NAIL VARNISH ALLERGY IN THE DIFFERENTIAL- DIAGNOSIS OF CONTACT-DERMATITIS

History and clinical findings: Case 1. A 34-year-old woman presented w ith a recurrent, itching and erythematous plaque on her right cheek. C ase 2. A 27-year-old woman reported itching erythema on her fingertips from time to time recently. Inspection revealed dyshidrosiform bliste rs. Both patients had been using nail varnish and varnish remover. Cas e 3. A 49-year-old woman had, for about 5 years, repeatedly experience d itching erythema at the perionychium of several fingers on which she had placed artificial nails. Marked oedema and erythema was noted. In vestigations: Extensive epicutaneous tests were performed on these pat ients. They showed sensitisation against important allergens in nail v arnish (toluolsulphonamide-formaldehyde resin), nail varnish remover ( benzophenone-2) and artificial nails (ethylacrylate), respectively. Th e three patients also showed type IV sensitisation against other subst ances. Diagnosis, treatment and course: Epicutaneous tests documented type IV allergies to important constituents of nail varnish, nail varn ish remover and artificial nails. Symptoms and skin changes disappeare d when these three items were no longer used. Conclusion: Allergies ag ainst nail varnish and its remover and against artificial nails should be included in the differential diagnosis of skin allergies, even whe n patients have additional type IV sensitisations against common aller gens. As the causative allergen can be easily avoided, knowledge of th e particular problems associated with these allergies is of a great pr actical significance.