A 40-year-old patient presents with a rash on his hands, as shown. It has developed in the past 6 months and is gradually becoming more severe. He describes intense pruritus. The patient is a construction worker, working primarily with concrete. He was prescribed clobetasol ointment, which provides some relief but does not clear the rash. He notes that he recently took a week-long vacation at a resort in the Dominican Republic, and notes that his hands had improved at the end of the vacation, but flared again after he returned. Which of the following is most likely allergen to react on patch testing?

A. Carba mix

B. Formaldehyde

C. Potassium dichromate

D. Nickel sulfate

E. Thimerosal

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