Dermatitis of the hands in caterers

Hand eczema among 50 caterers was occupational in 47 and endogenous in 3 cases. Irritants were considered more important than sensitisers. There was a correlation between atopy and sensitisation to type-I but not type-IV allergens. The commonest type-I sensitiser was fish and for type-IV was garlic. Dilutions of garlic and of onion 50% in arachis oil were not irritant and seemed effective patch test materials. The prognosis was not good and the hand eczema continued even in some of those who changed their jobs.