“I itch and I know it's my work.” But what caused his work itch? A twenty-one-year-old man showed us a very itchy red rash on his forearms, lower legs, and eyelids. It had started twelve days before, within hours after returning from vacation to his job in a wholesale florist supply shop. The rash had become worse every day and was now so severe that he had missed work for the past six days.

He had worked in this shop for six years, with only one previous attack of dermatitis, four months ago. No cause had been found for the rash, and it had responded to steroid injections from his family doctor. The patient was in good health, but had known sensitivities to poison ivy and bee stings.

Originally, he had had small blisters, but now only scratch marks remained on his inflamed skin. We suspected an occupational dermatitis, because he had not been exposed to poison ivy on his vacation. He remained off work for four more days. Back at work he was fine the first day, but the next day the itch became worse and was especially severe in the finger webs.

We saw him a week later, when our scrapings of the fingerwebs ruled out scabies. He denied all exposure to solvents, harsh soaps, fiberglass, and epoxy resins, but did have to handle a wide variety of plants at work.