Occupational opiate contact dermatitis.

Two female laboratory workers aged 38 and 58 years were employed for 18 and 7months, respectively, in a pharmaceutical company that manufactures several opiates. Both handled morphine and codeine. The first one also worked with dihydrocodeine, and the second one with naltrexone. Both developed papulovesicular contact dermatitis with an airborne pattern. Patch tests were performed according to ICDRG criteria (2), with the products from the plant at different concentrations (0.01–5% or 10%) in pet. and aq., respectively. The products tested were morphine, codeine, thebaine, ethylmorphine, naloxone, and oxycodone. Prick and intradermal tests were also performed with synthetic products such as alfentanil, sufentanil, fentanyl, and tramadol. All substances tested in water gave negative results (0.01–10%). Both cases showed positive patch test reactions to codeine 5% pet. (+), which was still positive on D9 for case 2, and ethylmorphine 1% and 10% pet. (+). Case 1 also showed positive patch test reactions to morphine [(+) for a 0.1% dilution and (++) for higher