[Psoriasis following contact with rubber gloves in a patient sensitized to rubber additives].

were performed according to the guidelines of the Spanish Contact Dermatitis Research Group (abbreviated in Spanish to GEIDAC) using the standard GEIDAC series and a rubber series (Chemotechnique, Malmö, Sweden). Readings at 48 and 96 hours were positive (++) for the carba mix, the thiuram mix, the black rubber mix, tetramethylthiuram monosulfide, tetramethylthiuram disulfide, N-cyclohexylN-phenyl-4-phenylenediamine, and N-isopropyl-N-phenyl4-phenylenediamine (Figure 2). The patch test reactions were clearly eczematous and were not biopsied. A skin prick test for latex was negative. The lesions disappeared almost completely when the patient was assigned to another work station and started to wear vinyl gloves; just a few small plaques persisted on the elbows and back of the hands. There have been reports of psoriasis exacerbation on the hands attributed to a Koebner phenomenon (a relatively common and well-known response) following irritant contact dermatitis.1 Psoriasis flare-ups following ACD are much rarer but have also been attributed to a Koebner response in patients with existing psoriasis.2-5 Hyperkeratotic eczema is a well-known manifestation of ACD to different rubber additives and black rubber mix (antioxidant amines).6 In our case, however, considering the histology and clinical findings (psoriasiform plaques on the back of the hands) and the presence of generalized lesions, we believe that our patient had psoriasis. The prevalence of skin sensitization in patients with psoriasis is a matter of debate. While several authors have reported higher prevalence in these patients compared to the general population,7 others have reported similar or even lower levels.8,9 In the case reported here, the patient’s reaction to the rubber additive patch tests was clearly relevant considering that he wore rubber gloves at work and showed marked improvement when he stopped using these gloves. Although there have been reports of psoriasis flare-ups following ACD due to rubber additives, the case we describe