Contact allergy to an organic solvent: Immediate sensitivity and serum-sicknesslike reaction

A 30-year-old sewing machine operator began to develop hives after the introduction of a solvent (N355) used to clean the sewing machine. She also described individual lesions requiring 2–3 weeks to resolve along with joint pain that began 1–2 days after the hives had developed. Routine patch testing was negative except for gold, which was not believed to be relevant. Patch testing for immediate hypersensitivity to N355 was positive. At 48 hours, she was noted to have a nonpalpable purpuric area at the site of testing.