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A 30-year-old chemical process worker presented with an itchy red scaly rash affecting his right thumb. The appearance was of a severe irritant dermatitis. Careful history taking and a detailed assessment to his personal pretective gloves and of his workplace did not reveal any potential cause.
Eventually the physician enquired about other activities. It transpired that he had purchased an acetoxysilane-based filler for crackle between his bath and the surrounding tiles, and had used his bare thumb as the grouting tool. The physician explained that this activity was equivalent to pickling his thumb in vinegar. He stayed off work for a week and applied aqueous cream to his skin while it healed.
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