Essential Oils from Citrus Peel as Causes of Occupational Contact Dermatitis: A Case Report

Occupational contact dermatitis is a common condition among individuals who handle plant-based substances, yet reports involving citrus essential oils in food and beverage workers are scarce. We present a 47-year-old bartender with a 19-year history of chronic hand eczema, improving only during vacation periods. Patch testing revealed positive reactions to lemongrass, lemon essence, neroli essence, and geraniol, implicating lemon and orange peel essential oils as causative agents. The lesions' distribution corresponded to the patient’s handling of citrus fruits, and perioral involvement was likely due to airborne particles. Management with topical corticosteroids, oral antihistamines, and protective measures resulted in clinical improvement. This case highlights the need to consider citrus essential oil sensitization in individuals with chronic hand eczema exposed to citrus fruits, including cooks, bartenders, and fruit handlers.