Dermatology: Practical and Conceptual Image Letter | Dermatol Pract Concept. 2024;14(4):e2024255 1 Elaioconiosis: An Uncommon Dermatoses of a Common Occupation Arjun Prakashey¹, Gitesh U. Sawatkar¹, Prerna Nagi¹ 1 Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences (AIIMS), Nagpur, India Citation: Prakashey A, Sawatkar GU, Nagi P. Elaioconiosis: An Uncommon Dermatoses of a Common Occupation. Dermatol Pract Concept. 2024;14(4):e2024255. DOI: https://doi.org/10.5826/dpc.1404a255 Accepted: July 1, 2024; Published: October 2024 Copyright: ©2024 Prakashey et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding Author: Dr. Gitesh U. Sawatkar, Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences (AIIMS), NAGPUR, 441108 India. Tel: +91-8872479565 E-mail: drgitesh@gmail.com Case Presentation A 21-year-male presented with complain of an asymptom- atic rash over both hands extending to his elbows. Cutane- ous examination revealed monomorphic open comedones symmetrically arranged on dorsal aspect of both hands ex- tending to the forearms (Figure 1A). As a mechanic, the pa- tient had frequent exposure to occupational oils and greases. Dermoscopy displayed monomorphic comedoniform black dots arranged in whorls, localized at follicular openings (Figure 1B). The clinical and dermoscopic morphology on the background of associated occupation led to the diagno- sis of elaioconiosis. After comedone expression, standard therapy consisting of topical retinoids and urea-containing creams was advised. The patient was counseled regarding use of protective gloves while working and to avoid direct contact with oils and grease. Teaching Point Occupational acne is caused by professional contact with chemical substances as well as by the action of environmental physical agents. Potentially all the follicles of the body may be affected [1]. Prolonged contact with oils leads to follicular irritation, with reactive hyperkeratosis and sebum retention leading to formation of such lesions [1]. Elaioconiosis is an acneiform eruption affecting mechanics and metal industry workers exposed to cutting oils [2]. Fortunately, the occur- rence of oil acne has declined primarily due to raised aware- ness, the increased use of gloves and personal protective equipment, and implementation of automated technology. Elaioconiosis is a substantially underreported occupa- tional dermatosis. Such uncommon presentation can at times be overlooked and lead to delay in treatment. By reporting this case we aim to raise awareness for early diagnosis and treatment of such cases. 2 Image Letter | Dermatol Pract Concept. 2024;14(4):e2024255 References 1. Kokelj F. Occupational acne. Clin Dermatol. 1992 Apr-Jun; 10(2):213-7. DOI: 10.1016/0738-081x(92)90108-b. PMID: 1393957. 2. Valgas N, Salaro CP, Bornhausen-Demarch E, Bonora CJ, Broce AA. Elaioconiosis--case report. An Bras Dermatol. 2011 Jul-Aug;86(4 Suppl 1):S53-6. English, Portuguese. DOI: 10.1590 /s0365-05962011000700013. PMID: 22068771. Figure 1. (A) Multiple bilateral symmetrical open comedones on both dorsal hands. (B) Multiple follicular black dots without any background inflammation and in a whorl-like arrangement (inset).