2020 and had worsened in the past year. Social history is significant for working as a registered nurse and having a baby 9 months ago. She admitted to frequent use of Clorox wipes without gloves at home since her baby was born. On exam she had numerous small papules with flare on bilateral dorsal hand, forearm, right orbit, and upper back. Patch testing was done and positive for benzyl alcohol. We recommended she use soap and water to clean her hands, avoid alcohol gels, and use gloves when using antiseptic wipes. She had abrupt improvement in symptoms. DISCUSSION: This case emphasizes the importance of cleaning gels and wipes as a cause of contact dermatitis. It particularly important to remember in the context of healthcare workers who frequently clean their hands, new parents who may using sanitizing wipes more often, and people with darker colored skin.