I have a rash on my eyelids, behind my ears, around my neck and inside my elbows. I was advised that it may be due to a cat allergy, but could it be caused by something in my work environment? -- Rose I.

Rashes are often associated with exposure to allergens. However, the most common cause of skin rash is the direct contact with an irritant substance or materials that contain them. This is commonly described as irritant contact dermatitis. It is responsible for 80% or more of rashes that individuals experience.

Since your rash may be due to contact irritant your exposure is likely to be associated with something that you are touching. But what?

The places on your body are your best clues. The rash occurs where the irritant comes in contact with your skin.

The rash on the inside of your elbows is a major clue. It appears that you’re placing your arms on something, as if you were working at a desk. In such work, the insides of ones elbows are a major point of contact.

The rash on your eyelids, behind your ears , and around your neck are a different matter. Do you rub your eyes, ears, and neck when you are working, particularly if you are fatigued or bored?

Your rash pattern suggests that you are working with paper products that contain a contact irritant, an irritant that is being transferred to parts of your head and neck on your hands.

It is not uncommon to develop a rash working at ones desk. Such rashes have been reported to be associated with some carbonless copy paper products, and may be associated with toners on printed materials and photocopies.

What is one to do? Firstly, evaluate whether your hand/arm behavior patterns are consistent with rashes you have been experiencing. If the answer is yes, examine materials that you are handling to identify what the irritant material may be. Does it have a chemical odor? Avoid the behavior that is causing irritant contact. Wash your hands and arms frequently if contact with paper products or other potential irritant sources can be avoided.

(Nov. 17, 1999)