An adult with allergic contact dermatitis Name: Sophie Age: 26 years History: For as long as she can remember, Sophie has developed a rash about 24 hours after she has applied a sticking plaster. It is extremely itchy and lasts for some time after she has removed the plaster. The rash is usually roughly plaster-shaped, although sometimes it spreads slightly. Sophie also gets rashes under her underwear straps if they contain metal or rubber, and a rash on her ears and neck from earrings and necklaces. She is young, with an active social life. She often buys herself fashion jewellery, as she likes to keep up with the latest trends. She has guessed that she might be allergic to this jewellery. Sophie also appears to be allergic to make-up; her eyelids often puff up when she uses it, and she gets a rash on her hands after applying it. This causes her problems at work because she is a secretary and she finds typing painful when she has her rash on her hands. She has tried putting creams, and even emollients, on her rash, but these do not help and can even make it worse. Diagnosis: Sophie goes to her doctor for help. The doctor confirms that she has allergic contact dermatitis. Management: Sophie's doctor realises that it is not practical to tell her to stop wearing her jewellery and make-up. He tells her that he cannot really help, beyond advising Sophie to buy gold or hypo-allergenic jewellery and non-allergenic make-up and sticking plasters, all of which he realises are more expensive than normal products. Prognosis: Sophie is likely to have allergic contact dermatitis for the rest of her life.