The spectrum of occupational skin diseases will be illustrated. Ninety five percent of cases are contact dermatitis, of which up to 80% is irritant contact dermatitis (ICD). Cumulative ICD, in contrast to acute ICD and chemical burns, is the most common type and develops slowly after additive, sub threshold exposures to mild irritants (e.g. soap, water, detergents, industrial cleansers, and solvents) under a variety of conditions. Allergic contact dermatitis (ACD) is the next most frequent disorder accounting for about 20% of contact dermatitis cases. Major occupational contact allergens include biocides (e.g. isothiazolones and formaldehyde releasing chemicals), chromate, cobalt, colophony, dyes, epoxy resins, formaldehyde and formaldehyde resins, fragrances and essences, nickel, plants and woods, and rubber processing chemicals. Other disorders include contact urticaria, photosensitivity, acne and folliculitis, increased and decreased pigmentation, ulcerations, granulomas, and neoplasms.

Essential to evaluating and managing occupational skin diseases are:
1) Accurate diagnosis, including underutilized procedures to identify allergy (patch and photo patch testing, and serologic and cutaneous tests for contact urticaria);
2) Determining causation or work relatedness of disease;
3) Recommendations for a) medical therapy, b) prevention {environmental (hazard identification, substitution, and other industrial hygiene and environmental engineering methods), personal (chemical protective clothing, cleansers and barrier agents), and medical (initial and periodic examination, workplace accommodation, etc)}, c) job placement, d) impairment and disability evaluation, and e) rehabilitation.

Key to management of occupational skin disease is health risk assessment:
1) Hazard identification,
2) Dermal exposure assessment,
3) Dose response assessment, and
4) Risk characterization.