History: These are the hands of a young first year apprentice hairdresser who is allergic to nickel and paraphenylenediamine the allergen in hair dye.First year hairdressers do a lot of shampooing.Hence they often have an irritant dermatitis but sudden onset of swollen, painfull hands like this suggests an acute contact dermatitis and patch testing is mandatory.These hands are swollen,painfull and infected.Oral steroids and antibiotics are necessary to settle the problem down quickly. Latex glove dermatitis should also be tested for in this situation.