Occupational allergic contact dermatitis to Hydrangea in an Italian florist

A 49-year-old non-atopic man presented at our department with itchy hand eczema (Figure 1). Physical examination revealed severe scaling, xerosis, and fissures of the dorsum of his right hand and first, second, third, and fourth fingers; his left hand was affected only on the third finger. The patient reported that his hand eczema always disappeared during time off work and always recurred within a few days after returning to work. He had been employed since 2010 as a florist, but stated that the skin lesions had appeared when he started processing and handling Hydrangea spp. He denied the use of any protective device. [...]