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Occupational allergic contact dermatitis of the ears caused by thiurams in a headset

A 56-year-old female was referred with a 6-month history of recurrent eczema of the auditory canal and adjacent auricle (Fig. 1a). She had been working as a secretary for more than 30 years, and her principal duty was typing dictated letters. In this function, she wore a headset with white or black rubber ear olives for more than 6-hrs a day. The eczema healed spontaneously during holidays, but relapsed within several days after she returned to work. She reported some episodes of contact dermatitis after wearing costume jewellery and perfume as a teenager, but now avoided those items. Patch testing with a Deutsche Kontaktallergie-Gruppe baseline series, rubber allergens (Allmirall Hermal, Reinbek, Germany) and her worn ear olives was performed. For patch testing, the ear olives were shaved and moistened with tap water. Allergens were applied on the upper back with Finn Chambers® on Scanpor® tape (Epitest, Tuusula, Finland) and Fixomull® stretch tape (BSN Medical, Hamburg, Germany), which were removed after 24 hr. Readings were taken on days 2, 3 and 4, according to International Contact Dermatitis Research Group guidelines. Positive reactions