Clinical features - one or more of the following:
(1) erythematous maculopapular rash
(2) pruritic rash
(3) lichenfied plaques
(4) urticaria
(5) folliculitis
The distribution of lesions corresponds to areas of skin exposed to the fiberglass or its dust. The hands, forearms and face are commonly affected but other sites may be as well depending on the person's clothing and personal protective equipment.
If the person is continuously exposed (as in a factory) then the findings are fairly continuous (although they may improve over weekends or vacations). For a person with intermittent exposures, the rash coincides with the exposures.
Chemicals that may be associated with an allergic response:
(1) methyl ethyl ketone peroxide (a hardener)
(2) methyoxysilane
(3) cobalt napthenate
(4) styrene
(5) acrylates
In addition to people who work with fiberglass, other groups may have exposures that may not be immediately obvious:
(1) boat or watercraft builders or repairers
(2) bathtub or hot tub builders
(3) school children
(4) do-it-yourself insulation installers
(5) aircraft industry
(6) office workers
(7) automobile body shop workers
Diagnostic testing:
(1) patch testing (to sample of fiberglass and the chemicals used in the manufacture)
(2) skin scrapings of affected skin demonstrating fiberglass spicules
Differential diagnosis:
(1) abrasion
(2) foreign body reaction to fibers introduced into the skin
(3) allergic reaction to other construction materials
(4) scabies
(5) dermatophyte infection
(6) bacterial infection (Staphylococcus, Pseudomonas, etc)
