Occupational dermatitis in hairdressers - influence of individual and environmental factors.
Carøe, Tanja K; Ebbehøj, Niels E; Agner, Tove
2017-03-01
Hairdressers are at risk of developing occupational contact dermatitis because of their intense contact with wet work in combination with chemicals. To perform an analysis of a cohort study of hairdressers with occupational contact dermatitis recognized in the period 2006-2011, focusing on individual and environmental factors associated with the disease. The study was a descriptive, register-based survey including all hairdressers with recognized occupational contact dermatitis in Denmark in the period January 2006 to September 2011. Data were obtained from the Danish National Board of Industrial Injuries. The study comprised 381 patients (373 women and 8 men). The median age was 25 years, 64.8% were apprentices, and 35.2% were fully trained hairdressers. The prevalence of atopic dermatitis was 36.0%, and was significantly higher among apprentices than among fully trained hairdressers (44.9% and 19.4%, respectively) (p < 0.001). Of the patients, 48.3% had their dermatitis recognized as occupational irritant contact dermatitis, 46.7% had their dermatitis recognized as as occupational allergic contact dermatitis or combined allergic and irritant contact dermatitis, and 5.0% were recognized as having occupational contact urticaria. The low median age, the high percentages of atopic dermatitis in apprentices and the fact that more apprentices than fully trained hairdressers had recognized occupational contact dermatitis underlines the importance of early prevention. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Febriana, Sri Awalia; Jungbauer, Frank; Soebono, Hardyanto; Coenraads, Pieter-Jan
2012-11-01
Tannery workers are at considerable risk of developing occupational contact dermatitis. Occupational skin diseases in tannery workers in newly industrialized countries have been reported, but neither the prevalence of occupational allergic contact dermatitis nor the skin-sensitizing agents were specifically examined in those studies. To assess the prevalence of occupational allergic contact dermatitis in Indonesian tanneries, identify the causative allergens, and propose a tannery work series of patch test allergens. A cross-sectional study in all workers at two Indonesian tanneries was performed to assess the prevalence of occupational contact dermatitis via a questionnaire-based interview and skin examination. Workers with occupational contact dermatitis were patch tested to identify the causative allergens. Occupational contact dermatitis was suspected in 77 (16%) of the 472 workers. Thirteen (3%) of these 472 workers were confirmed to have occupational allergic contact dermatitis. Potassium dichromate (9.2%), N,N-diphenylguanidine (5.3%), benzidine (3.9%) and sodium metabisulfite (2.6%) were found to be the occupationally relevant sensitizers. The sensitization pattern showed some differences from the data in studies reported from other newly industrial countries. We compiled a 'tannery work series' of allergens for patch testing. A number of these allergens may also be considered for patch testing in patients with (leather) shoe dermatitis. © 2012 John Wiley & Sons A/S.
[News on occupational contact dermatitis].
Crépy, Marie-Noëlle; Bensefa-Colas, Lynda
2014-03-01
Contact dermatitis--irritant contact dermatitis, allergic contact dermatitis and protein contact dermatitis--are the most common occupational skin diseases, most often localized to the hands. Contact urticaria is rarer The main occupational irritants are wet work, detergents and disinfectants, cutting oils, and solvents. The main occupational allergens are rubber additives, metals (chromium, nickel, cobalt), plastics (epoxy resins, acrylic), biocides and plants. Diagnosis is based on clinical examination, medical history and allergy testing. For a number of irritating or sensitizing agents, irritant or allergic dermatitis can be notified as occupational diseases. The two main prevention measures are reducing skin contact with irritants and complete avoidance of skin contact with offending allergens.
Cost-of-illness of patients with contact dermatitis in Denmark.
Saetterstrøm, Bjørn; Olsen, Jens; Johansen, Jeanne Duus
2014-09-01
Contact dermatitis is a frequent occupational and non-occupational skin disease. To investigate the effects of contact dermatitis on labour market affiliation and societal costs in terms of healthcare costs and production loss. A total of 21 441 patients patch tested either in hospital departments or at dermatological clinics in the period 2004-2009 were included in the study. The analyses were stratified by children (age 0-15 years), occupational contact dermatitis (age 16-65 years), and non-occupational dermatitis (age ≥ 16 years). Controls were selected from a 30% random sample of the population. Individual encrypted data were retrieved on healthcare utilization, socio-demographics, education, labour market affiliation and transfer payments from public registers in Denmark for cases and controls. Attributable healthcare costs for 4 years prior to patch testing (1 year for children) and the year after patch testing were €959 for children, €724 for occupational contact dermatitis, and €1794 for non-occupational dermatitis. Productivity costs for the same period were €10 722 for occupational contact dermatitis and €3074 for non-occupational contact dermatitis. The main findings of this study were that there were statistically significant attributable healthcare costs for both children and adults, and statistically significant productivity loss for adults. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Epidemiological analysis of occupational dermatitis notified in Brazil in the period 2007 to 2012.
Plombom, Gabriela Yumi; Oliveira, Mariana Santos de; Tabushi, Fernanda Lika; Kassem, Amanda Joekel; Purim, Kátia Sheylla Malta; Nisihara, Renato Mitsunori
2016-01-01
Occupational dermatitis affects the quality of life and productivity of workers. Studies on the subject are scarce in Brazil. It is estimated that the disease is underreported and that many affected patients do not seek health care. To conduct an epidemiological analysis of occupational dermatitis notified via SINAN in Brazil from January 2007 to December 2012; evaluate the profile of patients assisted; and check the main etiological agents involved. We analyzed the compulsory notification forms of cases of occupational dermatitis filled nationwide during January 2007 to December 2012. During the study period 3027 cases of occupational dermatitis were notified in Brazil. In 61.4% of cases patients were men aged between 35-49 years (39.6%). The most described etiological agent was chromium (13.9%). The location of the body most affected was the hands, with 28.4% of cases. The construction sector is implicated in 28.7% of cases and domestic services by 18%. Allergic contact dermatitis is the most prevalent occupational dermatitis (20.6%) and the region with the highest number of notifications was the Midwest, with 376.4 cases per million inhabitants. The profile of patients most affected by occupational dermatitis in Brazil during the study period was: men with elementary school, aged between 20 and 49 years old and working in the construction industry. The most common occupational dermatitis were allergic contact dermatitis caused by chromium after years of exposure, being the hands and head the parts of the body most affected.
Pesonen, Maria; Jolanki, Riitta; Larese Filon, Francesca; Wilkinson, Mark; Kręcisz, Beata; Kieć-Świerczyńska, Marta; Bauer, Andrea; Mahler, Vera; John, Swen M; Schnuch, Axel; Uter, Wolfgang
2015-03-01
Occupational contact dermatitis is one of the most common occupational diseases in Europe. In order to develop effective preventive measures, detailed and up-to-date data on the incidence, main causes and professions at risk of occupational contact dermatitis are needed. To describe the pattern of patch test reactivity to allergens in the European baseline series of patients with occupational contact dermatitis in different occupations. We analysed data collected by the European Surveillance System on Contact Allergy (ESSCA) network from 2002 to 2010, from 11 European countries. Allergens in the European baseline series associated with an at least doubled risk of occupational contact dermatitis include: thiuram rubber chemical accelerators, epoxy resin, and the antimicrobials methylchloroisothiazolinone/methylisothiazolinone, methyldibromo glutaronitrile, and formaldehyde. The highest risk of occupational contact dermatitis was found in occupations classified as 'other personal services workers', which includes hairdressers, nursing and other healthcare professionals, precision workers in metal and related materials, and blacksmiths, tool-makers and related trades workers. In the planning and implementation of measures aimed at preventing occupational contact dermatitis, the focus should be on the identified high-risk occupational groups and the most common occupational allergies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Epidemiological analysis of occupational dermatitis notified in Brazil in the period 2007 to 2012*
Plombom, Gabriela Yumi; de Oliveira, Mariana Santos; Tabushi, Fernanda Lika; Kassem, Amanda Joekel; Purim, Kátia Sheylla Malta; Nisihara, Renato Mitsunori
2016-01-01
BACKGROUND Occupational dermatitis affects the quality of life and productivity of workers. Studies on the subject are scarce in Brazil. It is estimated that the disease is underreported and that many affected patients do not seek health care. OBJECTIVES To conduct an epidemiological analysis of occupational dermatitis notified via SINAN in Brazil from January 2007 to December 2012; evaluate the profile of patients assisted; and check the main etiological agents involved. METHODS We analyzed the compulsory notification forms of cases of occupational dermatitis filled nationwide during January 2007 to December 2012. RESULTS During the study period 3027 cases of occupational dermatitis were notified in Brazil. In 61.4% of cases patients were men aged between 35-49 years (39.6%). The most described etiological agent was chromium (13.9%). The location of the body most affected was the hands, with 28.4% of cases. The construction sector is implicated in 28.7% of cases and domestic services by 18%. Allergic contact dermatitis is the most prevalent occupational dermatitis (20.6%) and the region with the highest number of notifications was the Midwest, with 376.4 cases per million inhabitants. CONCLUSIONS The profile of patients most affected by occupational dermatitis in Brazil during the study period was: men with elementary school, aged between 20 and 49 years old and working in the construction industry. The most common occupational dermatitis were allergic contact dermatitis caused by chromium after years of exposure, being the hands and head the parts of the body most affected. PMID:28099592
Fathi, Fatemeh; Jafarpoor, Moslem
2013-01-01
Skin disorders comprise more than 35% of all occupationally related diseases. 90-95% of work-related dermatoses are contact dermatitis. Effects of occupational dermatitis in the lives of workers are substantial. To plan any preventive program we need basic statistics of the problem, that we had no reliable one which includes a lot of industries in Iran. Therefore we decided to determine occupational contact dermatitis, and it's subtypes prevalence in various jobs. The objective of this study is determination of occupational contact dermatitis, and it's subtypes prevalence and comparison among various jobs. In this cross -sectional study, we examined 3061 workers of various industries during 2007-2012 and recognized contact dermatitis cases. Irritant and allergic cases were separated according to clinical judgment of physician and patch test using European standard series. We found 271 (prevalence=8.8%) occupational contact dermatitis cases which 247 (91.1%) were irritant, and the rest were allergic. The highest prevalence was in washing powder production and then glaze and paint workers, mechanists and chemical workers were located. There is a great variability for occupational contact dermatitis in various industries and between different countries. These statistics changes during the time by changing in number of workers and their characteristics, variation in material and process and glove use situation. So every country must have a national data bank of occupational contact dermatitis, which must be updated after a period of time.
Occupational contact dermatitis.
Lushniak, Boris D
2004-01-01
The dermatologist should be aware of the many facets of occupational skin diseases, which can be caused by physical, chemical, and biological insults. The most common manifestation of occupational skin diseases is contact dermatitis (both irritant and allergic). Three factors point out the importance of occupational skin diseases as diseases that have a public health impact: 1) occupational skin diseases are common; 2) they often have a poor prognosis; and 3) they result in a noteworthy economic impact for society and for an individual. They are also diseases amenable to public health interventions. Specific industries and exposures may put a worker at risk of occupational contact dermatitis. The accuracy of the diagnosis of occupational contact dermatitis is related to the skill level, experience, and knowledge of the medical professional who makes the diagnosis and confirms the relationship with a workplace exposure. Prevention of occupational contact dermatitis is important, and a variety of prevention strategies are available.
Pestana, Catarina; Gomes, Raquel; Pinheiro, Vítor; Gouveia, Miguel; Antunes, Isabel; Gonçalo, Margarida
2016-08-01
Allergic contact dermatitis, along with irritant contact dermatitis and immediate contact reactions, contact urticarial, are the most frequent dermatological occupational disease, but seldom reported to the National authorities. We performed a 3-year retrospective study at the allergology section in the Dermatology Clinic of the University Hospital of Coimbra to evaluate the main occupations diagnosed as occupational allergic contact dermatitis, most common allergens and the effect of the modification of the work station in the evolution of the disease. During 2012 - 2014 among the 941 patch tested patients, 77 (8.2%) were diagnosed with occupational allergic contact dermatitis, with 169 positive patch tests related to occupational exposure, 55 detected within the baseline and 114 in complementary test series. In most cases allergic contact dermatitis involved the hands (88.3%), main professional activities were nail estheticians and hairdressers due to the manipulation of (meth)acrylates, the most common allergen in the study. After the diagnosis, 27.3% abandoned the work, 23.4% changed the work station, 49% avoided exposure to the responsible allergen. Contact dermatitis resolved in 39% of the patients, improved in 39% but had no change in the remaining 22%. This study, although including only patients from the center of Portugal, evaluates a large sample of patients with different occupations studied with a larger variety of allergens. Apart from classical allergens and professions responsible for occupational allergic contact dermatitis that we found in lower numbers (thiuram mix, paraphenylenodiamine, chromium and cobalt in health care workers, hairdressers and in the building industry), (meth)acrylates tested outside the European and Portuguese Baseline Series were the main cause of occupational allergic contact dermatitis, namely in nail estheticians. Methylisothiazolinone, the second more frequent occupational contact allergen in the present study was identified in different occupations as a result of the widespread use of this preservative that is causing a real 'epidemics' of allergic contact dermatitis all over Europe in the last years. Nail estheticians are not usually referred as an occupation with a high risk of developing allergic contact dermatitis. Nevertheless, the current fashion combined with professionals poorly informed about the risk of their activity and the high sensitizing potential of (meth)acrylates, leads to a higher frequency of allergic contact dermatitis in recent years.
Pattern of occupational allergic dermatitis in the Dermatology Clinic, Hospital Kuala Lumpur.
Rohna, R; Ganesapillai, T; Salbiah, D; Zaiton, I
1999-03-01
A two years retrospective analysis of patients diagnosed as contact allergic dermatitis with positive patch test attending the Dermatology clinic was performed. Of the 346 patients with a positive patch test, 14% had occupational dermatitis. This condition affected mainly young and inexperienced workers. An inverse relationship was seen between age and prevalence of occupational allergic dermatitis. Allergic hand dermatitis was the commonest presentation in occupational allergic dermatitis. This was followed by dermatitis of the exposed skin (face, neck, hands and forearms). The common sensitising agents identified were rubber chemicals and nickel. The two main groups at risk were factory workers and medical personnel. The common allergens found in factory workers were epoxy resin, pewter, nickel and rubber chemicals. Exposure dermatitis occurred in patients working in the pewter industry. Two thirds of medical personnel with hand dermatitis were allergic to rubber gloves. One year follow up after patch testing showed that 19% of patients still suffered from chronic dermatitis. Dermatitis improved in 34% of patients. Forty-seven percent were cured and stopped attending the clinic after patch testing and adequate counselling.
Occupational poison ivy and oak dermatitis.
Epstein, W L
1994-07-01
Among the growing and diverse groups of outdoor and environmental workers, poison ivy and poison oak continue to be the major cause of occupational contact dermatitis. This article reviews the practical and theoretic means to prevent poison ivy and poison oak dermatitis in workers occupationally exposed to these weeds.
Warshaw, Erin M; Hagen, Solveig L; DeKoven, Joel G; Zug, Kathryn A; Sasseville, Denis; Belsito, Donald V; Zirwas, Matthew J; Fowler, Joseph F; Taylor, James S; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Maibach, Howard I; Mathias, C G Toby
Little is known about the epidemiology of contact dermatitis in production workers (PWs). The aims of this study were to estimate the prevalence of contact dermatitis and characterize clinically relevant and occupationally related allergens among North American PWs undergoing patch testing. This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1998 to 2014. Of 39,332 patch-tested patients, 2732 (7.0%) were PWs. Among PWs, most were men (62.4%) and white (83.9%). A history of childhood eczema was uncommon (11.3%). Prevalent occupations included machine operators (27.3%); fabricators, assemblers, and hand-working occupations (16.8%); and precision metalworking occupations (16.1%). The most frequent sites of dermatitis were the hands (53.8%) and arms (29.4%), which were significantly more commonly affected compared with non-PWs (P < 0.0001). Occupationally related skin disease, allergic contact dermatitis, and irritant contact dermatitis were also significantly more common in PWs (49.9% vs 10.6%, 58.9% vs 53.7%, and 32.7% vs 25.7%, respectively; all Ps < 0.0001). Epoxy (15.3%), thiuram mix (8.3%), carba mix (8.1%), formaldehyde (6.3%), and cobalt (5.9%) were the most frequent occupationally related allergens. The top allergen sources included adhesives/glues (16.0%), metalworking fluids/cutting oils (6.8%), and coatings (6.3%). Production workers had a high rate of occupationally related skin disease, as well as irritant and allergic contact dermatitis. Involvement of exposed body areas was common. Frequently identified allergens included adhesives/glues, rubber accelerators, metals, and preservatives.
Schwensen, Jakob F; Menné, Torkil; Veien, Niels K; Funding, Anne T; Avnstorp, Christian; Østerballe, Morten; Andersen, Klaus E; Paulsen, Evy; Mørtz, Charlotte G; Sommerlund, Mette; Danielsen, Anne; Andersen, Bo L; Thormann, Jens; Kristensen, Ove; Kristensen, Berit; Vissing, Susanne; Nielsen, Niels H; Thyssen, Jacob P; Johansen, Jeanne D
2014-12-01
Blue-collar workers have a high risk of occupational contact dermatitis, but epidemiological studies are scarce. To investigate allergic contact dermatitis in blue-collar workers with dermatitis registered by the Danish Contact Dermatitis Group. A retrospective analysis of patch test data from 1471 blue-collar workers and 1471 matched controls tested between 2003 and 2012 was performed. A logistic regression was used to test for associations. The blue-collar workers often had occupational hand dermatitis (p < 0.001). Atopic dermatitis was less commonly observed among blue-collar workers (19.6%) than among controls (23.9%) (p = 0.005). Allergens with a statistically significant association with the occupational group of blue-collar workers were epoxy resins, methyldibromo glutaronitrile, 2-bromo-2-nitro-1,3-propanediol, potassium dichromate, and methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI). The following occupations were additionally identified as risk factors for contact sensitization to MCI/MI and MI, epoxy resins, and potassium dichromate, respectively: painting, construction work, and tile setting/terrazzo work. Contact allergy is a major problem among blue-collar workers. The data indicate a healthy worker effect among blue-collar workers diagnosed with dermatitis, as blue-collar workers were diagnosed significantly less often with atopic dermatitis than were controls. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Prevention of occupational dermatitis.
Sartorelli, P; Kezic, S; Larese Filon, F; John, S M
2011-01-01
Occupational dermatitis is among the most frequent occupational diseases. Dermal exposure risk affects many professional categories such as healthcare workers, hairdressers, bakers, cleaning and kitchen employees. The economical burden of occupational dermatitis (OD) is huge (greater than 5 billion Euro per year in Europe), comprising direct costs (treatment, compensation), as well as indirect costs due to sick leave and lack of productivity. A scientifically based preventive program consisting of skin protection during work, cleaning and skin care after work has generally been recommended to prevent occupational contact dermatitis. However the rate of reported occupational skin diseases seems unchanged in the recent years. In cases of impaired skin condition the secondary prevention (i.e. therapeutic treatment by dermatologists and health-educational intervention seminars) is fundamental. For cases of occupational dermatoses in which these outpatient prevention measures are not successful, interdisciplinary inpatient rehabilitation measures have been developed (tertiary individual prevention). In the past years, various pilot-concepts to improve occupational dermatitis prevention have been successfully put into practice focussing on interdisciplinary (dermatological and educational) skin protection training programmes for high-risk professions. Currently a multi-step intervention approach is implemented which is aiming at offering quick preventive help at all levels of severity of occupational contact dermatitis. Recent data reveals that there are reliable evidence-based options for multidisciplinary prevention and patient management of occupational dermatitis using a combined approach by a network of clinics, practices and statutory social insurance bodies. At this stage, it seemed reasonable to form a European joint initiative for skin prevention. Recently a European network of preventive dermatology (European Initiative for the Prevention of Occupational Skin Diseases-EPOS) has been organized based on the German experience in the specific field.
Occupational Airborne Contact Dermatitis From Proton Pump Inhibitors.
DeKoven, Joel G; Yu, Ashley M
2015-01-01
Few published reports have described occupational contact dermatitis from proton pump inhibitor (PPI) exposure in the literature. We present an additional case of a 58-year-old male pharmaceutical worker with an occupational airborne allergic contact dermatitis to PPIs confirmed by patch testing. This is a novel report of workplace exposure to dexlansoprazole and esomeprazole PPIs with resultant clinical contact allergy and relevant positive patch test results to these 2 agents. A literature review of all previously reported cases of occupational contact dermatitis to PPI is summarized. The case also emphasizes the importance of even minute exposures when considering workplace accommodation.
Epidemiology of occupational contact dermatitis in a North Italian population.
Lodi, A; Mancini, L L; Ambonati, M; Coassini, A; Ravanelli, G; Crosti, C
2000-03-01
Occupational contact dermatitis (OCD) is a very important skin disease both for its high frequency and for its social and economic implications. The aim of our work is to evaluate the epidemiology of occupational contact dermatitis in a north-Italian population and the possibility of a correct etiological diagnosis using the patch test standard series of GIRDCA (Italian Group of Resarch on Contact Dermatitis). We patch tested 1,565 out-patients affected by dermatitis with standard series GIRDCA and with other specific professional haptens. The manifestations were suspected of being of occupational origin by a dermatologist on the basis of clinical and anamnestic data. Of all the recorded professions we have considered only the more numerically significant: food industry, building industry, textile industry, employees, cleaners, hospital personnel, hairdressers, housewives, mechanics and metallurgists. Sixty-nine percent of contact dermatitis was found in women, the hairdressers had the greatest number of patients in the younger group (68.7% in the 11-20 years age group) and the textile industry workers in older group (100% in the 41-50 years age group). A positive allergological anamnesis emerged in 32.3% of allergic contact dermatitis. Irritant contact dermatitis (10.6%) was more frequent than allergic contact dermatitis (8.4%). The hands are the most common localization (94. 4%). The allergen with the highest frequency of positive reactions is p-phenylenediamine (25.3%). We discuss the frequency of positives to various groups of allergens in each profession and the principal means of contact. Because of the frequency of this type of occupational skin disease, we stress the importance of prevention. The standard series GIRDCA was found to be adequate for recognizing occupational contact dermatitis in most of our patients (74%).
Liskowsky, Joanna; Geier, Johannes; Bauer, Andrea
2011-09-01
Occupational contact allergy is a common problem in the cleaning industry. To identify the most frequent occupation-associated allergens and time trends in contact allergy in female cleaners. We analysed the patch test data concerning 803 female cleaners, who were evaluated for occupational contact dermatitis in 45 dermatological departments contributing to the Information Network of Departments of Dermatology (IVDK) from 1996 to 2009. Female patients, except cleaners, with occupational dermatitis (n = 14494) and female controls without occupational dermatitis (n = 64736) patch tested during this time period formed the control groups. One hundred and fifty-six (19.4%) cleaners had past or present atopic dermatitis. Six hundred and fifty-five (81.6%) cleaners suffered from occupational hand dermatitis. Allergic contact dermatitis was diagnosed in 249 (31%) of the cleaners. As compared with the control group without occupational dermatitis, female cleaners were significantly more often sensitized to occupationally relevant allergens such as rubber additives, especially thiurams [11.6%, 95% confidence interval (CI) 9.1-14.1 vs. 1.5%, 95% CI 1.4-1.6], zinc diethyldithiocarbamate (3.4%, 95% CI 2.1-4.7 vs. 0.4, 95% CI 0.3-0.4), and mercaptobenzothiazole (1.8, 95% CI 0.7-2.9 vs. 0.5, 95% CI 0.4-0.6), as well as formaldehyde (3.4, 95% CI 2.0-4.7 vs. 1.4%, 95% CI 1.3-1.5). No differences were seen in patterns of sensitization to occupational allergens in younger (≤40 years of age) and older (>40 years of age) female cleaners. Formaldehyde and rubber additives such as thiurams, zinc diethyldithiocarbamate and mercaptobenzothiazole are occupationally relevant allergens in female cleaners. Prevention strategies are needed to address the problem. © 2011 John Wiley & Sons A/S.
Schwensen, Jakob Ferløv; Friis, Ulrik Fischer; Menné, Torkil; Flyvholm, Mari-Ann; Johansen, Jeanne Duus
2017-05-01
The aim of the study is to investigate risk factors for sensitization to preservatives and to examine to which extent different preservatives are registered in chemical products for occupational use in Denmark. A retrospective epidemiological observational analysis of data from a university hospital was conducted. All patients had occupational contact dermatitis and were consecutively patch tested with 11 preservatives from the European baseline series and extended patch test series during a 5-year period: 2009-2013. Information regarding the same preservatives in chemical products for occupational use ('substances and materials') registered in the Danish Product Register Database (PROBAS) was obtained. The frequency of preservative contact allergy was 14.2% (n = 141) in 995 patients with occupational contact dermatitis. Patients with preservative contact allergy had significantly more frequently facial dermatitis (19.9 versus 13.1%) and age > 40 years (71.6 versus 45.8%) than patients without preservative contact allergy, whereas atopic dermatitis was less frequently observed (12.1 versus 19.8%). Preservative contact allergy was more frequent in painters with occupational contact dermatitis as compared to non-painters with occupational contact dermatitis (p < 0.001). This was mainly caused by contact allergy to methylisothiazolinone and contact allergy to formaldehyde. Analysis of the registered substances and materials in PROBAS revealed that preservatives occurred in several product categories, e.g., 'paints and varnishes', 'cleaning agents', 'cooling agents', and 'polishing agents'. Formaldehyde and isothiazolinones were extensively registered in PROBAS. The extensive use of formaldehyde and isothiazolinones in chemical products for occupational use may be problematic for the worker. Appropriate legislation, substitution, and employee education should be prioritized.
Luckhaupt, Sara E; Dahlhamer, James M; Ward, Brian W; Sussell, Aaron L; Sweeney, Marie H; Sestito, John P; Calvert, Geoffrey M
2013-06-01
Prevalence patterns of dermatitis among workers offer clues about risk factors and targets for prevention, but population-based estimates of the burden of dermatitis among US workers are lacking. Data from an occupational health supplement to the 2010 National Health Interview Survey (NHIS-OHS) were used to estimate the prevalence of dermatitis overall and by demographic characteristics and industry and occupation (I&O) of current/recent employment. Data were available for 27,157 adults, including 17,524 current/recent workers. The overall prevalence rate of dermatitis among current/recent workers was 9.8% (range among I&O groups: 5.5-15.4%), representing approximately 15.2 million workers with dermatitis. The highest prevalence rates were among I&O groups related to health care. Overall, 5.6% of dermatitis cases among workers (9.2% among healthcare workers) were attributed to work by health professionals. Dermatitis affected over 15 million US workers in 2010, and its prevalence varied by demographic characteristics and industry and occupation of employment. The prevalence rate of work-related dermatitis based on the NHIS-OHS was approximately 100-fold higher than incidence rates based on the Bureau of Labor Statistics' Survey of Occupational Illness and Injury. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.
Schwensen, Jakob F; Menné, Torkil; Johansen, Jeanne D
2014-12-01
The diagnosis of combined allergic and irritant contact dermatitis is an accepted subdiagnosis for hand dermatitis, and it is often considered in a patient with contact dermatitis, a positive and relevant patch test result, and wet work exposure. We therefore hypothesize that it is arbitrary for wet work exposure to be taken into consideration in a patient with newly diagnosed relevant contact allergy. Furthermore, an overestimation of the diagnosis will probably occur if the criteria for wet work exposure are applied correctly, as many occupations have an element of wet work. To find the statistically expected number of combined allergic and irritant contact dermatitis cases in 1000 patients, and to evaluate the diagnostic criteria for the diagnosis. One thousand consecutive patients with occupational contact dermatitis from a hospital unit in Denmark were assessed. The expected number of cases with the diagnosis of combined allergic and irritant contact dermatitis was 0.33%, as compared with the observed number of 6.4%. Females occupied in wet occupations were often diagnosed with combined allergic and irritant contact dermatitis (p < 0.005). The diagnosis of combined allergic and irritant contact dermatitis should be used critically to avoid misclassification, and possible criteria for the diagnosis are proposed. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Timmerman, Johan G; Heederik, Dick; Spee, Ton; van Rooy, Frits G; Krop, Esmeralda J M; Rustemeyer, Thomas; Smit, Lidwien A M
2017-10-01
A high contact dermatitis symptoms prevalence has been observed in Dutch construction workers. Contact dermatitis was diagnosed by an expert panel using questionnaire data and photographs of 751 subjects' hands. A subset was evaluated by two occupational physicians. Their diagnoses were compared to those of the expert panel. In addition, two self-reported questionnaire-based assessment methods were compared to the expert panel evaluation. Associations between contact dermatitis and determinants were assessed using log-binomial regression analysis. Contact dermatitis prevalence was high: 61.4% (expert panel's diagnosis) and 32.9% (self-reported). Agreement between occupational physicians and the expert panel was low but increased after training. Washing hands with solvents and performing job-related tasks at home were related to contact dermatitis. Contact dermatitis prevalence among construction workers is high. Recognition of contact dermatitis by occupational physicians is poor but can be improved by training. Awareness of skin disorders should be raised. © 2017 Wiley Periodicals, Inc.
Poltronieri, Anna; Patrini, L; Pigatto, P; Riboldi, L; Marsili, Chiara; Previdi, M; Margonari, M; Marraccini, P
2010-01-01
Hairdressers are exposed to irritants and allergenic compounds that may cause contact dermatitis, rhinitis and asthma. In this paper we describe the case of a female, age 33 years, who developed contact dermatitis after 10 years of exposure to ammonium persulfate. After 7 months of progressively extensive and persistent skin lesions, respiratory symptoms appeared that were related to the occupational exposure (on-off test). SIDAPA and specific occupational patch test for hairdressers and occupational challenge with ammonium persulfate were performed. Clinical parameters of inflammation, ECP (eosinophil cationic protein) and exhaled nitric oxide (FeNO) were detected before and after the specific bronchial challenge. The patch test was positive to ammonium persulfate (++), and bronchial challenge for ammonium persulfate showed a significant late response (FEV1 decrease--33%). Both FeNO and ECP showed a significant increase after 24 hours. Dermatitis, urticaria and angioedema occurred on the uncovered skin due to airborne contact. Topic steroids and anti-histaminic drugs resolved the clinical symptoms. Bronchial challenge is, in fact, considered to be the gold standard for the diagnosis of occupational asthma, although new inflammatory parameters can contribute to the diagnosis and can be useful for monitoring after a specific inhalation test with occupational agents. The described case summarizes the evolution from contact dermatitis to inhalation allergy, suggesting the occurrence of an allergic "march" for occupational allergy.
Warshaw, Erin M; Hagen, Solveig L; Sasseville, Denis; Maibach, Howard I; DeKoven, Joel G; Belsito, Donald V; Fowler, Joseph F; Zug, Kathryn A; Taylor, James S; Mathias, C G Toby; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Zirwas, Matthew J; Storrs, Frances J
Contact dermatoses are common in mechanic and repair occupations. This study aimed to (1) estimate the prevalence of occupationally related contact dermatitis among mechanics/repairers patch tested from 1998 to 2014 by the North American Contact Dermatitis Group, (2) characterize responsible allergens and irritants, and their sources, and (3) compare results among 3 occupational subgroups (mechanics, electrical/electronic, and other). A cross-sectional analysis of patients patch tested by the North American Contact Dermatitis Group between 1998 and 2014. Of 38,784 patients patch tested, 691 (1.8%) were mechanics/repairers. Male sex (93.5%) and hand involvement (59.5%) were common overall. Occupationally related skin disease was more prevalent among vehicle and mobile equipment mechanics/repairers (52.7%) and other mechanics/repairers (41.4%) than electrical/electronic equipment mechanics/repairers (21.3%). Overall, carba mix, thiuram mix, and methylchloroisothiazolone/methylisothiazolone were the most common occupation-related clinically relevant allergens. Gloves, automotive vehicles, solvents, oils, lubricants, and fuels were the most common sources of responsible allergens. Common occupationally related allergens included rubber accelerators and the preservative methylchloroisothiazolone/methylisothiazolone.
Epoxy-based production of wind turbine rotor blades: occupational dermatoses.
Pontén, A; Carstensen, O; Rasmussen, K; Gruvberger, B; Isaksson, M; Bruze, M
2004-06-01
Occupational dermatoses were investigated in a factory producing rotor blades for wind turbines by an epoxy-based process. In a blinded study design, 603 workers were first interviewed and thereafter clinically examined. Based on a history of work-related skin disease, clinical findings of dermatitis, or both, 325 (53.9%) of the workers were patch tested with a specially profiled occupational patch-test series and the European standard patch-test series. Calculated on all investigated workers, 17.1% of the workers were diagnosed with occupational dermatoses caused by work. Occupational allergic contact dermatitis was found in 10.9% of the workers. The estimated frequency of irritant contact dermatitis caused by work was 6.1%. Dermatitis on the hands was associated with contact allergy to epoxy resin (P = 0.017). The number of days on leave before the clinical examination was negatively associated with the presence of dermatitis (P = 0.001). Among workers employed 7-12 months, the frequency of occupational contact allergy was higher than that among workers employed for =6 months (P = 0.004). Females both washed their hands more often (P < 0.001) and used more moisturizers/protection creams at work (P < 0.001) than males. No sex differences were found concerning dermatitis on the hands.
Occupational contact dermatitis in the UK: a surveillance report from EPIDERM and OPRA.
Meyer, J D; Chen, Y; Holt, D L; Beck, M H; Cherry, N M
2000-05-01
Since February 1993 the EPIDERM surveillance scheme has collected data on occupational skin disease from consultant dermatologists in the UK. Reporting by occupational physicians to the scheme began in May 1994 and was superseded in January 1996 by the Occupational Physicians Reporting Activity (OPRA). The schemes currently receive reports on incident cases from 244 dermatologists and 790 occupational physicians. An estimated total of 9937 cases of contact dermatitis reported by dermatologists was calculated from surveillance data; 8129 contact dermatitis cases were estimated from reports by occupational physicians. The annual incidence of occupational contact dermatitis from dermatologist reports was 6.4 cases per 100,000 workers and 6.5 per 100,000 from reports by occupational physicians, an overall rate of 12.9 cases per 100,000 workers. Manufacturing industries account for the greatest number of cases seen by both sets of reporting physicians, with health care employment second. Reports from dermatologists also indicate high rates of dermatitis in the personal service industries (mainly hairdressers and barbers) and in agriculture. With the exception of an increase in cases seen in nurses in both schemes, the numbers and proportions of cases of contact dermatitis within occupations have remained fairly constant over the 6-year reporting period. Agents accounting for the highest number of allergic contact dermatitis cases were rubber (23.4% of allergic cases reported by dermatologists), nickel (18.2), epoxies and other resins (15.6), aromatic amines (8.6), chromium and chromates (8.1), fragrances and cosmetics (8.0), and preservatives (7.3). Soaps (22.0% of cases), wet work (19.8), petroleum products (8.7), solvents (8.0), and cutting oils and coolants (7.8) were the most frequently cited agents in cases of irritant dermatitis. The national scope of the data, together with the parallel structure by which both dermatologists and occupational physicians report incident cases, is useful in determining the extent of skin hazards in UK industry and may help in better targeting efforts to reduce the burden of skin disease at work.
Warshaw, Erin M; Wang, Michael Z; Mathias, C G Toby; Maibach, Howard I; Belsito, Donald V; Zug, Kathryn A; Taylor, James S; Zirwas, Matthew J; Fransway, Anthony F; Deleo, Vincent A; Marks, James G; Pratt, Melanie D; Storrs, Frances J; Rietschel, Robert L; Fowler, Joseph F; Sasseville, Denis
2012-01-01
European studies document that occupational contact dermatitis (CD) is common in hairdressers, but studies from North America are lacking. The objectives of this study were to estimate the prevalence of occupational CD among North American hairdressers/cosmetologists (HD/CS) and to characterize responsible allergens and irritants as well as their sources. A cross-sectional analysis of patients patch tested by the North American Contact Dermatitis Group between 1994 and 2010 was conducted. Of 35,842 patients, 432 (1.2%) were HD/CS. Significantly, most of the HD/CS were female (89.8%) and younger than 40 years (55.6%) as compared with non-hairdressers (P < 0.0001). The rates for allergic and irritant CD in HD/CS were 72.7% and 37.0%, respectively. The most common body site of involvement was the hand, and this was significantly more common than in non-HD/CS (P < 0.0001). The most frequent currently relevant and occupationally related allergens were glyceryl thioglycolate, p-phenylenediamine, nickel sulfate, 2-hydroxyethyl methacrylate, and quaternium-15. Hair dyes, permanent wave solutions, and other hair products were common sources of allergens. The North American Contact Dermatitis Group allergen series missed at least 1 occupationally-related allergen in 26.2% of patients. Contact dermatitis in North American HD/CS is common, and occupationally related allergens are those found in HD/CS products. Supplemental hairdressing/cosmetology antigen series are important in detecting all occupationally related allergens in this population.
Occupational contact allergic dermatitis in dentistry.
Mikov, Ivan; Turkalj, Ivan; Jovanović, Marina
2011-06-01
Dental professionals may be at increased risk of developing occupational allergic diseases specially to methacrylates that can permeate protective disposable gloves. We presented a case of occupational allergic contact dermatitis in a 28-year-old dental technician. The patient had complained of itching and cracking of fingers for 6 months. The dermatitis improved over weekends. Skin erythema and scaling were present with primarily involvement of the fingertips. Patch testing with dental series gave positive vesicular reaction to methyl methacrylate. Follow-up after 6 months of allergen avoidance showed a complete regression of dermatitis. Methacrylates serve as bases for acrylic resins which are used in prosthetics. Methyl methacrylate as a small molecular acrylate can permeate thin protective disposable gloves. Using adequate personal protective equipment, like nitrile rubber gloves, is the most important preventive measure in this occupation. Health practitioners should recognize possible occupational hazards in dentistry and implement appropriate preventive measures to protect health of workers.
[Medicolegal aspects of occupational dermatitis].
Frimat, P; Fantoni-Quinton, S
2009-01-01
Occupational dermatitis is very common with considerable social and economic implications. Routine screening for occupational factors is essential since it may be necessary to introduce preventive measures and compensation could be due to the patient. The general practitioner may be assisted either by the occupational therapist or by specialised services to help the patient take the administrative steps necessary in order to identify a professional disease.
An update on airborne contact dermatitis: 2001-2006.
Santos, Raquel; Goossens, An
2007-12-01
Reports on airborne dermatoses are mainly published in the context of occupational settings. Hence, in recent years, dermatologists and also occupational physicians have become increasingly aware of the airborne source of contact dermatitis, resulting mainly from exposure to irritants or allergens. However, their occurrence is still underestimated, because reports often omit the term 'airborne' in relation to dust or volatile allergens. For the present update, we screened the journals 'Contact Dermatitis' (July 2000 to December 2006); 'Dermatitis', formerly named 'American Journal of Contact Dermatitis'; 'La Lettre du Gerda' (January 2000 to December 2006); and also included relevant articles from other journals published during the same period. This resulted in an updated list of airborne dermatitis causes.
Epidemiological data on airborne contact dermatitis - results of the IVDK.
Breuer, Kristine; Uter, Wolfgang; Geier, Johannes
2015-10-01
Airborne contact dermatitis (AirbCD) is not uncommon, according to a large number of published case reports and review articles. Epidemiological data on AirbCD based on larger clinical samples have not yet been published. To investigate demographic characteristics and patch test reactivity in patients diagnosed with both occupational and non-occupational AirbCD. A retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 1994-2013, including 201 344 consecutively patch tested patients, was performed. One thousand two hundred and three patients (0.6%) were diagnosed with AirbCD, 421 (35.0%) of these with an occupational background. Occupational dermatitis and face involvement were more prevalent than in patients without AirbCD (n = 200 141). Sensitization to epoxy resin and sensitization to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) were significantly associated with AirbCD, and there was a trend for sensitization to Compositae mix and/or sesquiterpene lactone mix to be associated with AirbCD. Adhesives, plastics, construction materials, paints and varnishes in occupational cases, and plants in non-occupational cases, were the most commonly documented culprit product categories. AirbCD is more common in patients with occupational dermatitis than in patients with non-occupational dermatitis. In our clinical sample, components of epoxy resin systems, MCI/MI and Compositae allergens were the most important contact allergens associated with AirbCD. Patch testing with additional allergens is important. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Chen, Yu-Xin; Gao, Bing-Ai; Cheng, Hai-Yan; Li, Lin-Feng
2017-01-01
Occupational population-based epidemiological data relating to occupational contact allergies in the Chinese clothing industry are limited. To investigate the prevalence of occupational allergic contact dermatitis (OACD) and to identify the causative allergens among clothing employees in China, a cross-sectional study was conducted in 529 clothing employees at 12 clothing factories in Beijing. All employees were subjected to an interview using self-administered questionnaire and skin examination, and those who were diagnosed with occupational contact dermatitis (OCD) were patch tested. In the present survey, we found that the overall 1-year prevalence of OACD among the clothing employees was 8.5%. The 1-year prevalence of OACD among workers (10.8%) was significantly higher than that among managers (3.2%). The lesions were primarily on the hands and wrists in workers, but the face and neck in managers. The major allergens were nickel sulfate and cobalt dichloride in workers and colophony and p -tert-butylphenol formaldehyde resin in managers. In conclusion, workers are at a higher risk of OACD compared with managers in the Chinese clothing industry. In addition to hand dermatitis in workers, airborne contact dermatitis on the face and neck should be also addressed in managers.
Chen, Yu-Xin; Gao, Bing-Ai; Cheng, Hai-Yan
2017-01-01
Occupational population-based epidemiological data relating to occupational contact allergies in the Chinese clothing industry are limited. To investigate the prevalence of occupational allergic contact dermatitis (OACD) and to identify the causative allergens among clothing employees in China, a cross-sectional study was conducted in 529 clothing employees at 12 clothing factories in Beijing. All employees were subjected to an interview using self-administered questionnaire and skin examination, and those who were diagnosed with occupational contact dermatitis (OCD) were patch tested. In the present survey, we found that the overall 1-year prevalence of OACD among the clothing employees was 8.5%. The 1-year prevalence of OACD among workers (10.8%) was significantly higher than that among managers (3.2%). The lesions were primarily on the hands and wrists in workers, but the face and neck in managers. The major allergens were nickel sulfate and cobalt dichloride in workers and colophony and p-tert-butylphenol formaldehyde resin in managers. In conclusion, workers are at a higher risk of OACD compared with managers in the Chinese clothing industry. In addition to hand dermatitis in workers, airborne contact dermatitis on the face and neck should be also addressed in managers. PMID:28396866
Warshaw, Erin M; Kwon, Gina P; Mathias, C G Toby; Maibach, Howard I; Fowler, Joseph F; Belsito, Donald V; Sasseville, Denis; Zug, Kathryn A; Taylor, James S; Fransway, Anthony F; Deleo, Vincent A; Marks, James G; Pratt, Melanie D; Storrs, Frances J; Zirwas, Matthew J; Dekoven, Joel G
2013-01-01
Contact dermatoses are common in food service workers (FSWs). This study aims to (1) determine the prevalence of occupationally related contact dermatitis among FSWs patch tested by the North American Contact Dermatitis Group (NACDG) and (2) characterize responsible allergens and irritants as well as sources. Cross-sectional analysis of patients patch tested by the NACDG, 1994 to 2010, was conducted. Of 35,872 patients patch tested, 1237 (3.4%) were FSWs. Occupationally related skin disease was significantly more common in FSWs when compared with employed non-FSWs. Food service workers were significantly more likely to have hand (P < 0.0001) and arm (P < 0.0006) involvement. The rates for irritant and allergic contact dermatitis in FSWs were 30.6% and 54.7%, respectively. Although the final diagnosis of irritant contact dermatitis was statistically higher in FSWs as compared with non-FSWs, allergic contact dermatitis was lower in FSWs as compared with non-FSWs. The most frequent currently relevant and occupationally related allergens were thiuram mix (32.5%) and carba mix (28.9%). Gloves were the most common source of responsible allergens. The NACDG standard tray missed at least 1 occupationally related allergen in 38 patients (4.3%). Among FSWs patch tested by the NACDG between 1994 and 2010, the most common allergens were thiuram mix and carba mix. Gloves were the most common source of responsible allergens.
Huilaja, L; Kubin, M E; Riekki, R
2016-01-01
Allergic contact dermatitis caused by wood dust remains uncommon and most cases are occupational. Contact allergy to finished wooden products is even more rare and only few cases of contact dermatitis to wooden furnishings and furniture are described. During 2012-2014 surprisingly many patients with dermatitis associated to sauna baths were referred to our clinic. We report three novel cases with allergic contact dermatitis to western red cedar due to exposure during sauna baths. Three cases of non-occupational contact dermatitis to western red cedar were confirmed by patch testing. Allergic contact dermatitis to interior decoration or furniture is a rarity, but can be induced by novel exposures, like western red cedar in sauna interior decoration. © 2015 European Academy of Dermatology and Venereology.
Illness perception and quality of life in patients with contact dermatitis.
Benyamini, Yael; Goner-Shilo, Daphna; Lazarov, Aneta
2012-10-01
People's subjective perceptions of illness are important determinants of their ways of coping with health threats and the ensuing physical and mental outcomes, including quality of life (QoL), which has been consistently reported to be impaired by contact dermatitis. To investigate the relationships of subjective illness perceptions and dermatological QoL in atopic, contact and occupational dermatitis patients and a comparison group of patients with other dermatological diseases. Three hundred and three patients of four diagnostic groups filled in the Brief Illness Perception Questionnaire and the Skindex-16 (+ occupational impact items) Dermatological QoL questionnaire before clinical examination and patch testing. Perceptions of serious consequences, greater symptom burden and more uncertainty and worry were associated with lower QoL (r(s) > 0.50). Overall, patients reported low personal control over their condition and low understanding of the disease (3.5 and 4.8, respectively, on a 0-10 scale). QoL was most impaired among occupational dermatitis patients (mean = 46) and least impaired among patients who were later diagnosed as suffering from conditions other than contact dermatitis (mean = 62). Identifying critical components of illness perceptions in patients with atopic, contact and occupational dermatitis may enable the design of consultations and interventions to fit patients' perceptions, which could affect their QoL. © 2012 John Wiley & Sons A/S.
Skin-specific training experience of workers assessed for contact dermatitis.
Zack, B; Arrandale, V; Holness, D L
2018-05-17
Contact dermatitis is a common and preventable work-related disease. Skin-specific training may be effective for preventing occupational contact dermatitis, but little information is available regarding actual workplace training and its effectiveness. To describe workplace skin-specific training among workers with suspected contact dermatitis. Patch test patients being assessed for suspected contact dermatitis at an occupational health clinic in Toronto, Canada, completed a questionnaire on training experiences, workplace characteristics, exposures and skin protection practices. Of 175 patients approached, 122 (71%) workers completed questionnaires. Many (80%) had received general occupational health and safety and hazardous materials training (76%). Fewer (39%) received skin-specific training. Of those with work-related contact dermatitis, 52% did not receive skin-specific training. Skin-specific training was commonly provided by health and safety professionals or supervisors using video, classroom and online techniques. Content included glove use, exposure avoidance and hand washing information. Workers that received skin-specific training found it memorable (87%), useful (85%) and common sense in nature (100%). This study indicates gaps in workplace training on skin disease prevention for workers with contact dermatitis. Workers perceived skin-specific training to be useful. Understanding worker training experiences is important to prevention programme development and reducing work-related skin disease.
Pontén, Ann; Hamnerius, Nils; Bruze, Magnus; Hansson, Christer; Persson, Christina; Svedman, Cecilia; Thörneby Andersson, Kirsten; Bergendorff, Ola
2013-02-01
An increased frequency of occupational contact hand dermatitis among surgical operating theatre personnel has been noticed. To evaluate patients with occupational contact dermatitis caused by their rubber gloves, and to describe a method for analysing the content of the allergens in the gloves. Patch tests were performed with the baseline series, a rubber chemical series, and the patients' own gloves. A method for analysing 1,3-diphenylguanidine (DPG) and cetylpyridinium chloride in the gloves was developed. Contact allergy to thiuram mix was found in 8 of 16 patients, whereas 12 of 16 patients reacted to DPG. In 7 of 8 patients, contact allergy to cetylpyridinium chloride was found. In the patients' gloves, cetylpyridinium chloride and DPG were detected at higher concentrations on the inside of the gloves than on the outside. Most patients had worked for decades in their present occupations, but their hand dermatitis had only been present for months. Contact allergy to DPG in gloves has been disputed, but, in this study, we were able to confirm the presence of DPG and cetylpyridinium chloride in the causative gloves by using a modified method for the analysis. The presence of these chemicals in gloves caused an increase in occupational contact dermatitis in surgical operating theatre personnel. © 2012 John Wiley & Sons A/S.
Coman, Garrett; Zinsmeister, Chris; Norris, Patricia
2015-01-01
Workers are exposed to potential irritants and allergens with constant introduction of new industrial chemicals in the workplace. Characterize the final diagnoses, demographics, occupations, exposures, clinical presentations, patch test results, dermatologic histories, and risk factors of workers evaluated for suspected work-related allergic contact dermatitis (ACD). A retrospective chart review of 310 workers' compensation independent medical examinations evaluated for suspected work-related ACD was performed. Workers were seen in a community dermatology clinic in Portland, Oregon, from 2005 to 2014. Evaluation included history, physical examination, patch testing, and further diagnostic workup when indicated. Hand dermatitis was the most common presentation (n = 148, 47.7%). Prevalent occupations included health care workers (n = 51, 16.5%), custodial staff (n = 41, 13.2%), and machinists (n = 36, 11.6%). Allergic contact dermatitis (47.5%) was more common than irritant contact dermatitis (ICD) (38.9%) in those diagnosed as having occupational skin disease (n = 185). The highest-frequency work-related allergens were thiuram mix (21 of 88, 23.9%), carba mix (20 of 88, 22.7%), potassium dichromate (9 of 88, 10.2%), and epoxy resin (9 of 88, 10.2%). Allergic contact dermatitis and ICD are common occupational skin disorders. In this population of workers' compensation referrals, ACD was more common, with 73.3% of those cases work related, compared with 86.7% of ICD. Blue collar work and wet work were risk factors for the development of ACD and ICD.
Occupational contact dermatitis due to essential oils.
Trattner, Akiva; David, Michael; Lazarov, Aneta
2008-05-01
Allergic contact dermatitis induced by the occupational use of products containing essential oils has not been studied comprehensively. The aim of the present report was to describe the characteristics, diagnosis, and outcome of 5 patients with occupational contact dermatitis because of essential oils attending our outpatient dermatology clinics over a 2-year period. These patients are added to the 11 cases reported thus far in the literature. The research shows that for proper diagnosis, patch tests with the standard series and the fragrance series should be performed, in addition to tests with the specific oils to which the patients were exposed. Patients should be instructed to avoid the allergens identified. Sensitization to essential oils has important implications for the occupational future of affected individuals.
Carriers of filaggrin gene (FLG) mutations avoid professional exposure to irritants in adulthood.
Bandier, Josefine; Ross-Hansen, Katrine; Carlsen, Berit C; Menné, Torkil; Linneberg, Allan; Stender, Steen; Szecsi, Pal B; Meldgaard, Michael; Thyssen, Jacob P; Johansen, Jeanne D
2013-12-01
Loss-of-function mutations in the filaggrin gene (FLG) are associated with xerosis, atopic dermatitis, and early onset of hand eczema. Irritant exposure is a risk factor for occupational hand eczema, and FLG mutations increase the risk of occupational irritant contact dermatitis on the hands in hospital cohorts. It is unknown whether FLG mutations affect the level of irritant exposure. To evaluate whether exposure to occupational irritants was dependent on FLG mutations, atopic dermatitis, and age at hand eczema onset. Randomly chosen Danish adults completed a questionnaire on general health and occupational exposures. Genotyping for FLG mutations (R501X, 2282del4, and R2447X) and patch testing were performed. Overall, 38.7% of subjects reported present or previous occupational exposure to irritants. Among individuals who reported hand eczema onset before entering their work life, 50.6% (45/89) of FLG non-mutation carriers became exposed to irritants, as compared with 28.6% (4/14) of heterozygous and 0% (0/6) of homozygous mutation carriers (p = 0.006). Avoidance was conspicuous among mutation carriers reporting childhood hand eczema and atopic dermatitis (odds ratio 0.08, 95% confidence interval 0.01-0.65). Carriers of FLG mutations who have had hand eczema onset in childhood avoid occupational exposure to irritants; the association is most marked with homozygous mutation status combined with atopic dermatitis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
ALGERIAN IVY DERMATITIS—A California Disease
Dorsey, Clete S.
1959-01-01
A hitherto unrecognized cause of contact dermatitis in California is the widely cultivated plant known as Algerian ivy. This plant, which grows in California (and its close relative, English ivy) causes a dermatitis which is similar to although milder than that caused by poison oak. Dermatitis from this cause occurs most frequently when persons who have become sensitive to it by previous contact trim the plant back in the spring after its seasonal spurt of growth. For persons whose occupations require repeated contact with the plant, dermatitis from this cause is an occupational hazard. Dermatitis from this plant is easily diagnosed by means of a simple patch test. In a series of 12 cases the only effective treatment was with corticosteroid agents. ImagesFigure 1.Figure 2. PMID:13629356
Febriana, Sri Awalia; Soebono, Hardyanto; Coenraads, Pieter-Jan
2014-02-01
Shoe manufacturing workers are exposed daily to an extensive range of potential physical and chemical occupational hazards. Shoe manufacturing in Indonesia is one of the industrial sectors that has shown sustained growth amongst the newly industrialized countries (NICs). In this study, we investigated the possible potential exposure of the workers to physical and occupational hazards and determined the prevalence of occupational skin diseases at a shoe manufacturing factory in Indonesia. A cross-sectional study on the observation of the working process and an inventory and risk assessment of exposure to the chemicals used. Classification of chemicals as potential sensitizers/irritants and qualitative assessments of these chemicals were done. Workers were examined and interviewed using the Nordic Occupational Skin Questionnaire-2002/LONG. The risk of Occupational skin diseases (OSD) at the shoe factory was mainly related to the exposure of the workers' skin to potential physical and chemical hazards in hot and humid environmental conditions. From a total of 514 workers, 8.5 % reported current OSD and 4.8 % reported a history of OSD. Occupational skin diseases were diagnosed in 29 % of the workers by dermatologists and 7.6 % had an occupational contact dermatitis (OCD). Of the 39 workers with contact dermatitis, 33 consented to being patch tested, 14 (3 %) workers showed a positive results and considered as having an occupational allergic contact dermatitis (OACD) and 25 (4.9 %) had an occupational irritant contact dermatitis (OICD). We observed a repeated and prolonged exposure of the workers to numerous physical and chemical skin hazards at this factory.
Occupational dermatitis. An epidemiological study in the rubber and cement industries.
Varigos, G A; Dunt, D R
1981-03-01
An epidemiological study of occupational dermatitis in a tyre company and a cement company is reported. Ninety-seven percent of 999 tyre workers and 78% of 151 cement workers were screened by an occupational nurse and subsequently assessed by a specialist dermatologist. Prevalence rates of occupational contact dermatitis were 37 per 1000 and 68 per 1000 in the tyre and cement companies, respectively. Maintenance workers and tyre builders - particularly if they were Yugoslav and female - had high prevalence rates amongst tyre workers. Worker's compensation claim rates for the tyre company are similar to U.K. and U.S. rates for this industry. Prevalence rates of 37 per 1000 can be considered as a lower limit for this industry. The high prevalence rates in the cement company are noteworthy and require further study.
Occupational protein contact dermatitis in food handlers.
Hjorth, N; Roed-Petersen, J
1976-02-01
The preparation of food in restaurant kitchens carries a high risk of occupational dermatoses. Analysis of 33 cases revealed four different etiological types. Simple irritant dermatitis was rare (2 cases), plain contact dermatitis was more common (6 cases). Fifteen patients had relevant patch tests and scratch tests; ten had positive scratch tests only to explain the cause of their dermatitis. The last type was termed protein contact dermatitis. The major type IV allergens incriminated were metals, onion and garlic. The major proteinaceous allergens indicated by history and test results were fish and shell-fish. Open patch tests with the incriminated foods may cause erythema or oedema on normal skin after 20 minutes. Previously eczematous, now normal looking, skin often responds with a crop of dyshidrotic vesicles preceded by erythema and itching 30 minutes after the application of an open test. Examination for specific IgE is not always positive in such cases. Inhalant allergy was rare. The results indicate that food handlers are sensitized by the protein they touch, and then react to later contact with the proteins. Protein contact dermatitis is similarly common among veterinary surgeons, while the importance in other occupational groups remains to be studied.
Paulsen, E; Søgaard, J; Andersen, K E
1998-03-01
The clinical part of the study aimed at describing epidemiological and diagnostic aspects of occupational Compositae dermatitis. Patch testing with the sesquiterpene lactone (SL) and Compositae mixes, feverfew extract and supplementary allergens in 250 selected gardeners showed Compositae allergy in 25, 17 females and 8 males. 24 were possibly occupationally sensitized. The mean age was lower and the preponderance of women higher compared to classical Compositae dermatitis, and the distribution and course of the dermatitis most often did not differ from other occupational plant dermatoses. The Compositae mix detected 2x as many as the SL mix, and the overall detection rate with both was 76%, making aimed patch testing necessary. Chrysanthemum (Dendranthema), marguerite daisy (Argyranthemum frutescens) and lettuce (Lactuca sativa) were frequent sensitizers. Occupational type I allergy to Compositae comprised sensitization to Gerbera, chrysanthemum, lettuce, Senecio cruentus and Aster. Among 1657 respondents in the questionnaire part of the study, 824 had worked with Compositae, and 160 (19%) reported occupational Compositae-related symptoms of skin and mucous membranes. Possible risk factors for the development of these were assessed in a stepwise logistic regression model and a history of childhood eczema, hay fever and duration of exposure were significantly associated with Compositae-related irritant and allergic symptoms in both sexes.
Extended documentation for hand dermatitis patients: Pilot study on irritant exposures.
Uter, Wolfgang; Bauer, Andrea; Bensefa-Colas, Lynda; Brans, Richard; Crépy, Marie-Noëlle; Giménez-Arnau, Ana; Larese Filon, Francesca; Ljubojević Hadžavdić, Suzana; Pesonen, Maria; Schuttelaar, Marie L; Wilkinson, Mark; Lidén, Carola
2018-05-30
Irritant exposure may be a contributory cause or the sole cause of (occupational) hand dermatitis. However, the documentation of irritant exposures in clinical practice is not standardized. To examine the feasibility and usefulness of a form with different items addressing both occupational and non-occupational irritant exposures in a semiquantitative way. Between May 2016 and May 2017, successive patients with work-related hand dermatitis, irrespective of aetiology, were examined in 9 specialized European departments. Department-specific investigation was supplemented with the above proforma. The results were recorded by use of an anonymized secured online documentation system in a pilot study. Altogether, 193 patients were included; 114 females and 79 males, with a mean age of 40 years (range 18-68 years). The most common occupational group comprised healthcare workers (n = 35); occupational exposure of the hands to gloves, dusts and water without detergents of >2 hours/day was seen in 54.5%, 24.4% and 24.3% of patients, respectively. Non-occupational exposures rarely exceeded 2 hours/day. It is hoped that the set of descriptors will offer a basis for (clinical) epidemiological studies assessing the role of irritant exposures in occupational hand dermatitis, and to support a high level of quality and consistency in daily patient care. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Chromate and amine contact allergies in workers manufacturing precast concrete elements.
Mowitz, Martin; Zimerson, Erik; Hauksson, Inese; Pontén, Ann
2016-12-01
Five workers from a plant manufacturing concrete wall panels and beams were referred to our department because of suspected occupational dermatitis. When patch tested, 3 workers reacted to potassium dichromate. Four workers reacted to ethylenediamine dihydrochloride, without any obvious exposure. Owing to the high proportion of workers with recent-onset skin disease, an investigation of all workers at the plant was initiated. To investigate the prevalence of occupational dermatitis and contact allergy in the workers at the plant. All 24 workers at the plant underwent a clinical investigation and were patch tested. Four cases of allergic occupational contact dermatitis and 3 cases of irritant occupational contact dermatitis were diagnosed. Contact allergy to potassium dichromate was found in 4 workers. All 4 also reacted to ethylenediamine dihydrochloride and/or amines that were present as additives in the cement. Chromate contact allergy can still be found in concrete workers, despite the legislation regulating the amount of hexavalent chromium (chromate) in cement. Occupational contact allergy to amines can be found in workers exposed to cement and concrete, so amines should be tested in these workers. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Aalto-Korte, Kristiina; Pesonen, Maria; Suuronen, Katri
2015-12-01
Epoxy products are among the most common causes of occupational allergic contact dermatitis. Diglycidyl ether of bisphenol A resin (DGEBA-R) is the most important sensitizer in epoxy systems. To describe patients with occupational allergic contact dermatitis caused by epoxy products. Patients with allergic reactions to epoxy chemicals were chosen from test files (January 1991 to June 2014). Only patients with occupational contact allergy to some component of epoxy resin systems were included. We analysed patch test results, occupation, symptoms, and exposure data. We found a total of 209 cases with occupational contact allergy to epoxy chemicals. The largest occupational groups were painters (n = 41), floor layers (n = 19), electrical industry workers (n = 19), tile setters (n = 16), and aircraft industry workers (n = 15). A total of 82% of the patients reacted to DGEBA-R. Diagnosis of the DGEBA-R-negative patients required testing with m-xylylenediamine, N,N'-tetraglycidyl-4,4'-methylenedianiline, 1,4-butanediol diglycidyl ether, 2,4,6-tris-(dimethylaminomethyl)phenol, diglycidyl ether of bisphenol F resin, N,N'-diglycidyl-4-glycidyloxyaniline, isophoronediamine, 4,4'-diaminodiphenylmethane, diethylenetriamine, and cresyl glycidyl ether. The hands/upper extremities were most commonly affected (69%), but facial symptoms were also frequent (60%). Allergic contact dermatitis caused by to epoxy products cannot always be diagnosed by the use of commercial test substances. Workplace products need to be tested. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Jet Fuel-Associated Occupational Contact Dermatitis.
Contestable, James J
2017-03-01
Occupational contact dermatitis is a ubiquitous problem. Sailors onboard U.S. Navy vessels are at high risk given the multitude of potential workplace exposures. Solvents, petrochemicals, and fuels are abundant and can cause irritant or allergic contact dermatitis. Symptoms of contact dermatitis can cause inability to work and, if chronic, may require a change in rating or job. Prevention of this issue requires patient education about the risks and correct personnel protective equipment. Even with preventative strategies in place, exposures and cases of contact dermatitis will occur. Treatment consists of topical steroids and immunomodulators, as well as barrier creams and emollients. The goal of treatment is to fully restore the skin's natural barrier and prevent further exposure. A classic case of jet fuel-associated contact dermatitis is reviewed. A literature review utilizing PubMed, Google Scholar, and Google Search was conducted to elucidate our understanding of this issue, current occupational health guidelines, preventative approaches, and treatments. This case report provides guidance and recommendations for providers who encounter contact dermatitis related to petrochemicals, such as jet fuel. The literature review revealed limited knowledge surrounding in vivo human skin effects of jet fuel, specifically JP-5. Even larger gaps were found in our understanding of, and guidelines for, protective modalities against jet fuel exposure and dermatitis. A case is presented to facilitate recognition of jet fuel contact dermatitis and guidance for treatment and prevention. Given our current limited knowledge and guidelines concerning protective equipment and skin protectants, multiple proposals for future studies are suggested. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
Occupational protein contact dermatitis.
Barbaud, Annick; Poreaux, Claire; Penven, Emmanuelle; Waton, Julie
2015-01-01
Occupational contact dermatitis is generally caused by haptens but can also be induced by proteins causing mainly immunological contact urticaria (ICU); chronic hand eczema in the context of protein contact dermatitis (PCD). In a monocentric retrospective study, from our database, only 31 (0.41%) of patients with contact dermatitis had positive skin tests with proteins: 22 had occupational PCD, 3 had non-occupational PCD, 5 occupational ICU and 1 cook had a neutrophilic fixed food eruption (NFFE) due to fish. From these results and analysis of literature, the characteristics of PCD can be summarized as follows. It is a chronic eczematous dermatitis, possibly exacerbated by work, suggestive if associated with inflammatory perionyxix and immediate erythema with pruritis, to be investigated when the patient resumes work after a period of interruption. Prick tests with the suspected protein-containing material are essential, as patch tests have negative results. In case of multisensitisation revealed by prick tests, it is advisable to analyse IgE against recombinant allergens. A history of atopy, found in 56 to 68% of the patients, has to be checked for. Most of the cases are observed among food-handlers but PCD can also be due to non-edible plants, latex, hydrolysed proteins or animal proteins. Occupational exposure to proteins can thus lead to the development of ICU. Reflecting hypersensitivity to very low concentrations of allergens, investigating ICU therefore requires caution and prick tests should be performed with a diluted form of the causative protein-containing product. Causes are food, especially fruit peel, non-edible plants, cosmetic products, latex, animals.
Heede, Nina G; Thuesen, Betina H; Thyssen, Jacob P; Linneberg, Allan; Szecsi, Pal B; Stender, Steen; Menné, Torkil; Johansen, Jeanne D
2017-08-01
Atopic dermatitis and hand eczema often impair the ability of people to work. Only a few studies have investigated whether individuals with loss-of-function filaggrin gene (FLG) mutations, who often have severe and early onset of dermatitis, experience occupational consequences. To investigate the personal consequences of having atopic dermatitis and/or hand eczema and FLG mutations. Adult Danes from the general population (n = 3247) and patients with atopic dermatitis and/or hand eczema (n = 496) were genotyped for common FLG mutations, and completed a questionnaire about skin symptoms and hand eczema. Socioeconomic variables, including disability pension, and information on work in risk occupations were retrieved from national registries. The reasons for granting disability pension were unknown. Disability pension was associated with hand eczema in the general population, especially among individuals with a history of atopic dermatitis. Moreover, self-reported hand eczema and atopic dermatitis were associated with particularly high risk of disability pension among FLG mutation carriers [odds ratio (OR) 4.02 and 95% confidence interval (CI): 1.15-14.11; and OR 6.01 and 95%CI: 2.37-15.34, respectively]. Furthermore, 60% of the FLG mutation carriers with atopic dermatitis who developed hand eczema had experienced symptoms before adulthood. In the general population, self-reported hand eczema and atopic dermatitis, particularly in individuals with a genetically impaired skin barrier, were associated with disability pension, suggesting that FLG mutations carriers with a history of atopic dermatitis and hand eczema could benefit from early attention with respect to choice of occupation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Occupational dermatitis in health care workers evaluated for suspected allergic contact dermatitis.
Kadivar, Salmon; Belsito, Donald V
2015-01-01
Contact dermatitides occur commonly among health care workers (HCWs). To contrast the atopic status and incidence, location, and final diagnosis of skin diseases afflicting HCWs versus non-HCWs (NHCWs) evaluated for suspicion of allergic contact dermatitis (ACD); and among the population diagnosed with ACD, to compare the incidence and occupational relatedness of allergens found in HCWs with the rates observed in NHCWs. Between July 1, 1994, and May 30, 2014, 2611 patients underwent patch testing by the senior author. Of these, 165 were classified as HCWs based on their primary occupation. Statistical analysis was done using a χ test. Health care workers were more likely than NHCWs to be women and to have hand dermatitis. Women, but not men, HCWs suffered more irritant contact dermatitis. Health care workers had significantly more work-related ACD, especially to formaldehyde, quaternium-15, 2-bromo-2-nitropropane-1,3-diol, cocamide diethanolamine (DEA), thiuram mix, carba mix, thimerosal, benzalkonium chloride, glutaraldehyde, and bacitracin. Only patients suspected of having ACD were tested. Our population was geographically limited to metropolitan Kansas City, MO and metropolitan New York, NY. Health care workers suffer more from occupational ACD, especially of the hands, than do NHCWs, including to allergens not present on available standard allergen series.
Warshaw, Erin M; Hagen, Solveig L; Belsito, Donald V; DeKoven, Joel G; Maibach, Howard I; Mathias, C G Toby; Zug, Kathryn A; Sasseville, Denis; Zirwas, Matthew J; Fowler, Joseph F; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Taylor, James S
Little is known about the epidemiology of contact dermatitis (CD) in print machine operators (PMOs). The aims of this study were to estimate the prevalence of CD and characterize clinically relevant and occupationally related allergens among PMOs undergoing patch testing. This was a retrospective cross-sectional analysis of the North American Contact Dermatitis Group data from 1998 to 2014. Of 39,332 patch-tested patients, 132 (0.3%) were PMOs. Among PMOs, most were male (75.0%) and white (92.4%). The majority were printing press operators (85.6%). The most frequent sites of dermatitis were hands (63.6%), arms (29.5%), and face/scalp (24.2%). More than half had an occupationally related skin condition (56.1%). Final diagnoses were most commonly allergic CD (58.3%) and irritant CD (33.3%). Cobalt (20.8%), carba mix (12.5%), thiuram mix (8.3%), and formaldehyde (8.3%) were the most frequent occupationally related allergens. The top allergen sources included inks (22.9%), gloves (20.8%), and coatings/dye/copy/photographic chemicals (14.6%). Allergic CD, irritant CD, and involvement of exposed body areas were common among PMOs. Common allergens included rubber accelerators, metals, and preservatives.
Occupational contact dermatitis in manual cloud seeding operations.
Ng, W T; Koh, D
2011-05-01
This is a case report on irritant contact dermatitis secondary to calcium oxide exposure during manual cloud seeding operations. A less hazardous substitute such as sodium chloride should be considered wherever possible. Cloud seeding operations are briefly discussed in this report, and the impact of calcium oxide exposure as an occupational hazard is elaborated.
Papadatou, Zoi; Williams, Hector; Cooper, Kay
2018-06-01
The aim of this review was to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed here) in preventing occupational irritant hand dermatitis (OIHD) in wet workers, comparing each intervention to an alternative intervention or to usual care (workers' regular skin care regimen). The most significant occupational skin problem potentially encountered in wet work occupations is occupational dermatitis. When the skin comes into contact with hazardous substances at work, this can cause occupational dermatitis. Substances which may cause occupational dermatitis include cleaning products, organic solvents, metalworking fluids, cement, flour, adhesives, other chemicals and even certain plants. Occupational skin disease has adverse effects on quality of life and the long term prognosis for skin health is poor unless workplace exposures are addressed. To date, no systematic review has been undertaken to determine the effectiveness of interventions for the primary prevention of OIHD in wet workers. The review included any workers from healthcare (e.g. nurses, doctors and allied health professionals) and also people in different wet work occupations (e.g. hairdressers, florists, catering workers, metal workers) at similar risk of OIHD. Studies that assessed the following interventions in the primary prevention of OIHD in wet workers at the workplace and at home (before and after work) were included:Types of studies considered were experimental study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, and before and after studies. Primary outcome measures were OIHD incidence, and secondary outcome measures were product evaluation and change of occupation because of OIHD versus staying in the occupation. Published and unpublished literature in the English language was sought between 2004 and 2017. The databases searched included: COCHRANE CENTRAL, MEDLINE, CINAHL, AMED and Embase. The search for unpublished studies included: Google Scholar, Open DOAR and Robert Gordon University's thesis database, "OPEN AIR". There were no studies located that met the inclusion requirements of this review. There is currently no evidence available to determine the effectiveness of interventions to prevent OIHD amongst wet workers that met this review's inclusion criteria.
Occupational dermatoses in restaurant, catering and fast-food outlets in Singapore.
Teo, Sylvia; Teik-Jin Goon, Anthony; Siang, Lee Hock; Lin, Gan Siok; Koh, David
2009-10-01
The restaurant industry is a rapidly growing sector in Singapore and workers in this industry are trained in culinary skills but not on recognition of safety and health hazards and their control measures. Anecdotal clinical evidence has suggested an increased prevalence of occupational dermatoses among restaurant workers. To determine the prevalence and risk factors for contact dermatitis and burns among restaurant, catering and fast-food outlet (FFO) staff. Workers were interviewed and then clinical examination and patch and/or prick tests were conducted in selected individuals. In total, 335 of 457 workers (73% response) were interviewed and 65 (19%) had occupational dermatitis or burns and were examined. Of these, contact dermatitis was the commonest diagnosis, with a 12-month period prevalence of 10% (35 workers) and 3-month period prevalence of 8% (26 workers). All 35 workers had irritant contact dermatitis (ICD) and there were no cases of allergic contact dermatitis. The adjusted prevalence rate ratios of risk factors for ICD were 2.78 (95% CI 1.36-5.72) for frequent hand washing >20 times per day, 3.87 (95% CI 1.89-7.93) for atopy and 2.57 (95% CI 1.21-5.47) for contact with squid. The 3-month period prevalence for burns was 6% (20 workers). Ten workers had other occupational dermatoses such as work-related calluses, paronychia, heat rash and allergic contact urticaria to prawn and lobster. ICD and burns are common occupational skin disorders among restaurant, catering and FFO workers.
[Facial allergic contact dermatitis. Data from the IVDK and review of literature].
Schnuch, A; Szliska, C; Uter, W
2009-01-01
The face is exposed to many foreign substances and may thus be a site of allergic contact dermatitis. Our aim is to elucidate the spectrum of factors associated with facial dermatitis by analyzing data of patients patch tested in the Information Network of Departments of Dermatology (IVDK) between 1995 and 2007. In 18,572 patients the main anatomical site of dermatitis was the face. Among these, the proportion of females and of patients with past or present atopic eczema was increased, while probable occupational causation was less common than in the overall group. Cosmetic allergens, as well as nickel, were significantly more common in women than men, including fragrance mix (10.8% vs. 8.3%), p-phenylenediamine (4.0% vs. 2.8%), lanolin alcohols (3.0% vs. 2.2%), Lyral(TM) (3.1% vs. 2.0%) and bufexamac (1.8% vs. 1.1%). In comparison, only epoxy resin contact allergy was diagnosed significantly more often in men than women: In patients with airborne contact dermatitis, over-represented allergens included sesquiterpene lactone mix, compositae mix, epoxy resin, (chloro-) methylisothiazolinone and oil of turpentine. In the clinical approach to patients with facial dermatitis, occupational airborne causation should be considered in addition to non-occupational (e.g., cosmetic) allergen exposure.
Schwensen, Jakob F; Menné, Torkil; Andersen, Klaus E; Sommerlund, Mette; Johansen, Jeanne D
2014-11-01
In recent years, the prevalence of contact allergy to isothiazolinones has reached epidemic levels. Few studies have presented data on occupations at risk of developing contact allergy to isothiazolinones. To present demographics and examine risk factors for sensitization to methylisothiazolinone (MI), methylchloroisothiazolinone (MCI) in combination with MI and benzisothiazolinone (BIT) in Danish dermatitis patients. A retrospective epidemiological analysis of data from three Danish hospitals departments was conducted. All patients consecutively patch tested with MI, MCI/MI and BIT between 2009 and 2013 were included. MI contact allergy showed a significantly increased trend in prevalence from 1.8% in 2009 to 4.2% in 2012 (p < 0.001). Females with facial dermatitis mainly drove the increase in 2012. Adjusted logistic regression analysis showed that MI sensitization was significantly associated with occupational exposures, hand and facial dermatitis, age > 40 years, and the occupational groups of tile setters/terrazzo workers, machine operators, and painters. MCI/MI contact allergy was significantly associated with the following high-risk occupations: painting, welding (blacksmiths), machine operating, and cosmetology. The occupational group of painting was frequent in the group of patients with BIT contact allergy. Several high-risk occupations for sensitization to isothiazolinones exist. Regulation on the allowed concentration of isothiazolinones, and especially MI, in both consumer products and industrial products is needed. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Hand dermatitis in auto mechanics and machinists.
Donovan, Jeffrey C H; Kudla, Irena; Holness, D Linn
2007-09-01
Auto mechanics and machinists presenting with suspected allergic contact dermatitis (ACD) have traditionally been patch-tested with a standard screening tray and a specialty tray such as the Oil and Cooling Fluid Series. While this has proven useful for patch-testing the machinist, there is a need for the development of a more specific allergen testing tray for the auto mechanic. The objective of the study was to compare clinical features and patch-test results of auto mechanics and machinists with hand dermatitis to evaluate differences in allergen profiles. We performed a chart review of 33 auto mechanics and 24 machinists referred to our Occupational Contact Dermatitis Clinic from 2002 to 2005 for evaluation of hand dermatitis. With a panel of 84 allergens, 52 positive reactions were detected in 17 cases of ACD in mechanics. The profiles were different from the cases of ACD diagnosed in 10 of 24 machinists. Mechanics and machinists differ in the spectrum of occupational exposures. Patch testing with greater numbers of allergens likely identifies a larger proportion of mechanics with occupationally relevant ACD. Further study is needed to determine the most appropriate allergens to include in a clinically useful "mechanic's tray."
The identification of a sensitizing component used in the manufacturing of an ink ribbon.
Anderson, Stacey E; Tapp, Loren; Durgam, Srinivas; Meade, B Jean; Jackson, Laurel G; Cohen, David E
2012-01-01
Skin diseases including dermatitis constitute ≈ 30% of all occupational illnesses, with a high incidence in the printing industry. An outbreak of contact dermatitis among employees at an ink ribbon manufacturing plant was investigated by scientists from the National Institute for Occupational Safety and Health (NIOSH). Employees in the process areas of the plant were exposed to numerous chemicals and many had experienced skin rashes, especially after the introduction of a new ink ribbon product. To identify the causative agent(s) of the occupational dermatitis, the murine local lymph node assay (LLNA) was used to identify the potential of the chemicals used in the manufacture of the ink ribbon to induce allergic contact dermatitis. Follow-up patch testing with the suspected allergens was conducted on exposed employees. Polyvinyl butyral, a chemical component used in the manufacture of the ink ribbon in question and other products, tested positive in the LLNA, with an EC3 of 3.6%, which identifies it as a potential sensitizer; however, no employees tested positive to this chemical during skin patch testing. This finding has implications beyond those described in this report because of occupational exposure to polyvinyl butyral outside of the printing industry.
The identification of a sensitizing component used in the manufacturing of an ink ribbon
Anderson, Stacey E.; Tapp, Loren; Durgam, Srinivas; Meade, B. Jean; Jackson, Laurel G.; Cohen, David E.
2015-01-01
Skin diseases including dermatitis constitute ≈ 30% of all occupational illnesses, with a high incidence in the printing industry. An outbreak of contact dermatitis among employees at an ink ribbon manufacturing plant was investigated by scientists from the National Institute for Occupational Safety and Health (NIOSH). Employees in the process areas of the plant were exposed to numerous chemicals and many had experienced skin rashes, especially after the introduction of a new ink ribbon product. To identify the causative agent(s) of the occupational dermatitis, the murine local lymph node assay (LLNA) was used to identify the potential of the chemicals used in the manufacture of the ink ribbon to induce allergic contact dermatitis. Follow-up patch testing with the suspected allergens was conducted on exposed employees. Polyvinyl butyral, a chemical component used in the manufacture of the ink ribbon in question and other products, tested positive in the LLNA, with an EC3 of 3.6%, which identifies it as a potential sensitizer; however, no employees tested positive to this chemical during skin patch testing. This finding has implications beyond those described in this report because of occupational exposure to polyvinyl butyral outside of the printing industry. PMID:22375946
(Meth)Acrylate Occupational Contact Dermatitis in Nail Salon Workers: A Case Series.
DeKoven, Samuel; DeKoven, Joel; Holness, D Linn
Recently, many cases of acrylate-associated allergic contact dermatitis have appeared among nail salon workers. Common acrylate-containing products in nail salons include traditional nail polish, ultraviolet-cured shellac nail polish, ultraviolet-cured gel nails, and press-on acrylic nails. Nail salon technicians seen in the occupational medicine clinic in 2015 and 2016 were identified, and their patch test results and clinical features were summarized. Patch testing was done with the Chemotechnique (Meth)Acrylate nail series, and either the North American Standard series or the North American Contact Dermatitis Group screening series. Six patients were identified, all women, ages 38 to 58. Common presentations included erythematous dermatitis of the dorsa of the hands, palms, and forearms and fissures on the fingertips. Less common sites of eruptions included the periorbital region, cheeks, posterior ears, neck, sacral area, lateral thighs, and dorsa of the feet. All patients reacted to hydroxyethyl methacrylate, and 5 patients reacted to ethyl acrylate. Each patient also reacted to (meth)acrylates that are not found on either standard series, including ethyleneglycol dimethacrylate, 2-hydroxypropyl methacrylate, and 2-hydroxyethyl acrylate. The authors report 6 cases of allergic contact dermatitis to acrylates in nail technicians seen over the past year, representing a new trend in their clinic. These cases are reflective of a growing trend of nail technicians with allergic contact dermatitis associated with occupational (meth)acrylate exposure. Efforts to improve prevention are needed.
Occupational contact dermatitis in the wind energy industry.
Lárraga-Piñones, G; Heras-Mendaza, F; Conde-Salazar, L
2012-12-01
In 2010, wind energy coverage in Spain increased by 16%, making the country the world's fourth largest producer in a fast-developing industry that is also a source of employment. Occupational skin diseases in this field have received little attention. The present study aims to describe the main characteristics of skin diseases affecting workers in the wind energy industry and the allergens involved. We performed a descriptive, observational study of workers from the wind energy industry with suspected contact dermatitis who were referred to the occupational dermatology clinic of the National School of Occupational Medicine (Escuela Nacional de Medicina del Trabajo) between 2009 and 2011. We took both a clinical history and an occupational history, and patients underwent a physical examination and patch testing with the materials used in their work. We studied 10 workers (8 men, 2 women), with a mean age of 33.7 years. The main finding was dermatitis, which affected the face, eyelids, forearms, and hands. Sensitization to epoxy resins was detected in 4 workers, 1 of whom was also sensitized to epoxy curing agents. One worker was sensitized to bisphenol F resin but had a negative result with epoxy resin from the standard series. In the 5 remaining cases, the final diagnosis was irritant contact dermatitis due to fiberglass. Occupational skin diseases are increasingly common in the wind energy industry. The main allergens are epoxy resins. Fiberglass tends to produce irritation. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.
Association between cobalt allergy and dermatitis caused by leather articles--a questionnaire study.
Bregnbak, David; Thyssen, Jacob P; Zachariae, Claus; Menné, Torkil; Johansen, Jeanne D
2015-02-01
Cobalt is a strong skin sensitizer and a prevalent contact allergen. Recent studies have recognized exposure to leather articles as a potential cause of cobalt allergy. To examine the association between contact allergy to cobalt and a history of dermatitis resulting from exposure to leather. A questionnaire case-control study was performed: the case group consisted of 183 dermatitis patients with a positive patch test reaction to cobalt chloride and a negative patch test reaction to potassium dichromate; the control group consisted of 621 dermatitis patients who did not react to either cobalt or chromium in patch testing. Comparisons were made by use of a χ(2) -test, Fisher's exact, and the Mann-Whitney test. Logistic regression analyses were used to test for associations while taking confounding factors into consideration. Leather was observed as the most frequent exposure source causing dermatitis in the case group. Although the case group significantly more often reported non-occupational dermatitis caused by leather exposure (p < 0.001), no association was found between cobalt allergy and dermatitis caused by work-related exposure to leather. Our study suggests a positive association between cobalt allergy and a history of dermatitis caused by non-occupational exposure to leather articles. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Silva, Eliane Aparecida; Bosco, Marcia Regina Miras; Mozer, Erika
2012-01-01
Contact dermatitis to cosmetics is a common dermatosis, especially in adults and professionals who handle them. The objective of this study was to evaluate the frequency of sensitization to cosmetics' components in patients with suspected allergic contact dermatitis and to identify the main sensitizers related to occupational contact dermatitis. During the period of January 2008 to June 2010, all the patients with a presumptive diagnosis of allergic contact dermatitis to cosmetics were selected. The patients were submitted to the patch tests of cosmetics series, composed by ten substances. Among the 147 patients studied sensitization to cosmetics components occurred in 31,29% of the cases, 14 of those (19,18%) equally corresponding to BHT and triethanolamine substances, 13 (17,81%) to ammonium thioglycolate, 09 to sorbic acid (12,33%), 08 to tosilamida (10,95%), 06 to germall (8,22%). The other elements tested showed indices of 5% or less. A higher frequency of contact dermatitis to cosmetics was observed in women and the age most affected was concordant with the age range of greatest professional activity of the population. Allergic contact dermatitis was more frequently associated with Triethanolamine, BHT and ammonium thioglycolate, and the relation with occupational contact dermatitis was discreet.
Gaps in Workplace Education For Prevention of Occupational Skin Disease.
Gupta, Tanya; Arrandale, Victoria H; Kudla, Irena; Holness, D Linn
2018-02-13
Occupational contact dermatitis (OCD) is a common occupational disease. Evidence suggests that education and training are effective prevention strategies. In spite of these known prevention strategies, workers continue to develop OCD. Little is reported regarding the actual training experience of workers. To examine the training experience of workers with contact dermatitis to identify areas for improvement. Participants were workers being assessed for contact dermatitis in an occupational health clinic. The anonymous survey collected demographics, workplace characteristics, and education and prevention practices. Approximately 80% reported general occupational health and safety training; however, only 49% reported skin-specific training (SST). For workers reporting SST, most received information regarding exposure avoidance, hand washing, and glove use. This content was reported as helpful by at least 50%. Workers who did not receive SST indicated the most important content would be warning signs of skin problems, how to avoid exposure and skin care while using gloves. While the study was anonymous and used self-reported of training experience, the study suggests there are gaps in skin protection training. Addressing these gaps may lead to improved prevention and reduction in OCD. © The Author(s) 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.
Occupational Contact Dermatitis in the Canadian Aircraft Industry.
Loranger, Camille; Moreau, Linda; Sasseville, Denis
Aircraft building exposes workers to irritant and sensitizing products. The aim of this article was to study occupational dermatoses among aircraft workers over 25 years. The files of aerospace workers referred between 1990 and 2015 were extracted from the database of the McGill University Health Centre contact dermatitis clinic. These were subdivided according to demographics, type of work, patch testing results, and final diagnosis. Of 305 workers, 58% were 40 years or younger; one third were women. Onset of dermatitis varied from 2 months to 25 years, but 120 cases (39%) occurred during the first 3 years. Fifty-one percent of the cases involved assemblers, and 27% were composite material technicians, which were overrepresented as they constitute 10% of the workforce. Of the 305 workers, 152 suffered from allergic contact dermatitis, and 96 had irritant contact dermatitis. Of those with allergic contact dermatitis, 124 reacted to epoxy-based workplace products, but only 48 had positive patch tests to commercially available epoxy allergens. More than 60% of the cases of epoxy allergy would have been missed without testing with workplace products.
Occupational Contact Dermatitis in the Canadian Aircraft Industry: A 25-Year Retrospective Study.
Loranger, Camille; Moreau, Linda; Sasseville, Denis
2018-03-24
Aircraft building exposes workers to irritant and sensitizing products. The aim of this article was to study occupational dermatoses among aircraft workers over 25 years. The files of aerospace workers referred between 1990 and 2015 were extracted from the database of the McGill University Health Centre contact dermatitis clinic. These were subdivided according to demographics, type of work, patch testing results, and final diagnosis. Of 305 workers, 58% were 40 years or younger; one third were women. Onset of dermatitis varied from 2 months to 25 years, but 120 cases (39%) occurred during the first 3 years. Fifty-one percent of the cases involved assemblers, and 27% were composite material technicians, which were overrepresented as they constitute 10% of the workforce. Of the 305 workers, 152 suffered from allergic contact dermatitis, and 96 had irritant contact dermatitis. Of those with allergic contact dermatitis, 124 reacted to epoxy-based workplace products, but only 48 had positive patch tests to commercially available epoxy allergens. More than 60% of the cases of epoxy allergy would have been missed without testing with workplace products.
Allergic contact dermatitis associated with reactive dyes in a dark garment: a case report.
Moreau, Linda; Goossens, An
2005-09-01
In this study, we present a case of a patient who has not been occupationally exposed to reactive dyes, but did present with a dermatitis from wearing a dark cotton garment. The patient experienced reactivation of his dermatitis when rewearing a new unwashed dark T-shirt made of 100% cotton (in fact, the patient reported that it had to be washed at least 3 times before the skin reaction disappeared). He presented positive patch tests to 6 reactive dyes from Chemotechnique textile series. The clothing could not be proved as the true cause of the dermatitis, but resolution occurred upon removal of the suspected garment. This suggests that contact allergy to the reactive dyes (he did not react to any other dyes and his garment was a natural fabric) was likely responsible. With this report, we would like to emphasize that reactive dyes, as a class, should be considered as potential allergens, both occupationally and from non-occupational exposure such as garments. If garments containing reactive dyes are not properly rinsed in the manufacturing process, we believe that excess of dye can be retained that may cause allergic contact dermatitis (ACD). As the reactive dyes and their hydrolysis products are very water-soluble, they can be easily washed off to prevent ACD.
Angelova-Fischer, Irena; Hoek, Anne-Karin; Dapic, Irena; Jakasa, Ivone; Kezic, Sanja; Fischer, Tobias W; Zillikens, Detlef
2015-12-01
Fruit-derived organic compounds and detergents are relevant exposure factors for occupational contact dermatitis in the food industry. Although individuals with atopic dermatitis (AD) are at risk for development of occupational contact dermatitis, there have been no controlled studies on the effects of repeated exposure to multiple irritants, relevant for the food industry, in atopic skin. The aim of the study was to investigate the outcomes of repeated exposure to a fruit-derived organic acid and a detergent in AD compared to healthy volunteers. The volunteers were exposed to 2.0% acetic acid (AcA) and/or 0.5% sodium lauryl sulfate (SLS) in controlled tandem repeated irritation test. The outcomes were assessed by measurements of erythema, transepidermal water loss (TEWL) and natural moisturizing factor (NMF) levels. In the AD volunteers, repeated AcA exposure led to barrier disruption and significant TEWL increase; no significant differences after the same exposure in the healthy controls were found. Repeated exposure to SLS and the irritant tandems enhanced the reactions and resulted in a significantly higher increase in TEWL in the AD compared to the control group. Cumulative irritant exposure reduced the NMF levels in both groups. Differences in the severity of irritant-induced barrier impairment in atopic individuals contribute to the risk for occupational contact dermatitis in result of multiple exposures to food-derived irritants and detergents. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Occupational dermatoses from exposure to epoxy resin compounds in a ski factory.
Jolanki, R; Tarvainen, K; Tatar, T; Estlander, T; Henriks-Eckerman, M L; Mustakallio, K K; Kanerva, L
1996-06-01
Of 22 workers in a ski factory, occupational allergic contact dermatitis was found in 8. 6 were sensitive to epoxy resin compounds, i.e., epoxy resins, hardeners or diluents, 1 to cobalt in glass-fiber reinforcements, and 1 to formaldehyde in a urea-formaldehyde glue and a lacquer. 4 workers had irritant contact dermatitis from epoxy resin compounds, lacquers, sanding dust, or glass-fiber dust. 3 had contact allergy from a new sensitizer, diethyleneglycol diglycidyl ether, in a reactive diluent. Immediate transfer of workers sensitized to epoxy resin from epoxy exposure prevents aggravation of their dermatitis and broadening of the sensitization to epoxy hardeners, diluents and other compounds.
Workplace screening for hand dermatitis: a pilot study.
Nichol, K; Copes, R; Spielmann, S; Kersey, K; Eriksson, J; Holness, D L
2016-01-01
Health care workers (HCWs) are at increased risk for developing occupational skin disease (OSD) such as dermatitis primarily due to exposure to wet work. Identification of risk factors and workplace screening can help early detection of OSD to avoid the condition becoming chronic. To determine risk factors and clinical findings for hand dermatitis using a workplace screening tool. Employees at a large teaching hospital in Toronto, Canada, were invited to complete a two-part hand dermatitis screening tool. Part 1 inquired about hand hygiene practices and Part 2 comprised a visual assessment of participants' hands by a health professional and classification as (i) normal, (ii) mild dermatitis or (iii) moderate/severe dermatitis. Risk factors were determined using chi-square and Cochran-Armitage analysis on a dichotomous variable, where Yes represented either a mild or moderate/severe disease classification. There were 183 participants out of 643 eligible employees; response rate 28%. Mild or moderate/severe dermatitis was present in 72% of participants. These employees were more likely to work directly with patients, have worked longer in a health care setting, wash hands and change gloves more frequently, wear gloves for more hours per day, have a history of eczema or dermatitis and report a current rash on the hands or rash in the past 12 months. There was a high percentage of HCWs with dermatitis and risk factors for dermatitis. These findings argue for increased attention to prevention and early identification of hand dermatitis and support further testing of the workplace screening tool. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Occupational allergic and irritant contact dermatitis in workers exposed to polyurethane foam.
Kieć-Świerczyńska, Marta; Swierczyńska-Machura, Dominika; Chomiczewska-Skóra, Dorota; Nowakowska-Świrta, Ewa; Kręcisz, Beata
2014-04-01
To evaluate sensitization to chemicals present in work environment after an outbreak of contact dermatitis in workers of vehicle equipment factory, exposed to polyurethane foam, based on 4,4'-diphenylmethane diisocyanate (MDI). From among 300 employees, 21 individuals reporting work-related skin and/or respiratory tract symptoms underwent clinical examination, patch testing, skin prick tests, spirometry and MDI sIgE measurement in serum. Patch tests included isocyanates series, selected rubber additives, metals, fragrances, preservatives, and an antiadhesive agent. Clinical examination revealed current eczema in the area of hands and/or forearms in 10 workers. Positive patch test reactions were found in 10 individuals, the most frequent to diaminodiphenylmethane and 4-phenylenediamine (7 persons). Reactions to an antiadhesive agent were assessed as irritant (5 workers). Except for sensitization to common aeroallergens, no significant abnormalities were found in the remaining tests. Occupational allergic contact dermatitis was diagnosed in 7 workers, irritant contact dermatitis in 10 and coexisiting allergic and irritant contact dermatitis in 3 workers. In workers manufacturing products from polyurethane foam, attention should be paid to the risk of developing contact dermatitis. Skin problems in our study group were attributable probably to insufficient protection of the skin.
An update on airborne contact dermatitis.
Huygens, S; Goossens, A
2001-01-01
This review is an update of 2 previously published articles on airborne contact dermatoses. Because reports in the literature often omit the term 'airborne', 18 volumes of Contact Dermatitis (April 1991-June 2000), 8 volumes of the American Journal of Contact Dermatitis (1992 1999) and 4 volumes of La Lettre du Gerda (1996-1999) were screened, and the cases cited were classified as to history, lesion locations, sensitization sources, and other factors. Reports on airborne dermatitis are increasingly being published, sometimes in relation to specific occupational areas.
Bhatia, Riti; Sharma, Vinod K; Ramam, M; Sethuraman, Gomathy; Yadav, Chander P
2015-09-01
Data regarding occupational contact dermatitis (OCD) and its effect on quality of life (QOL) in India are limited. To evaluate patients with OCD and record the outcome of treatment. All patients with OCD were evaluated for severity of disease (by the use of physician global assessment) and its effect on QOL (by use of the Dermatology Life Quality Index) questionnaire) at the first visit and after 3 months of treatment. Among 117 patients with OCD, hand eczema was present in 81.2%. Positive patch test reactions were found in 76%. The most common allergens were Parthenium hysterophorus and potassium dichromate. The most frequent diagnosis was occupational allergic contact dermatitis (OACD) (57%), caused by farming and construction work, followed by occupational irritant contact dermatitis (OICD) (24%), caused by wet work. Severe psychosocial distress was recorded in 62.5% of patients. After 3 months of treatment, 83% improved significantly, and 54% had improvement in QOL. Farmers were most frequently affected, followed by construction workers and housewives. OACD was found at a higher frequency than OICD. The most frequent allergens were Parthenium hysterophorus in farmers, potassium dichromate in construction workers, and vegetables in housewives. OCD has a significant impact on QOL. Patch testing, in addition to standard treatment, improves the outcome considerably. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Friis, Ulrik F; Menné, Torkil; Schwensen, Jakob F; Flyvholm, Mari-Ann; Bonde, Jens P E; Johansen, Jeanne D
2014-12-01
Irritant contact dermatitis (ICD) is a common diagnosis in patients with occupational contact dermatitis (OCD). Studies are lacking on the usefulness of material safety data sheets (MSDSs) in making the diagnosis of ICD. To characterize irritant exposures leading to the diagnosis of occupational ICD (OICD), and to evaluate the occurrence of concomitant exposures to contact allergens. We included 316 patients with suspected occupational hand dermatitis, referred to the Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Denmark during January 2010-August 2011, in a programme consisting of a clinical examination, exposure assessment, and extensive patch/prick testing. OCD was diagnosed in 228 patients. Of these patients, 118 were diagnosed with OICD. The main irritant exposures identified were wet work (n = 64), gloves (n = 45), mechanical traumas (n = 19), and oils (n = 15). Exposure to specific irritant chemicals was found in 9 patients, and was identified from MSDSs/ingredients labelling in 8 of these patients. Review of MSDSs and ingredients labelling showed that 41 patients were exposed to 41 moderate to potent contact allergens, and 18 patients were exposed to 25 weak workplace contact allergens. In the present study, the systematic exposure assessment did not reveal any new irritants. MSDSs have a limited role in the investigation of ICD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Occupational skin hazards from synthetic plastics.
Tosti, A; Guerra, L; Vincenzi, C; Peluso, A M
1993-01-01
Epoxy and acrylic resins have numerous industrial applications but are also widely used in the household environment. These compounds are presently one of the most important sources of occupational contact dermatitis. Contact sensitization to epoxy resins is usually caused by the resin itself but hardeners or other additives, such as reactive diluents, plasticizers, fillers and pigments, can occasionally be responsible. Since completely cured epoxy resins are not sensitizers, epoxy resin sensitization is always due to the presence, in the final polymer, of uncured allergenic low molecular weight oligomers. Acrylates are now considered the fourth most common cause of contact sensitization due to resins. Unpolymerized monomers of acrylic compounds are known to be responsible for the contact allergy. Accelerators, inhibitors and catalysts, which are usually added to the acrylates to promote the polymerization process, can also sensitize. Both allergic and irritant contact dermatitis may be caused by exposure to epoxy or acrylic resins and their additives. Contact urticaria, allergic or irritant airborne contact dermatitis caused by volatile compounds, onychia and paronychia can also occur. From January of 1984 to May of 1992 we detected 39 cases of occupational allergic contact dermatitis to epoxy resin system substances and 11 cases of occupational contact sensitization to acrylic compounds. In our experience, the electronics industry as well as paint and glue related activities were the most important sources of epoxy sensitization. Dental materials and anaerobic sealants were found to be the most frequent acrylate sensitizers.
Occupational contact dermatitis caused by aniline epoxy resins in the aircraft industry.
Pesonen, Maria; Suuronen, Katri; Jolanki, Riitta; Aalto-Korte, Kristiina; Kuuliala, Outi; Henriks-Eckerman, Maj-Len; Valtanen, Ilona; Alanko, Kristiina
2015-08-01
Tetraglycidyl-4,4'-methylenedianiline (TGMDA) is an aniline epoxy resin used in, for example, resin systems of pre-impregnated composite materials (prepregs) of the aircraft industry. Allergic contact dermatitis caused by TGMDA in prepregs has been described previously. To report on 9 patients with occupational allergic contact dermatitis caused by TGMDA in epoxy glues used in helicopter assembly. The patients were examined with patch testing at the Finnish Institute of Occupational Health in 2004-2009. The first patient was diagnosed by testing both components of two epoxy glues from the workplace, and was also tested with glue ingredients, including TGMDA. The following patients were tested with the glues and TGMDA. The resin parts of the glues were analysed for their epoxy compounds, including TGMDA. All of the patients had a patch test reaction to one or both of the resin parts of the TGMDA-containing glues. Eight of them had a strong allergic reaction to TGMDA, and one had a doubtful reaction to TGMDA. Two of the patients also had an allergic reaction to triglycidyl-p-aminophenol (TGPAP), another aniline epoxy resin, which was not present in the TGMDA-containing glues. In aircraft industry workers with suspected occupational dermatitis, aniline epoxy resins should be considered and patch tested as possible contact allergens. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Percival, L; Tucker, S B; Lamm, S H; Key, M M; Wilds, B; Grumski, K S
1995-02-01
An example of interdisciplinary problem solving by occupational health professionals is presented. Approximately one dozen employees in an aircraft wire harness assembly line complained of dermatitis, alleging workplace exposures as causation. The plant's and consulting industrial hygienists prepared toxicology and exposure assessments for all process materials, manufacturing procedures, and protective equipment used. They identified no common elements in the work environment that may have caused the dermatitis, suggesting multiple causation and possible individual worker sensitivities. An investigative team composed of the industrial hygienists and physicians in outside practice, including dermatologists and occupational medicine physicians, conducted a review of plant operations and proposed that workers with dermatitis complaints receive diagnostic medical examinations. An initial examination medically documented each worker's complaint, and a follow-up included patch testing for selected process materials. The physicians diagnosed a variety of mainly nonoccupationally induced illnesses such as fungal infections, skin cancer (solar induced), acne, etc., confirming the industrial hygienists' original assessment. One case appeared directly work-related and to be a specific assembly component sensitivity. Although several cases with a nonoccupational origin could have been aggravated by working conditions, these workers showed no sensitivity to the component when patch tested.
Return to Work for Nurses With Hand Dermatitis.
Chen, Jennifer; Gomez, Pilar; Kudla, Irena; DeKoven, Joel; Holness, D Linn; Skotnicki, Sandra
2016-01-01
Occupational skin disease is common in healthcare workers. If the healthcare worker develops moderate to severe dermatitis, return to work (RTW) may be challenging. The study objectives were to review the impact of an RTW program on the work status of nurses with occupational hand dermatitis and to identify successful intervention methods and strategies. Nurses who received RTW services at a tertiary occupational medicine clinic were identified, and information related to their diagnosis and RTW was abstracted from their charts. Eighteen nurses with irritant hand dermatitis who received RTW services were identified. Twelve nurses (67%) were performing administrative duties because of their skin condition when admitted to the RTW program, and others were performing patient care with modifications. A graduated RTW trial was commonly implemented with optimized skin care management and monitoring by physicians and the RTW coordinator. Upon discharge, 14 nurses (78%) had returned to their nursing roles with direct patient care, 3 (17%) were working as nurses in non-patient care roles, and 1 (6%) was on permanent disability. A graduated RTW trial to reduce cumulative irritant exposure is a crucial strategy to facilitate nurses' transition back to work and to maintain direct patient care nursing roles.
Klein, Thomas G; Woehlck, Harvey J; Pagel, Paul S
2009-01-01
We describe the clinical presentation and management of an anesthesiologist who developed a severe allergic contact dermatitis resulting from occupational exposure to tincture of benzoin aerosol spray. A previously healthy male anesthesiologist with a small laceration between his right thumb and forefinger used a tincture of benzoin aerosol spray to improve adhesion of a small bandage immediately before performing a spinal anesthetic. He had previously used benzoin for skin reinforcement on several occasions during weight-lifting. The anesthesiologist experienced severe pruritus in the affected hand 48 h after benzoin exposure. A well-demarcated, bright red erythematous confluent vesicular dermatitis with and without painful hemorrhagic bullae erupted on the palmar and dorsal surfaces, respectively, of his hand, accompanied by pronounced edema. The palmar bullae were drained with several small incisions and the anesthesiologist was treated with intravenous methylprednisolone. He was unable to work for 10 days while the dermatitis gradually resolved. The case emphasizes that occupational exposure to benzoin represents a potential risk for operating room personnel who may be susceptible to cutaneous delayed hypersensitivity-mediated allergic reactions as a result of previous exposure to benzoin or chemically related cross-reacting substances.
Skin Problems: How to Protect Yourself from Job-Related Skin Problems
... You can get it from contact or allergies. Contact dermatitis occurs from frequent contact with substances, such as: ... Health: Haz-Map, Chemicals that Cause Occupational Allergic Contact Dermatitis Last Updated: June 2, 2017 This article was ...
Occupational allergic contact dermatitis to nitromethane.
Webb, Kelli G; Fowler, Joseph F
2002-12-01
Nitromethane has wide industrial and commercial application as a polar solvent for adhesives and acrylics as well as explosive fuel. Allergic contact dermatitis to this chemical has not been described previously. The authors documented allergic contact hand dermatitis in 4 coworkers who similarly handled an adhesive solvent containing nitromethane. All 4 cases were confirmed by patch testing and resolved after allergen avoidance. Copyright 2002, Elsevier Science (USA)
Allergic contact dermatitis from acrylic nails in a flamenco guitarist.
Alcántara-Nicolás, F A; Pastor-Nieto, M A; Sánchez-Herreros, C; Pérez-Mesonero, R; Melgar-Molero, V; Ballano, A; De-Eusebio, E
2016-12-01
Acrylates are molecules that are well known for their strong sensitizing properties. Historically, many beauticians and individuals using store-bought artificial nail products have developed allergic contact dermatitis from acrylates. More recently, the use of acrylic nails among flamenco guitarists to strengthen their nails has become very popular. A 40-year-old non-atopic male patient working as a flamenco guitarist developed dystrophy, onycholysis and paronychia involving the first four nails of his right hand. The lesions were confined to the fingers where acrylic materials were used in order to strengthen his nails to play the guitar. He noticed improvement whenever he stopped using these materials and intense itching and worsening when he began reusing them. Patch tests were performed and positive results obtained with 2-hydroxyethyl methacrylate (2-HEMA), 2-hydroxyethyl acrylate (2-HEA), ethyleneglycol-dimethacrylate (EGDMA) and 2-hydroxypropyl methacrylate (2-HPMA). The patient was diagnosed with occupational allergic contact dermatitis likely caused by acrylic nails. Artificial nails can contain many kinds of acrylic monomers but most cases of contact dermatitis are induced by 2-HEMA, 2-HPMA and EGDMA. This is the first reported case of occupational allergic contact dermatitis from acrylates in artificial nails in a professional flamenco guitar player. Since the practice of self-applying acrylic nail products is becoming very popular within flamenco musicians, we believe that dermatology and occupational medicine specialists should be made aware of the potentially increasing risk of sensitization from acrylates in this setting. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Common Occupational Disorders: Asthma, COPD, Dermatitis, and Musculoskeletal Disorders.
Bepko, Jennifer; Mansalis, Katherine
2016-06-15
An occupational illness is an event or exposure that occurs in the workplace that causes or contributes to a condition or worsens a preexisting condition. If an occupational disorder is suspected, a directed history should be taken with particular attention to establishing a temporal relationship of symptoms and exposure at work. Occupational asthma is the most prevalent occupational lung disorder in industrialized countries and presents with classic asthma symptoms (cough, difficulty breathing, chest tightness, wheezing). Occupational chronic obstructive pulmonary disease has been linked with exposure to nonspecific vapors, gases, dusts, fumes, and cigarette smoke. Occupational contact dermatitis is the most common dermal exposure. It can be caused by exposure to a variety of agents, including primary irritants or sensitizers, physical agents, mechanical trauma, and biologic agents. Occupational musculoskeletal disorders include many common repetitive injuries such as carpal tunnel syndrome and medial or lateral epicondylitis. Treatment of occupational disorders is generally the same as for nonoccupational disorders. Ideally, the exposure should be controlled to protect the worker. The impact of an occupational injury reaches beyond lost wages and can have a negative impact on quality of life.
Allergic contact dermatitis: Patient management and education.
Mowad, Christen M; Anderson, Bryan; Scheinman, Pamela; Pootongkam, Suwimon; Nedorost, Susan; Brod, Bruce
2016-06-01
Allergic contact dermatitis is a common diagnosis resulting from exposure to a chemical or chemicals in a patient's personal care products, home, or work environment. Once patch testing has been performed, the education and management process begins. After the causative allergens have been identified, patient education is critical to the proper treatment and management of the patient. This must occur if the dermatitis is to resolve. Detailed education is imperative, and several resources are highlighted. Photoallergic contact dermatitis and occupational contact dermatitis are other considerations a clinician must keep in mind. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
AIRBORNE CONTACT DERMATITIS – CURRENT PERSPECTIVES IN ETIOPATHOGENESIS AND MANAGEMENT
Handa, Sanjeev; De, Dipankar; Mahajan, Rahul
2011-01-01
The increasing recognition of occupational origin of airborne contact dermatitis has brought the focus on the variety of irritants, which can present with this typical morphological picture. At the same time, airborne allergic contact dermatitis secondary to plant antigens, especially to Compositae family, continues to be rampant in many parts of the world, especially in the Indian subcontinent. The recognition of the contactant may be difficult to ascertain and the treatment may be even more difficult. The present review focuses on the epidemiological, clinical and therapeutic issues in airborne contact dermatitis. PMID:22345774
Smith, Suzanne M; Nedorost, Susan T
2010-01-01
The term "dermatitis" can be defined narrowly or broadly, clinically or histologically. A common and costly condition, dermatitis is underresourced compared to other chronic skin conditions. The lack of a collectively understood definition of dermatitis and its subcategories could be the primary barrier. To investigate how dermatologists define the term "dermatitis" and determine if a consensus on the definition of this term and other related terms exists. A seven-question survey of dermatologists nationwide was conducted. Of respondents (n = 122), half consider dermatitis to be any inflammation of the skin. Nearly half (47.5%) use the term interchangeably with "eczema." Virtually all (> 96%) endorse the subcategory "atopic" under the terms "dermatitis" and "eczema," but the subcategories "contact," "drug hypersensitivity," and "occupational" are more highly endorsed under the term "dermatitis" than under the term "eczema." Over half (55.7%) personally consider "dermatitis" to have a broad meaning, and even more (62.3%) believe that dermatologists as a whole define the term broadly. There is a lack of consensus among experts in defining dermatitis, eczema, and their related subcategories.
Hand dermatitis/eczema: current management strategy.
Sehgal, Virendra N; Srivastava, Govind; Aggarwal, Ashok K; Sharma, Alpna D
2010-07-01
Ever since its inception a couple of centuries ago, hand dermatitis/eczema has been in the reckoning. Idiosyncrasies continued to loom large thereafter, till it acquired its appropriate position. Dermatitis/eczema are synonymous, often used to indicate a polymorphic pattern of the inflammation of the skin, characterized by pruritus, erythema and vesiculation. A spectrum delineated into acute sub-acute and chronic dermatitis of the hands. Pompholyx, recurrent focal palmer peeling, ring, wear and tear and fingertip eczema, apron, discoid eczema, chronic acral dermatitis, gut and patchy papulosquamous eczema are its clinical variants. Occupational dermatitis/eczema may be contributory. Etiological definitions are clinched by detailed history of exogenous and endogenous factors. However, scientific confirmation of the entity is through patch testing by using available antigens.
The role of skin barrier in occupational contact dermatitis.
Jakasa, Ivone; Thyssen, Jacob P; Kezic, Sanja
2018-06-12
Skin diseases represent one of the most common work-related diseases and may have a detrimental effect on social, personal and occupational aspects of life. Contact dermatitis, which comprises predominately irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD) accounts for vast majority of occupational skin diseases, especially in occupations associated with frequent skin contact with irritants and contact allergens. Although ICD and ACD have similar clinical manifestation, their pathophysiology and the role of the skin barrier is different. In ICD, perturbation of the skin barrier is the primary event which sets into motion diverse metabolic processes and triggers activation of innate immunity without involvement of adaptive immune system. In ACD, a type IV hypersensitivity reaction induced by contact allergens, the skin barrier impairment may evoke innate signaling pathways during the sensitization phase required for the activation of T-cell adaptive response. Thus, skin barrier impairment may increase the risk of ICD or ACD not only because of enhanced permeability and ingress of irritants and allergens, but also by generation of innate immune signal needed for the induction of allergic response. Hence, an efficient way to prevent CD is to avoid skin barrier damage in the workplace. This review focuses on the skin barrier, how it is affected by skin irritants and how its impairment contributes to development of ICD and ACD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Hines, J; Wilkinson, S M; John, S M; Diepgen, T L; English, J; Rustemeyer, T; Wassilew, S; Kezic, S; Maibach, H I
2017-01-01
Contact dermatitis is one of the most common occupational diseases, with serious impact on quality of life, lost days at work and a condition that may be chronically relapsing. Regular prophylactic skin cream application is widely acknowledged to be an effective prevention strategy against occupational contact dermatitis; however, compliance rates remain low. To present a simple programme for skin cream application in the workplace with focus on implementation to drive down the rate of occupational irritant contact dermatitis, an expert panel of eight international dermatologists combined personal experience with extensive literature review. The recommendations are based on clinical experience as supported by evidence-based data from interventional studies. The authors identified three moments for skin cream application in the work place: (i) before starting a work period; (ii) after washing hands; and (iii) after work. Affecting behaviour change requires systematic communications, monitoring and reporting, which is proposed through Kotter's principles of organizational change management. Measurement tools are provided in the appendix. Interventional data based on application of this proposal is required to demonstrate its effectiveness. © 2016 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
Schubert, S; Bauer, A; Molin, S; Skudlik, C; Geier, J
2017-03-01
Geriatric nurses (GN) have a high risk of occupational contact dermatitis (OCD), with chronic irritant contact dermatitis predominating. However, allergic contact dermatitis is an important issue as well. Little is known whether the relevant occupational allergen spectrum reported in the 1990s, including fragrances, preservatives, rubber chemicals and ingredients of surface disinfectants to be the most common sensitizers in GN, is still valid. To monitor the current allergen spectrum in GN with OCD and verify the validity of the patch test recommendations (baseline-, preservative-, ointment base-, rubber-, disinfectant, series and fragrances) in GN with suspected OCD given by the German Contact Dermatitis Research Group (DKG). Retrospective analysis of IVDK data (2005-2014) of 743 female GN with OCD, in comparison to 695 GN without OCD. GN with OCD reacted significantly more frequently to both fragrance mixes, hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC), thiuram mix, zinc diethyldithiocarbamate and mercaptobenzothiazole than GN without OCD. Reactions to MDBGN, methylchloroisothiazolinone/methylisothiazolinone and oil of turpentine occurred substantially, but not significantly more frequently among GN with OCD. The latter may be due to former use of a special alcoholic liniment in geriatric care. Among material from the patients' workplaces, tetrazepam was a frequent allergen, due to dust exposure from pill crushing. Furthermore, occupationally used protective gloves, body care products as well as surface disinfectants were often tested positively. The general allergen spectrum in GN with OCD is unchanged, so the DKG patch test recommendations are still valid. Prevention of occupational sensitization should focus on fragrance-free hygiene and body care products, usage of accelerator-free protective gloves and avoidance of drug dust exposure. © 2016 European Academy of Dermatology and Venereology.
U.K. standards of care for occupational contact dermatitis and occupational contact urticaria
Adisesh, A; Robinson, E; Nicholson, PJ; Sen, D; Wilkinson, M
2013-01-01
The diagnosis of occupational contact dermatitis (OCD) and occupational contact urticaria (OCU) is a process that involves fastidious clinical and occupational history taking, clinical examination, patch testing and skin-prick testing. A temporal relationship of work and/or the presence of a rash on the hands only raises suspicion of an occupational cause, and does not necessarily confirm an occupational causation. The identification of allergy by patch or prick tests is a major objective, as exclusion of an offending allergen from the environment can contribute to clinical recovery in the individual worker and avoidance of new cases of disease. This can be a complex process where allergens and irritants, and therefore allergic and irritant contact dermatitis, may coexist. This article provides guidance to healthcare professionals dealing with workers exposed to agents that potentially cause OCD and OCU. Specifically it aims to summarize the 2010 British Occupational Health Research Foundation (BOHRF) systematic review, and also to help practitioners translate the BOHRF guideline into clinical practice. As such, it aims to be of value to physicians and nurses based in primary and secondary care, as well as occupational health and public health clinicians. It is hoped that it will also be of value to employers, interested workers and those with responsibility for workplace standards, such as health and safety representatives. Note that it is not intended, nor should it be taken to imply, that these standards of care override existing statutory and legal obligations. Duties under the U.K. Health and Safety at Work Act 1974, the Management of Health and Safety at Work Regulations 1999, the Control of Substances Hazardous to Health Regulations 2002, the Equality Act 2010 and other relevant legislation and guidance must be given due consideration, as should laws relevant to other countries. PMID:23374107
Bordel-Gómez, Ma T; Miranda-Romero, A; Castrodeza-Sanz, J
2010-01-01
In clinical practice, contact dermatitis is a relatively common skin complaint, whose prevalence has increased in recent years. Study by patch testing is essential for diagnosis of contact sensitization. To study the prevalence of sensitization to different allergens in a standard battery and observe the influence of different epidemiological and clinical variables on contact sensitization. A large number of allergens were included in our battery in order to detect new sensitizations whose prevalence might justify further study. This was a retrospective, observational, epidemiological study of 1092 patients, conducted in our skin allergy unit between January 1, 2000, and December 31, 2005. All patients were studied with a battery of 51 allergens. We assessed the following variables: sex, age, type of referral, occupation, site and course of skin lesions, personal and family history of atopy, positive patch tests, clinical significance, diagnosis, source of sensitization, and occupational relationship. At least 1 positive result was found in 55% of the patients, and 55.7% presented atopic dermatitis in one of its clinical variants: allergic contact dermatitis (28.2%), irritant contact dermatitis (20.1%), photoallergic contact dermatitis (2.2%), and phototoxic contact dermatitis (1.2%). The most prevalent allergens were nickel sulfate (29.3%), palladium chloride (11.7%), cobalt chloride (10.8%), potassium dichromate (7.5%), fragrance blends (6.3%), and p-phenylenediamine (6.1%). A positive occupational relationship was found in 41.1%, and 21.3% of the patients studied were diagnosed with occupational contact dermatitis. Metal workers, construction workers, and professional hairdressers were the most strongly represented groups. The most common source of sensitization was contact with metallic objects, followed by drugs, cosmetics, and rubber items. Female sex was the only independent variable that had a significant influence on the risk of contact sensitization in general. Women became sensitized at a younger age than men, and the frequency of positive results in the patch tests increased with age, reaching a maximum at between 60 and 69 years of age, when the greatest rate of sensitization occurred. Comparison of our results with other Spanish data showed a progressive and constant increase in sensitization to nickel sulfate, fragrance blends, balsam of Peru, and rosin, and a decrease in sensitization to potassium dichromate. The inclusion of new allergens such as palladium chloride, diallyl disulfide, and p-toluene sulfonamide formaldehyde improved the sensitivity of the standard battery in the detection of contact sensitization. We therefore recommend further studies of these allergens.
Toxicodendron dermatitis: poison ivy, oak, and sumac.
Gladman, Aaron C
2006-01-01
Allergic contact dermatitis caused by the Toxicodendron (formerly Rhus) species-poison ivy, poison oak, and poison sumac-affects millions of North Americans every year. In certain outdoor occupations, for example, agriculture and forestry, as well as among many outdoor enthusiasts, Toxicodendron dermatitis presents a significant hazard. This review considers the epidemiology, identification, immunochemistry, pathophysiology, clinical features, treatment, and prevention of this common dermatologic problem. Recent research in prevention is emphasized, and resources to help in the identification of plants are provided in the bibliography. The literature was searched using a MEDLINE query for "Toxicodendron dermatitis", and the identified article bibliographies were searched as well.
PLANT DERMATITIS: ASIAN PERSPECTIVE
Goon, Anthony Teik Jin; Goh, Chee Leok
2011-01-01
Occupational and recreational plant exposure on the skin is fairly common. Plant products and extracts are commonly used and found extensively in the environment. Adverse reactions to plants and their products are also fairly common. However, making the diagnosis of contact dermatitis from plants and plant extracts is not always simple and straightforward. Phytodermatitis refers to inflammation of the skin caused by a plant. The clinical patterns may be allergic phytodermatitis, photophytodermatitis, irritant contact dermatitis, pharmacological injury, and mechanical injury. In this article, we will focus mainly on allergy contact dermatitis from plants or allergic phytodermatitis occurring in Asia. PMID:22345775
Soder, Stefanie; Diepgen, Thomas L; Radulescu, Magdalena; Apfelbacher, Christian J; Bruckner, Thomas; Weisshaar, Elke
2007-08-01
Cleaning and kitchen employees have an increased risk of suffering from occupational dermatoses. Prevention including improving individual skin care and skin protection behavior, health education, optimizing diagnostics and therapy as well as avoidance of occupational skin disease (BK 5101) is important. Participants in the courses were patients suspected of having an occupational skin disease. Besides socio-demographic and disease-related data, health-related quality of life (QL) was measured using the SF-36 and Skindex-29. One year later all participants were interviewed by telephone about the course of their skin disease. Out of 212 participants, 84.0 % were female. The mean age was 41.6 (SD = 10.8) years.168 patients (79.2 %) suffered from hand dermatitis,with irritant contact dermatitis being the predominant diagnosis (46.2 %,n = 98). One year later 65.4 % (n = 85) of the patients interviewed still suffered from hand dermatitis.9.2 % (n = 12) had meanwhile quit their job due to the skin disease. QL was impaired in all age groups being lower with increasing age of the patients. The follow-up confirmed the positive impact of the skin protection courses on patients' skin disease and well-being. Occupational skin diseases impair health-related quality of life in these professions but disease severity does not seem to play a key role.
Occupational Skin Diseases in the San Francisco Bay Area
Gellin, Gerald A.; Wolf, C. Richard; Milby, Thomas H.
1970-01-01
From answers by one-third of the practicing dermatologists in the San Francisco Bay Area to a questionnaire on occupational skin diseases, contact dermatitis due to irritants and sensitizers was found to rank first. Poison oak, which is the leading reported cause on “Doctor's First Report of Work Injury” received by the California Department of Industrial Relations, was sixth on the list of the survey, trailing solvents, cleansing agents, petroleum products and epoxy resins. A history of atopic dermatitis was often noted in current cases of occupational diseases of the skin. Avoidance of exposure or limiting the contact with pathogenic substances—through engineering changes, observation of working conditions by physicians, education of workers—appeared to be the best preventive measures. PMID:4255687
Outbreak of Occupational Dermatitis Associated With Pyemotes ventricosus
Jędrzejewska-Jurga, Katarzyna; Limburska, Joanna; Tomczyk, Jarosław
2017-01-01
Importance Although Pyemotes species have been known to cause dermatitis, recent reports are rare. During the past 30 years, only 3 outbreaks of dermatitis caused by Pyemotes ventricosus have been reported. Objective To analyze the causative agent of skin changes in employees of a company that produced herbal medicines. Design, Setting, and Participants This case series includes 18 patients (8 men, 10 women; mean age, 44 years) who contracted unusual dermatitis after an occupational exposure in July and August of 2012 while working for a company that produced herbal medicines. The patients were examined at the Lower Silesia Regional Centre of Occupational Medicine in Wroclaw, Poland. Exposures Workers weighed and packed 1 part of the Helichrysum arenarium herb. Main Outcomes and Measures We hypothesized the causative agent to be P ventricosus. An examination of the herbal specimens for ectoparasites confirmed the diagnosis. Results Initially 16 employees developed pruritic skin changes. Skin lesions with pruritic vesicles on an erythematous base with surrounding swelling and edema were observed. Several employees also developed a flulike illness. After 44 days, 2 new employees presented with the same skin changes. The analysis of working conditions showed that the same part of the H arenarium herb was weighed and packed at that time. Conclusions and Relevance We found that changing the time when the herbs were weighed and abandoning gas fumigation containing methyl bromide resulted in the recurrence of an almost forgotten disease. PMID:28445563
Are You at Risk for Contact Dermatitis? | Poster
You probably don’t give much thought to hand health. Until something goes wrong, almost everyone takes for granted that these crucial appendages will continue working as they always have. But hand health is an important consideration, especially at work. According to the Centers for Disease Control and Prevention (CDC), allergic contact dermatitis and irritant contact dermatitis account for 15–20 percent of all reported occupational diseases, and they cost employers an estimated $1 billion each year in lost workdays and decreased productivity.
Dermatitis in a rubber tyre factory.
Zina, A M; Bedello, P G; Cane, D; Bundino, S; Benedetto, A
1987-07-01
An outbreak of occupational dermatitis in a rubber tyre factory is reported. An unusual clinical picture was recognized. Patch tests revealed a high sensitization rate to the MBT derivative used: 2-(2'-4'dinitrophenylthio)benzothiazole. Since tests with MBT mix and dinitrophenol were negative; sensitization to a contaminant was suspected. DNCB was traced as the substance responsible.
Occupational seafood allergy: a review
Jeebhay, M; Robins, T; Lehrer, S; Lopata, A
2001-01-01
BACKGROUND—Recent years have seen increased levels of production and consumption of seafood, leading to more frequent reporting of allergic reactions in occupational and domestic settings. This review focuses on occupational allergy in the fishing and seafood processing industry. REVIEW—Workers involved in either manual or automated processing of crabs, prawns, mussels, fish, and fishmeal production are commonly exposed to various constituents of seafood. Aerosolisation of seafood and cooking fluid during processing are potential occupational situations that could result in sensitisation through inhalation. There is great variability of aerosol exposure within and among various jobs with reported allergen concentrations ranging from 0.001 to 5.061(µg/m3). Occupational dermal exposure occurs as a result of unprotected handling of seafood and its byproducts. Occupational allergies have been reported in workers exposed to arthropods (crustaceans), molluscs, pisces (bony fish) and other agents derived from seafood. The prevalence of occupational asthma ranges from 7% to 36%, and for occupational protein contact dermatitis, from 3% to 11%. These health outcomes are mainly due to high molecular weight proteins in seafood causing an IgE mediated response. Cross reactivity between various species within a major seafood grouping also occurs. Limited evidence from dose-response relations indicate that development of symptoms is related to duration or intensity of exposure. The evidence for atopy as a risk factor for occupational sensitisation and asthma is supportive, whereas evidence for cigarette smoking is limited. Disruption of the intact skin barrier seems to be an important added risk factor for occupational protein contact dermatitis. CONCLUSION—The range of allergic disease associated with occupational exposure to crab is well characterised, whereas for other seafood agents the evidence is somewhat limited. There is a need for further epidemiological studies to better characterise this risk. More detailed characterisation of specific protein antigens in aerosols and associated establishment of dose-response relations for acute and chronic exposure to seafood; the respective roles of skin contact and inhalational exposure in allergic sensitisation and cross reactivity; and the contribution of host associated factors in the development of occupational seafood allergies are important areas for future research. Keywords: occupational seafood allergy; occupational asthma; protein contact dermatitis PMID:11511741
Evaluation of occupational allergic contact dermatitis and its related factors in Iran.
Nassiri-Kashani, Mansour; Nassiri-Kashani, Mohammad Hassan; Ghafari, Mostafa
2016-01-01
Background: Occupational contact dermatitis, especially in hand, is one of the most common occupational disorders. The present study aimed at evaluating patients with occupational allergic contact dermatitis (ACD) caused by common allergens based on occupation type and disease history. Methods: This cross-sectional study aimed at evaluating the data of the patients with probable diagnosis of ACD in Center for Research and Training in Skin Diseases and Leprosy (CRTSDL) in Iran. In the present study, 946 patients were assessed from different regions of Iran. One hundred fifty-one cases with positive patch test and relevant exposure were entered into the study; data related to their occupation and disease activity history were evaluated and recorded. Then, factors related to disease activity history were assessed considering the occupational groups and common exposures. Results: Nickel sulphate was the most common allergen in the 151 patients. Disease activity was constant in 29.8% of the patients; it increased in 27.8%, and decreased just before doing the patch test in 42.4%. Of the patients, 52.3% were getting worse during the working days. Occupational groups were significantly different in age and gender. Disease duration was also different in the occupational groups (p=0.001). The least disease duration was observed in healthcare workers, and the most in service workers. Lesions in the foot were related to period of employment. In administrative work group, (teachers, technicians and housewives) disease activity was decreased in the most cases, while it was increased in most patients of service workers (p=0.086). Conclusion: The present study, similar to previous reports, revealed that nickel sulphate is the most common allergen in ACD cases. Moreover, it was found that the symptoms of disease activity remained constant or increased in a significant proportion of the cases during the working days. Therefore, these workers should seriously follow up on this matter and change their occupation, or limit the exposure to allergens.
[Occupational dermatitis in the agriculture-food industry environment].
Tripodi, Dominique; Géraut, Christian
2002-09-01
The agricultural and food professions are those that touch agriculture, but also the restoration, the kitchens, and the employees of slaughterhouses. Various occupational skin diseases touch these salaried employees or craftsmen: eczemas or contact hives with plants or meats and fleshes of animals and all chemical substances that are added: pesticides, food additives and various preservatives. Irritation contact dermatitis or real skin burns are observed with housekeeping products imposed by the sanitary norms, increasingly powerful, but as increasingly caustic. Infectious illnesses transmitted from the animal to the man are sometimes observed especially among the breeders and employees of slaughterhouses.
Papadatou, Zoi; Cooper, Kay; Klein, Susan; MacDuff, Colin; Steiner, Markus
2016-10-01
The objective of this quantitative systematic review is to identify, appraise and synthesize the best available evidence on the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions (a combination of two or more of the interventions listed) in preventing occupational irritant hand dermatitis (OIHD) in wet workers. These interventions will be compared to an alternative intervention or to usual care (workers regular skin care regime). The specific review question is: "What is the effectiveness of moisturizers, barrier creams, protective gloves, skin protection education and complex interventions in preventing OIHD in wet workers?"
Wu, Peggy A; James, William D
2011-01-01
Lavender is a commonly used product in personal and household care items as well as for aromatherapy. It is increasing in popularity as a fragrance. Additionally, multiple recent publications attest to its antimicrobial activity. Whereas lavender has been associated with irritant dermatitis, allergic contact dermatitis, and photodermatitis, it is anticipated that with increasing exposure, more patients will experience these complications. Most cases of allergic contact dermatitis have been reported as being due to occupational exposures through massage and aromatherapy. One study of the Japanese population demonstrated an increased incidence of contact dermatitis from lavender (from 1.1% to 13.9% over 8 years). It is important that clinicians recognize lavender as a potential allergen.
De, Dipankar; Khullar, Geeti; Handa, Sanjeev
2015-01-01
Parthenium hysterophorus is the leading cause of phytogenic allergic contact dermatitis in India. The Indian Standard Series currently supplied by Systopic Laboratories Ltd and manufactured by Chemotechnique Diagnostics ® contains parthenolide as the only allergen representing plant allergens. The study was conducted to assess the performance of the Chemotechnique plant series (PL-1000), consisting of 14 allergens, in patients with clinically suspected occupational contact dermatitis to plant allergens. Ninety patients were patch tested with the Chemotechnique plant series from 2011 to 2013. Demographic details, clinical diagnosis and patch test results were recorded in the contact dermatitis clinic proforma. Of 90 patients, 24 (26.7%) showed positive reactions to one or more allergens in the plant series. Positive patch tests were elicited most commonly by sesquiterpene lactone mix in 19 (78.6%) patients, followed by parthenolide in 14 (57.1%), Achillea millefolium in 10 (42.9%) and others in decreasing order. The plant allergen series prepared by Chemotechnique Diagnostics is possibly not optimal for diagnosing suspected allergic contact dermatitis to plants in north Indians. Sesquiterpene lactone mix should replace parthenolide as the plant allergen in the Indian Standard Series until relevant native plant extracts are commercially available for patch testing.
Occupational skin disease in Victoria, Australia.
Cahill, Jennifer L; Williams, Jason D; Matheson, Melanie C; Palmer, Amanda M; Burgess, John A; Dharmage, Shyamali C; Nixon, Rosemary L
2016-05-01
To describe the characteristics of patients with occupational skin disease (OSD) in a tertiary referral clinic in Victoria, Australia. A retrospective review was conducted of records from patients seen at the Occupational Dermatology Clinic in Melbourne, Australia between 1 January 1993 and 31 December 2010. Of the 2894 people assessed in the clinic during the 18-year period, 44% were women and 56% were men. In all, 2177 (75%) were diagnosed with occupational skin disease (OSD). Of the patients with a work-related skin condition, 45% (n = 979) were considered to be atopic. The most common diagnosis in those with OSD was irritant contact dermatitis (ICD) (44%), followed by allergic contact dermatitis (33%) and endogenous eczema (11%). Women were significantly more likely to have soaps and detergents (P < 0.001) and water/wet work (P < 0.001) as causes of their ICD than men. Men were significantly more likely to have oils and coolants (P < 0.001) and solvent exposures (P < 0.001) as causes of their ICD. Occupational groups with the highest incidence of OSD were the hair and beauty professions (70 per 100 000), followed by machine and plant operators (38 per 100 000) and health-care workers (21 per 100 000). We confirm the importance of occupational contact dermatitis as the most common cause of OSD, with ICD being the most common diagnosis. There are differences in the causes of ICD between our group of male and female workers. For the first time in Australia, rates of OSD in certain industries have been calculated. © 2015 The Australasian College of Dermatologists.
Jensen, Charlotte D; Andersen, Klaus E
2003-01-01
Background Metal-working fluids contain complex mixtures of chemicals and metal workers constitute a potential risk group for the development of allergic contact dermatitis. Case presentation Two metal workers developed allergic contact dermatitis on the hands and lower arms from exposure to a neat oil used in metal processing. Patch testing revealed that the relevant contact allergen was a cycloaliphatic epoxy resin, 1,2-cyclohexanedicarboxylic acid, bis(oxiranylmethyl) ester, added to the oil as a stabilizer. None of the patients had positive reactions to the bisphenol A-based epoxy resin in the standard series. Conclusions These cases emphasize that well-known contact allergens may show up from unexpected sources of exposure. Further, it can be a long-lasting, laborious process to detect an occupational contact allergen and cooperation from the patient and the manufacturer of the sensitizing product is essential. PMID:12685935
Occupational carprofen photoallergic contact dermatitis.
Kerr, A C; Muller, F; Ferguson, J; Dawe, R S
2008-12-01
The nonsteroidal anti-inflammatory drug carprofen was used in humans in the 1980s, before its withdrawal due to adverse effects. It re-emerged for veterinary uses, for which it is still widely prescribed, in the 1990s. There has been one previous report published of photoallergic contact dermatitis (PACD) in a pharmaceutical factory worker exposed to carprofen. Investigation of carprofen as a cause of PACD in pharmaceutical factory workers presenting with facial dermatitis. Photopatch testing to carprofen dilutions in two pharmaceutical factory workers and three healthy volunteer controls using the European consensus methodology. This was followed by testing of eight further employees, referred by occupational health services, in the same factory. The index patient suspected a problem with carprofen and was found to have PACD to carprofen. The second patient presented with a widespread, although especially photoexposed site, dermatitis and was initially labelled as having an 'unclassified dermatitis'. Only subsequently was her exposure (indirect; she did not work in the packaging section of the factory like the first patient) to carprofen recognized and testing confirmed both contact allergy and PACD to carprofen. One of three healthy volunteer controls had an active photoallergy sensitization event to carprofen starting 10 days after photopatch testing. Three of eight factory employees subsequently referred because of skin problems had carprofen PACD. Carprofen is a potent photoallergen. These cases emphasize the importance of photopatch testing, and considering agents not included in standard series, when investigating patients presenting with a photoexposed site dermatitis.
Contact Dermatitis for the Practicing Allergist.
Bernstein, David I
2015-01-01
This article provides an overview of important practice recommendations from the recently updated Contact Dermatitis Practice Parameter. This updated parameter provides essential recommendations pertaining to clinical history, physical examination, and patch testing evaluation of patients suspected of allergic contact dermatitis. In addition to providing guidance for performing and interpreting closed patch testing, the updated parameter provides concrete recommendations for assessing metal hypersensitivity in patients receiving prosthetic devices, for evaluating workers with occupational contact dermatitis, and also for addressing allergic contact dermatitis in children. Finally, the document provides practical recommendations useful for educating patients regarding avoidance of exposure to known contact sensitizers in the home and at work. The Contact Dermatitis Parameter is designed as a practical, evidence-based clinical tool to be used by allergists and dermatologists who routinely are called upon to evaluate patients with skin disorders. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
[Ulcerative contact dermitis caused by premixed concrete (cement burns)].
Ancona Alayón; Aranda Martínez, J G
1978-01-01
Cement dermatitis manifests clinically as a chronic dermatitis of irritative character, due to its alkaline nature and as allergic contact dermatitis produced by sensitization to chromium and cobalt occurring as trace elements. the present report deals with a mason without previous dermatitis, presenting bullae, ulcers and necrosis in lower limbs, short time after incidental contact at work, with premixed concrete. The clinical manifestations, such as short evolution, clear limitation to sites in close contact with concrete, negativity to standard patch testing and good prognosis with early treatment, are mentioned. The acute irritant nature of the disease is clear, in opposition to the classical manifestations of cement dermatitis. The need of studies of the chemical properties of this material including pH, alkalinity and the possible roll of additives employed, is part of the strategy for prevention of occupational dermatitis in the building trade, which should include also, information of hazards and proper training in their trade.
Ofenloch, Robert F; Diepgen, Thomas L; Popielnicki, Ana; Weisshaar, Elke; Molin, Sonja; Bauer, Andrea; Mahler, Vera; Elsner, Peter; Schmitt, Jochen; Apfelbacher, Christian
2015-02-01
The Occupational Contact Dermatitis Disease Severity Index (ODDI) was designed in Australia to measure severity and functional disability in patients with occupational contact dermatitis (OCD) of the hands. The ODDI was translated into the German language with a linguistic validation process. The psychometric properties of the German version of the ODDI are still unclear. To report the linguistic validation procedure and to perform a psychometric validation by investigating the validity and reliability of the German ODDI version in a sample of patients with OCD. Data were drawn from the baseline assessment (T0) and first follow-up (T1) of the German chronic hand eczema (CHE) registry (CARPE). Spearman correlations of the ODDI with reference measures were computed to assess validity. Cronbach's alpha was calculated as a measure of internal consistency, and the intraclass correlation coefficient (ICC) was calculated to assess retest reliability. The smallest real difference (SRD) and minimal clinically important difference (MCID) were calculated to assess sensitivity to change. Physician Global Assessment (PGA) was used as an anchor for the MCID. Four hundred and twenty-two patients (54.5% female, mean age 45.1 years) were included for analysis. Cronbach's alpha was found to be 0.73. The ICC was 0.79. Correlations between the ODDI total and the Dermatology Life Quality Index (rho = 0.36), and between PGA (rho = 0.48) and patient-assessed disease severity (rho = 0.40), were of moderate strength. The MCID (1.29) was found to be smaller than the SRD (1.87). The German ODDI version is reliable and valid for the measurement of functional impairment and disease severity in patients suffering from OCD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Jordan, Laura
2016-11-01
Occupational irritant contact dermatitis (OICD) is a dif cult and hard to manage condition. It occurs more frequently in certain occupations where contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing heightens the risk. Treatment for OICD includes patient education in addition to physical, topical, and systemic therapies. To review the pathogenesis and treatment options for OICD and evaluate the ef cacy of a selective skin-care regimen involv- ing a hand protectant cream alone as well as combined with a repair cream and speci c cleanser. A single-center open study was performed comprising 42 healthy male and female adult volunteers prone to occupational irritant contact dermatitis due to frequent wet work or contact with detergents. Between day 0 and day 7, subjects applied a hand protectant cream as needed on both hands (at least twice daily). On days 7 to 14, subjects applied a hand protectant cream and cleanser as needed on both hands (at least twice daily) as well as a repair cream each evening. A diary log was given to each volunteer for application control and for a subjective evaluation of daily tolerability. In these subjects prone to occupational irritant contact dermatitis, the hand protectant cream applied during the initial 7-day period was effective in restoring the damaged skin barrier and improving the stratum corneum hydration. A regimen that combined the hand protectant and repair creams with a speci c cleanser during a further 7-day period allowed contin- ued improvement of skin hydration and additional clinical bene ts while respecting the skin barrier function. The results of this study support the use of a 3-step approach for patients who are at risk of repeated exposure to external irritants. J Drugs Dermatol. 2016;15(suppl 11):s81-85..
U.K. standards of care for occupational contact dermatitis and occupational contact urticaria.
Adisesh, A; Robinson, E; Nicholson, P J; Sen, D; Wilkinson, M
2013-06-01
The diagnosis of occupational contact dermatitis (OCD) and occupational contact urticaria (OCU) is a process that involves fastidious clinical and occupational history taking, clinical examination, patch testing and skin-prick testing. A temporal relationship of work and/or the presence of a rash on the hands only raises suspicion of an occupational cause, and does not necessarily confirm an occupational causation. The identification of allergy by patch or prick tests is a major objective, as exclusion of an offending allergen from the environment can contribute to clinical recovery in the individual worker and avoidance of new cases of disease. This can be a complex process where allergens and irritants, and therefore allergic and irritant contact dermatitis, may coexist. This article provides guidance to healthcare professionals dealing with workers exposed to agents that potentially cause OCD and OCU. Specifically it aims to summarize the 2010 British Occupational Health Research Foundation (BOHRF) systematic review, and also to help practitioners translate the BOHRF guideline into clinical practice. As such, it aims to be of value to physicians and nurses based in primary and secondary care, as well as occupational health and public health clinicians. It is hoped that it will also be of value to employers, interested workers and those with responsibility for workplace standards, such as health and safety representatives. Note that it is not intended, nor should it be taken to imply, that these standards of care override existing statutory and legal obligations. Duties under the U.K. Health and Safety at Work Act 1974, the Management of Health and Safety at Work Regulations 1999, the Control of Substances Hazardous to Health Regulations 2002, the Equality Act 2010 and other relevant legislation and guidance must be given due consideration, as should laws relevant to other countries. © 2013 Crown Copyright BJD © 2013 British Association of Dermatologists This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.
Occupational contact dermatitis caused by D-limonene.
Pesonen, Maria; Suomela, Sari; Kuuliala, Outi; Henriks-Eckerman, Maj-Len; Aalto-Korte, Kristiina
2014-11-01
Limonene is widely used as a fragrance substance and solvent in cleansing products. Oxidized limonene is a frequent contact allergen among consumers of cosmetics, personal care products, and scented household cleaning products. Less is known about the sources of occupational exposure and occupational contact dermatitis caused by limonene. To report 14 patients with occupational contact allergy to limonene. The patients were examined in 2008-2013. An in-house preparation of oxidized limonene was patch tested as 3% and 5% in petrolatum from 2008 to August 2010, and after this as 3%, 1% and 0.3% pet. From 2012 onwards, a commercial test substance of limonene hydroperoxides was also used. We assessed the patients' occupational and domestic exposure to limonene. Occupational limonene allergy was observed in workers who used limonene-containing machine-cleaning detergents and hand cleansers, and in workers who used limonene-containing surface cleaners and dishwashing liquids similar to those used by consumers. In 3 cases, the occupational limonene allergy resulted from work-related use of limonene-containing, leave-on cosmetic products. Limonene is a frequent occupational sensitizer in hand cleansers and cleaning products. Occupational limonene contact allergy may also be caused by exposure to cosmetic products scented with limonene. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Gatica-Ortega, Maria-Elena; Pastor-Nieto, Maria-Antonia; Mercader-García, Pedro; Silvestre-Salvador, Juan-Francisco
2017-12-01
Allergic contact dermatitis (ACD) caused by (meth)acrylates has been described both in occupational and in non-occupational settings. To evaluate the clinical patterns, the most frequent allergens and the prognosis in patients sensitized to (meth)acrylates in long-lasting nail polish. The files of patients with ACD caused by (meth)acrylates in long-lasting nail polish diagnosed between January 2013 and June 2016 in four dermatology departments in Spain were reviewed. Patients were followed up by telephone interview. Overall, 2353 patients were patch tested. Forty-three (1.82%) were diagnosed with ACD caused by (meth)acrylates in long-lasting nail polish during that period; all were female, and all had hand dermatitis. Patients were mostly less than 40 years old (72.1%), non-atopic (95.4%) and had an occupational cause of their dermatitis (93%), which developed ∼10.1 months after they had started to use this technique. The most frequent positive allergens were: 2-hydroxypropyl methacrylate, 2-hydroxyethyl methacrylate, and tetrahydrofurfuryl methacrylate. Eight of the 22 interviewed patients were able to improve their working technique and used 4H® protective material (fingerstalls/gloves). Long-lasting nail polishes have become widespread, and it is a matter of concern that we may be facing a new epidemic of ACD caused by these. Policies regulating their use are urgently needed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Pizza makers' contact dermatitis.
Lembo, Serena; Lembo, Claudio; Patruno, Cataldo; Balato, Anna; Balato, Nicola; Ayala, Fabio
2014-01-01
Contact eczema to foods, spices, and food additives can occur in occupational and nonoccupational settings in those who grow, handle, prepare, or cook food. Pizza is one of the most eaten foods in every continent, and pizza making is a common work in many countries. We aimed to evaluate the occurrence and the causes of contact dermatitis in pizza makers in Naples. We performed an observational study in 45 pizza makers: all the enrolled subjects had to answer a questionnaire designed to detect personal history of respiratory or cutaneous allergy, atopy; work characteristics and timing were also investigated. Every subject attended the dermatology clinic for a complete skin examination, and when needed, patients were patch tested using the Italian baseline series of haptens integrated with an arbitrary pizza makers series. Our results reported that 13.3% of the enrolled pizza makers (6/45) presented hand eczema, and that 8.9% (4/45) were affected by occupational allergic contact dermatitis. Diallyl disulfide and ammonium persulfate were the responsible substances. Performing patch tests in pizza makers and food handlers affected by hand contact dermatitis is useful. We propose a specific series of haptens for this wide working category.
Impact of regulation on contact dermatitis.
Hogan, Daniel; Ledet, Johnathan J
2009-07-01
Contact dermatitis is a serious public health and dermatologic concern. The prevalence of contact dermatitis in the United States was estimated to be 13.6 per 1000 population according to the National Health and Nutritional Examination Survey using physical examinations by dermatologists of a selected sample of Americans. The American Medical Care Survey estimated that for all American physicians dermatitis is the second most common dermatologic diagnosis proffered. It is essential that government, industry, and dermatologists work together to enhance regulatory methods to control and prevent contact allergy epidemics. Increased knowledge and awareness of occupational skin diseases by dermatologists and other health care professionals will assist in achieving national public health goals. This article reviews governmental regulations-some helpful for patients and workers and some not helpful for dermatologists in their quest to assist patients with contact dermatitis.
Hand dermatitis--differential diagnoses, diagnostics, and treatment options.
Mahler, Vera
2016-01-01
The pathogenesis of hand dermatitis is multifactorial, and includes factors such as genetic predisposition and exposure. A high incidence rate is associated with female gender, contact allergy, atopic dermatitis, and wet work. The most important risk factors for the persistence of hand dermatitis include its extent, contact allergic or atopic etiology, childhood dermatitis, and early onset (before the age of 20). The cost of illness of hand dermatitis corresponds to this seen in moderate to severe psoriasis. The diagnostic workup of hand dermatitis and its differential diagnoses requires a detailed assessment of occupational and recreational exposure. In case of possible work-related triggers, early notification of the accident insurer should be sought (via the dermatologist's report). Exposure to a contact allergen is a contributing factor in one-half of all cases of hand dermatitis. It is therefore imperative that all patients with hand dermatitis persisting for more than three months undergo patch testing. Successful and sustainable treatment of hand dermatitis starts with the proper identification and elimination of individual triggers, including the substitution of identified contact allergens and irritants, as well as optimizing preventive measures. Graded therapy taking the clinical severity into account is essential. Validated instruments may be used to monitor therapeutic efficacy. © 2015 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
Validation of a questionnaire on hand hygiene in the construction industry.
Timmerman, Johan G; Zilaout, Hicham; Heederik, Dick; Spee, Ton; Smit, Lidwien A M
2014-10-01
Construction workers are at risk of developing occupational contact dermatitis. Gloves, when used properly, may protect against chemicals and coarse materials. We investigated the prevalence and determinants of contact dermatitis in a population of Dutch construction workers and aimed at validating questionnaire items on hand hygiene. A cross-sectional study was conducted at 13 construction sites, yielding data of 177 subjects (95% response rate). A questionnaire covering questions on hand hygiene and contact dermatitis symptoms was used. Agreement between workplace observations and a number of questionnaire items was assessed by calculating Cohen's kappa. Log-binomial regression analysis was used to assess the association between contact dermatitis and various hand hygiene-related determinants. The 1-year prevalence of self-reported contact dermatitis in our study sample was 46.9%. Multiple regression analysis showed a positive association with difficulties with hand cleaning (prevalence ratio [PR]: 1.26, 95% confidence interval [CI]: 1.05-1.52), hand contamination at the end of the working day (PR: 2.30, 95% CI: 1.14-4.65), and intensive hand cream use (PR: 2.07, 95% CI: 1.42-3.01). Observations of hand contamination, glove use, and glove types were found to agree well with the self-reported data from the questionnaire (Cohen's kappa's 0.75, 0.97, and 0.88). Self-reported contact dermatitis prevalence in construction workers was high and related to hand hygiene. A strong agreement was found between workplace observations and self-reported questionnaire data. © The Author 2014. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.
Liu, Wei; Hong, Wen-Xu; Zhang, Yanfang; Huang, Peiwu; Yang, Xifei; Ren, Xiaohu; Huang, Haiyan; Liu, Jianjun
2015-11-01
Trichloroethylene (TCE) has long been well known as a major pollutant that affects both occupational and general environments. Occupational medicamentosa-like dermatitis induced by TCE (OMLDT) is an autoimmune disease, which has become one of the critical occupational health issues in China. In this study, we analyzed 18 OMLDT patients and 29 professional TCE contact people on serum proteomic analysis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry and ClinProTools bioinformatics software. The intensities of 35 protein/peptide peaks were significantly different between TCE contact controls and OMLDT patients. A pattern of six peaks (m/z 1,450.33, 1,866.16, 3,262.39, 4,109.55, 5,064.85 and 5,956.57) were selected to construct a diagnostic model to discriminate the OMLDT patients from controls with sensitivity and specificity of both 93.8 %. Our findings provide an alternative proteomic approach to differentiate the OMLDT patients from TCE contact workers with high sensitivity and high specificity, which will be of potential value in clinical diagnosis for occupational disease.
Surveillance of work-related diseases by occupational physicians in the UK: OPRA 1996-1999.
Cherry, N M; Meyer, J D; Holt, D L; Chen, Y; McDonald, J C
2000-09-01
The Occupational Physicians' Reporting Activity (OPRA) surveillance scheme for occupational physicians has now been in place for 4 years. During this period, an estimated 43,764 new cases of work-related disease have been reported. Musculoskeletal conditions make up nearly half (49%) of all cases; mental ill-health and skin disease account for 20% each, with respiratory conditions (8%) and hearing loss (5%) seen in lower proportions. Overall, eight of 42 diagnoses made up four-fifths of the new cases reported by occupational physicians. These were hand and arm disorders (8052 estimated cases), contact dermatitis (7104), disorders of the lumbar spine (6000), anxiety and depression (4788), work-related stress (3336), hearing loss (2100), elbow disorders (2040), and asthma (1680). Dermatitis and hearing loss were most frequent in manufacturing industries, lower back complaints in health care, and upper limb disorders in automotive manufacture. Psychiatric illnesses presented a different pattern, mainly affecting those in health, education and social service.
Systemic allergic contact dermatitis to fiberglass in a factory worker of wind turbine blades.
Nogueira, Ana; Morais, Paulo; Cunha, Ana Paula; Azevedo, Filomena
2011-09-01
Fiberglass is extensively used due to its properties of thermal, acoustic and electrical insulation, and also to reinforce other materials such as plastics. Irritant contact dermatitis to fiberglass is a well established occupational dermatose and is due to penetration of small fragments in the cornified layer of the skin. On the other hand, allergic contact dermatitis (ACD) is rare and is more often triggered by sensitivity to the additives and resins used in the manufacture of fiberglass products. We report a case of ACD to fiberglass in a factory worker of fiberglass reinforced products.
Occupational Dermatoses by Type of Work in Greece
Zorba, Eleni; Karpouzis, Antony; Zorbas, Alexandros; Bazas, Theodore; Zorbas, Sam; Alexopoulos, Elias; Zorbas, Ilias; Kouskoukis, Konstantinos; Konstandinidis, Theodoros
2013-01-01
Background To elucidate the relationship between seven occupational dermatoses (ODs) and 20 types of work in Greece. Methods This was a prevalence epidemiologic study of certain ODs among 4,000 workers employed in 20 types of enterprise, in 104 companies, in 2006–2012, using data from company medical records, questionnaires, occupational medical, and special examinations. The χ2 test was applied to reveal statistically significant relationships between types of enterprises and occurrence of ODs. Results A high percentage (39.9%) of employees included in the study population suffered from ODs. The highest prevalence rates were noted among hairdressers (of contact dermatitis: 30%), cooks (of contact dermatitis: 29.5%), bitumen workers (of acne: 23.5%), car industry workers (of mechanical injury: 15%), construction workers (of contact urticaria: 29.5%), industrial cleaning workers (of chemical burns: 13%), and farmers (of malignant tumors: 5.5%). We observed several statistical significant correlations between ODs (acute and chronic contact dermatitis, urticaria, mechanical injury, acne, burns, skin cancer) and certain types of enterprises. There was no statistically significant correlation between gender and prevalence of ODs, except for dermatoses caused by mechanical injuries afflicting mainly men [χ2 (1) = 13.40, p < 0.001] and for chronic contact dermatitis [χ2 (1) = 5.53, p = 0.019] afflicting mainly women. Conclusion Prevalence of ODs is high in Greece, contrary to all official reports by the Greek National Institute of Health. There is a need to introduce a nationwide voluntary surveillance system for reporting ODs and to enhance skin protection measures at work. PMID:24106644
Occupational dermatoses by type of work in Greece.
Zorba, Eleni; Karpouzis, Antony; Zorbas, Alexandros; Bazas, Theodore; Zorbas, Sam; Alexopoulos, Elias; Zorbas, Ilias; Kouskoukis, Konstantinos; Konstandinidis, Theodoros
2013-09-01
To elucidate the relationship between seven occupational dermatoses (ODs) and 20 types of work in Greece. This was a prevalence epidemiologic study of certain ODs among 4,000 workers employed in 20 types of enterprise, in 104 companies, in 2006-2012, using data from company medical records, questionnaires, occupational medical, and special examinations. The χ(2) test was applied to reveal statistically significant relationships between types of enterprises and occurrence of ODs. A high percentage (39.9%) of employees included in the study population suffered from ODs. The highest prevalence rates were noted among hairdressers (of contact dermatitis: 30%), cooks (of contact dermatitis: 29.5%), bitumen workers (of acne: 23.5%), car industry workers (of mechanical injury: 15%), construction workers (of contact urticaria: 29.5%), industrial cleaning workers (of chemical burns: 13%), and farmers (of malignant tumors: 5.5%). We observed several statistical significant correlations between ODs (acute and chronic contact dermatitis, urticaria, mechanical injury, acne, burns, skin cancer) and certain types of enterprises. There was no statistically significant correlation between gender and prevalence of ODs, except for dermatoses caused by mechanical injuries afflicting mainly men [χ(2) (1) = 13.40, p < 0.001] and for chronic contact dermatitis [χ(2) (1) = 5.53, p = 0.019] afflicting mainly women. Prevalence of ODs is high in Greece, contrary to all official reports by the Greek National Institute of Health. There is a need to introduce a nationwide voluntary surveillance system for reporting ODs and to enhance skin protection measures at work.
Preventing Occupational Skin Disease: A Review of Training Programs.
Zack, Bethany; Arrandale, Victoria H; Holness, D Linn
Occupational contact dermatitis (OCD) is a common occupational disease that impacts a variety of worker groups. Skin protection and disease prevention training programs have shown promise for improving prevention practices and reducing the incidence of OCD. This review details the features of training programs for primary prevention of OCD and identifies gaps in the literature. Twelve studies were identified for in-depth review: many studies included wet workers employed in health care, hairdressing, cleaning, and food preparation; 1 program featured manufacturing workers. Few programs provided content on allergic contact dermatitis, and only 1 was evaluated for long-term effectiveness. Effective programs were similar in content, delivery method, and timing and were characterized by industry specificity, multimodal learning, participatory elements, skin care resource provision, repeated sessions, and management engagement. Long-term effectiveness, generalizability beyond OCD, workplace health and safety culture impact, and translation of programs in the North American context represent areas for future research.
Two decades of occupational (meth)acrylate patch test results and focus on isobornyl acrylate.
Christoffers, Wietske A; Coenraads, Pieter-Jan; Schuttelaar, Marie-Louise A
2013-08-01
Acrylates constitute an important cause of occupational contact dermatitis. Isobornyl acrylate sensitization has been reported in only 2 cases. We encountered an industrial process operator with occupational contact dermatitis caused by isobornyl acrylate. (i) To investigate whether it is relevant to add isobornyl acrylate to the (meth)acrylate test series. (ii) To report patients with (meth)acrylate contact allergy at an occupational dermatology clinic. Our patch test database was screened for positive reactions to (meth)acrylates between 1993 and 2012. A selected group of 14 patients was tested with an isobornyl acrylate dilution series: 0.3%, 0.1%, 0.033%, and 0.01%. Readings were performed on D2, D3, and D7. One hundred and fifty-one patients were tested with our (meth)acrylate series; 24 had positive reactions. Most positive reactions were to 2-hydroxypropyl acrylate, 2-hydroxyethyl acrylate, 2-hydroxypropyl methacrylate, and diethyleneglycol diacrylate. Hypothetical screening with 2-hydroxypropyl acrylate, ethyleneglycol dimethacrylate, ethoxylated bisphenol A glycol dimethacrylate and trimethylolpropane triacrylate identified 91.7% of the 24 patients. No positive reactions were observed in 14 acrylate-positive patients tested with the isobornyl acrylate dilution series. The 0.3% isobornyl acrylate concentration induced irritant reactions in 3 patients. We report a rare case of allergic contact dermatitis caused by isobornyl acrylate. However, this study provides insufficient support for isobornyl acrylate to be added to a (meth)acrylate series. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Cement-Induced Chromate Occupational Allergic Contact Dermatitis.
Kridin, Khalaf; Bergman, Reuven; Khamaisi, Mogher; Zelber-Sagi, Shira; Weltfriend, Sara
2016-01-01
Hexavalent chromium in cement is a common cause of occupational allergic contact dermatitis (OACD). Analysis of patch test data during 1999 to 2013 was done. Patients with cement-induced chromate OACD filled the Dermatology Life Quality Index, graded 1 to 5. Of 4846 consecutive patients who were patch tested, 146 (3%) were chromate-sensitive. Of 46 (31.5%) who presented with chromate OACD, 27 (59%) had cement-induced chromate OACD. The proportion of chromate-sensitive patients with clinically relevant cement exposure increased from 7.7% in 2002 to 2004 to 28.7% in 2011 to 2013 (P = 0.04). The median age of presentation was younger than for other chromate-sensitive patients (32 vs 42 years). Hand eczema (88.9%) was the most frequent clinical presentation. Of the 27 with cement-induced chromate OACD, 21 (77.8%) had ongoing dermatitis at the time of the review. Although 14/27 (51.9%) changed their occupation to avoid exposure to cement, symptoms persisted in 9/14 (64.3%). Prolonged exposure to cement before development of symptoms was associated with chronicity. All the symptomatic patients experienced at least a moderate effect on their quality of life (grade 3 or higher on the Dermatology Life Quality Index). We recommend the adoption of the European legislation in Israel, to reduce the prevalence of chromate OACD from cement.
Kanerva, L; Jolanki, R; Estlander, T; Henriks-Eckerman, M; Tuomi, M; Tarvainen, K
2000-01-01
Very little is known about allergic contact dermatitis (ACD) from preimpregnated epoxy products (prepregs). To describe a patient with occupational ACD from prepregs, and report new quantitative data on the content of prepregs. A laminator developed work-related vesicular hand dermatitis. He worked in an aircraft plant assembling aircraft parts, being exposed to preimpregnated carbon fiber and fiberglass sheets (prepregs), and epoxy adhesive tapes and foams. Triglycidyl-p-aminophenol (TGPAP; 1-0.25%, 2+; 0.05%, 1+) and tetraglycidyl-4,4'-methylene dianiline (TGMDA; 1%, 3+; 0.5-0.05%, 2+) provoked allergic patch test reactions, whereas o-diglycidyl phthalate was negative (1-0.05% pet) and standard epoxy provoked a weak (?+) reaction. Six prepreg products provoking allergic patch test reactions were analyzed for their TGPAP, TGMDA and diglycidyl ether of bisphenol A (DGEBA) content using gas and liquid chromatographic methods, showing up to 10% of TGPAP, 19% of TGMDA and 5% of DGEBA in the prepregs. An epoxy primer contained 61% of TGPAP. TGPAP and TGMDA caused occupational ACD. These chemicals need to be used when patch testing patients are exposed to prepregs, because patch testing with DGEBA may be negative. Copyright 2000 S. Karger AG, Basel.
Supplemental tests in the evaluation of occupational hand dermatitis in soldiers.
Wolf, R; Movshowitz, M; Brenner, S
1996-03-01
Hand dermatitis in soldiers is a considerable problem. The purpose of the study was to evaluate appropriate screening tests to improve the diagnosis of hand dermatitis in soldiers. A group of 111 soldiers with occupational dermatitis from contact with fuels and oils underwent "tailored patch tests" with allergens relevant to their field of work and their environment. The control group consisted of 24 soldiers with various jobs similar to those of civilian life, who had not been exposed to oils and fuels. Seventy-three civilian patients, attending the clinic for patch testing, were also included. Twenty soldiers, who had a history of intensive contact with oil and fuels, but no contact dermatitis, and who were admitted because of various skin diseases (fungal infections, acne, etc.) also underwent the supplemental testing and served as an additional control group. Of the soldiers, 31 (29%) showed one or more positive skin tests of the oil series and 30 patients of this group one or more positive reactions to the standard patch tests trays. No patient of the control groups had a positive test to the oil series. Our results show the value of the supplementary tests as a first-step screening test for detection of oil allergy in soldiers and automobile-mechanics or in workers handling other gasoline- or diesel-powered engineering equipment. The test method appears to be practical, easy to perform, reliable and giving clear and accurate results, with a negligible rate of false positive reactions.
Warshaw, Erin M; Goodier, Molly C; DeKoven, Joel G; Maibach, Howard I; Taylor, James S; Sasseville, Denis; Belsito, Donald V; Fowler, Joseph F; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Mathias, Toby; Zirwas, Matthew J; Zug, Kathryn A
There is limited information regarding contact dermatitis (CD) associated with skin cleansers (SCs). The aim of the study was to evaluate the prevalence of allergic patch test (APT) reactions and irritant CD (ICD) associated with SCs. A retrospective cross-sectional analysis was performed using North American Contact Dermatitis Group data, 2000-2014. Of 32,945 tested patients, 1069 (3.24%) had either APT reaction or ICD associated with SCs. Of these, 692 (64.7%) had APT reaction only, 350 (32.7%) had ICD only, and 27 (2.5%) had both. Individuals with APT reaction and/or ICD were more likely to have occupationally related skin disease (relative risk [RR] = 3.8 [95% confidence interval {CI} = 3.3-4.5] for APT reaction and 10.0 [95% CI = 8.2-12.2] for ICD, respectively, P < 0.0001). As compared with those without APT reaction to SC, individuals with APT reaction had significantly higher frequencies of hand (RR = 2.4 [95% CI = 2.1-2.7]) and arm dermatitis (RR = 1.3 [95% CI = 1.1-1.6], P ≤ 0.001). Irritant CD was strongly associated with hand dermatitis (RR = 6.2 [95% CI = 5.2-7.3], P < 0.0001). More than 50 allergens were associated with SCs including quaternium-15 (11.2%), cocamidopropyl betaine (9.5%), methylchloroisothiazolinone/methylisothiazolinone (8.4%), coconut diethanolamide (7.9%), fragrance mix I (7.7%), Myroxylon pereirae (5.9%), 4-chloro-3,5-xylenol (5.8%), amidoamine (5.5%), and formaldehyde (4.4%). Many allergens, especially preservatives and surfactants, were associated with SCs. Most cases involved the hands and were occupationally related.
Marrero-Alemán, Gabriel; Saavedra Santana, Pedro; Liuti, Federica; Hernández, Noelia; López-Jiménez, Esmeralda; Borrego, Leopoldo
Sensitivity to methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI) has increased rapidly over recent years. This increase is mainly related to the extensive use of high concentrations of MI in cosmetic products, although a growing number of cases of occupational allergic contact dermatitis are caused by MCI/MI. The aim of this study was to examine the association between the increase in MCI/MI sensitization and the work performed by the patients in our area. A retrospective study was undertaken of the records of a total of 1179 patients who had undergone contact skin patch tests for MCI/MI from January 2005 to December 2015. A multivariate logistic regression analysis was performed to identify the factors independently associated with sensitivity to MCI/MI. A constant increase in MCI/MI sensitization was observed over the observation period. The only work associated with a significant increase in the prevalence of MCI/MI sensitization was cleaning, with 38.5% of the cleaning professionals with MCI/MI sensitization consulting for cosmetics-related dermatitis. Occupational sensitization to MCI/MI in cleaning professionals is worryingly increasing. This, in turn, could possibly account for many cases of cosmetics-associated contact dermatitis. Our findings suggest that a review of the regulations with regard to isothiazolinone concentrations in industrial and household detergents is necessary.
OCCUPATIONAL DERMATITIS DUE TO SENSITIZATION TO SODIUM AND CALCIUM URANYL CARBONATES (in French)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Thiers, H.; Chanial, G.; Rivoire, J.
1961-01-01
BS>A report on a rare type of occupational dermatitis from sensitization to Na and Ca uranates observed in two workers in the Guegnon uranium-processing plandt is presented. In both patients there was no history of personal or family allergies. The dermatitis was especially evident on the fingers and presented characteristics not reported previously: the skin was dry and wrinkled with small periangualar fissures. Small nodules 2--3 mm, appearing as centers of hyperkeratosis encased in the skin, appeared on the sides and under surface of fingers. The nails were grooved and peeling at the edges. Also, at the base of themore » fingers and over the hand hyperkeritosic eczema of a common type was seen. These lessons were filled with pus. Skin tests confirmed their sensitization to 2% solutions of Na and Ca uranates; otherwise these patients appeared to be completely normal. A survey of working conditions showed that there was no possibility of their dermatitis resulting from radioactivity. That excessive radiation was not involved in the pathogenesis of these lesions was attested to by their normal blood pictures. The manifestations of the lesions indicated their definite allergic origin. Both patients recovered eventually and, after occupying other positions in the plant, have had no recrudescence of the lesions. (BBB)« less
Engfeldt, Malin; Isaksson, Marléne; Zimerson, Erik; Bruze, Magnus
2013-03-01
A 43-year-old woman was referred by her occupational health service with suspected occupational contact dermatitis. In connection with the investigation, a workplace visit was undertaken at her company, which used an adhesive based on pre-polymeric diphenylmethane diisocyanate in one of its units. During the visit, we became aware of six other employees with skin problems who were then referred to our department for investigation. To investigate the seven employees complaining about skin problems. Seven employees were patch tested with a baseline series, an isocyanate series, and a series with work material. Five of seven patients had occupational contact allergy. Four reacted to isocyanate-related test preparations, and one to a cleanser used at the workplace. Workplace visits constitute an important part of an occupational investigation, as they might give a broader picture of the problems at a company. In this case, it was found that 5 of 100 employees currently had or had previously had occupation-related skin problems. Owing to 'healthy worker selection', some of these patients might have been missed if we had not performed a full-scale workplace visit. © 2012 John Wiley & Sons A/S.
Management of contact dermatitis due to nickel allergy: an update
Torres, Fernanda; das Graças, Maria; Melo, Mota; Tosti, Antonella
2009-01-01
Nickel is the major cause of allergic contact dermatitis in the general population, both among children and adults, as well as in large occupational groups. This metal is used in numerous industrial and consumer products, including stainless steel, magnets, metal plating, coinage, and special alloys, and is therefore almost impossible to completely avoid in daily life. Nickel contact dermatitis can represent an important morbidity, particularly in patients with chronic hand eczema, which can lead to inability to work, a decrease in quality of life and significant healthcare expenses. Therefore, its management is of great importance. This article reviews diagnostic, preventive and therapeutic strategies in this field. PMID:21436967
Identification of metallic items that caused nickel dermatitis in Danish patients.
Thyssen, Jacob P; Menné, Torkil; Johansen, Jeanne D
2010-09-01
Nickel allergy is prevalent as assessed by epidemiological studies. In an attempt to further identify and characterize sources that may result in nickel allergy and dermatitis, we analysed items identified by nickel-allergic dermatitis patients as causative of nickel dermatitis by using the dimethylglyoxime (DMG) test. Dermatitis patients with nickel allergy of current relevance were identified over a 2-year period in a tertiary referral patch test centre. When possible, their work tools and personal items were examined with the DMG test. Among 95 nickel-allergic dermatitis patients, 70 (73.7%) had metallic items investigated for nickel release. A total of 151 items were investigated, and 66 (43.7%) gave positive DMG test reactions. Objects were nearly all purchased or acquired after the introduction of the EU Nickel Directive. Only one object had been inherited, and only two objects had been purchased outside of Denmark. DMG testing is valuable as a screening test for nickel release and should be used to identify relevant exposures in nickel-allergic patients. Mainly consumer items, but also work tools used in an occupational setting, released nickel in dermatitis patients. This study confirmed 'risk items' from previous studies, including mobile phones.
Occupational asthma induced by tall oil in the rubber tyre industry.
Tarlo, S M
1992-01-01
A worker in the rubber tyre industry is described with occupational asthma from exposure to a solution of tall oil, a pine resin, confirmed by specific inhalation challenge. This supports studies of contact dermatitis which have suggested abietic and dehydroabietic acid oxidants to be the cause of colophony induced allergic reactions.
Epoxy-based production of wind turbine rotor blades: occupational contact allergies.
Pontén, Ann; Carstensen, Ole; Rasmussen, Kurt; Gruvberger, Birgitta; Isaksson, Marléne; Bruze, Magnus
2004-03-01
An industry producing rotor blades for wind turbines with an epoxy-based technology had experienced an increasing number of workers with dermatitis, among whom the frequency of occupational contact allergy (OCA) was suspected to be underestimated. To investigate the frequency of OCA by patch-testing with a specially profiled occupational patch test series. In a blinded study design, 603 workers were first interviewed and thereafter clinically examined. Based on a history of work-related skin disease, clinical findings of dermatitis, or both, 325 (53.9%) of the workers were patch-tested with an occupational patch test series and the European Standard patch test series. Of the 603 investigated workers, 10.9% had OCA and 5.6% had contact allergy to epoxy resin in the standard test series. Contact allergy to amine hardeners/catalysts was found in 4.1% of the workers. Among the workers with OCA, 48.5% reacted to work material other than epoxy resin in the European Standard patch test series. Approximately 50% of the workers with OCA would not have been detected if only the European Standard patch test series had been used.
Methotrexate use in allergic contact dermatitis: a retrospective study.
Patel, Ashaki; Burns, Erin; Burkemper, Nicole M
2018-03-01
Methotrexate, a folate antimetabolite, is used to treat atopic dermatitis and psoriasis. Although methotrexate's therapeutic efficacy has been noted in the literature, there are few data on the efficacy of methotrexate treatment for allergic contact dermatitis. To evaluate the efficacy and tolerability of methotrexate in treating allergic contact dermatitis at a single institution, and also to assess methotrexate efficacy in patients with chronic, unavoidable allergen exposure. We performed a retrospective chart review of 32 patients diagnosed with allergic contact dermatitis by positive patch test reactions, and who received treatment with methotrexate from November 2010 to November 2014. Demographic and treatment-associated data were collected from electronic medical records. Ten patients were identified as allergen non-avoiders secondary to their occupation, and were subgrouped as such. Seventy-eight per cent (25/32) of patients showed either a partial or a complete response. Methotrexate had a comparable efficacy rate in the allergen non-avoiders subset, at 10 of 10. Of the 32 patients, 23% (5/22) had complete clearance of their dermatitis, and 1/10 of allergen non-avoiders had complete clearance of their dermatitis. Methotrexate is a well-tolerated and effective treatment for allergic contact dermatitis, and shows comparable efficacy to immunomodulatory agents such as cyclosporine and azathioprine, with robust efficacy despite persistent allergen exposure in patients with allergic contact dermatitis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Stocks, S Jill; McNamee, Roseanne; van der Molen, Henk F; Paris, Christophe; Urban, Pavel; Campo, Giuseppe; Sauni, Riitta; Martínez Jarreta, Begoña; Valenty, Madeleine; Godderis, Lode; Miedinger, David; Jacquetin, Pascal; Gravseth, Hans M; Bonneterre, Vincent; Telle-Lamberton, Maylis; Bensefa-Colas, Lynda; Faye, Serge; Mylle, Godewina; Wannag, Axel; Samant, Yogindra; Pal, Teake; Scholz-Odermatt, Stefan; Papale, Adriano; Schouteden, Martijn; Colosio, Claudio; Mattioli, Stefano; Agius, Raymond
2015-04-01
The European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal are scarce. We aim to estimate and compare changes in incidence over time for occupational asthma, contact dermatitis, noise-induced hearing loss (NIHL), carpal tunnel syndrome (CTS) and upper limb musculoskeletal disorders across 10 European countries. OD surveillance systems that potentially reflected nationally representative trends in incidence within Belgium, the Czech Republic, Finland, France, Italy, the Netherlands, Norway, Spain, Switzerland and the UK provided data. Case counts were analysed using a negative binomial regression model with year as the main covariate. Many systems collected data from networks of 'centres', requiring the use of a multilevel negative binomial model. Some models made allowance for changes in compensation or reporting rules. Reports of contact dermatitis and asthma, conditions with shorter time between exposure to causal substances and OD, were consistently declining with only a few exceptions. For OD with physical causal exposures there was more variation between countries. Reported NIHL was increasing in Belgium, Spain, Switzerland and the Netherlands and decreasing elsewhere. Trends in CTS and upper limb musculoskeletal disorders varied widely within and between countries. This is the first direct comparison of trends in OD within Europe and is consistent with a positive impact of European initiatives addressing exposures relevant to asthma and contact dermatitis. Taking a more flexible approach allowed comparisons of surveillance data between and within countries without harmonisation of data collection methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
[Preservatives as important etiologic factors of allergic contact dermatitis].
Kręcisz, Beata; Chomiczewska-Skóra, Dorota; Kieć-Świerczyńska, Marta
2015-01-01
Preservatives present in cosmetics and other industrial products can cause allergic contact dermatitis. The aim of the study was to assess the frequency of allergy to selected preservatives in consecutive patients examined due to contact dermatitis in the Nofer Institute of Occupational Medicine, Łódź, and to establish whether individuals sensitized to formaldehyde react simultaneously to formaldehyde releasers. A group of 405 patients (308 females and 97 males) was examined in 2011-2013. In all participants patch tests with a series of 13 preservatives (paraben mix, formaldehyde, Quaternium 15, chloromethylisothiazolinone/methylisothiazolinone mix, methyldibromoglutaronitrile, diazolidinyl urea, imidazolidinyl urea, DMDM hydantoin, 2-bromo-2-nitropropane-1,3-diol, iodopropynyl butylcarbamate, benzalkonium chloride, sodium metabisulfite, produced by Chemotechnique Diagnostics, Sweden) were performed. Of the 405 patients 74 (including 52 females) showed positive results of patch tests. Contact allergy to at least 1 preservative was noted in 47 (11.6%) patients, including 34 (11%) females and 13 (13.4%) males. Methylisothiazolinone proved to be the most frequent sensitizer--4.7% (5.2% females, 3.1% males) while parabens, 2-bromo-2-nitropropane-1,3-diol and imidazolidinyl urea (0.2%) were found to be the least frequent. Fourteen (3.4%) participants, 10 women and 4 men, were allergic to formaldehyde and/or formaldehyde releasers. In 11 (78.6%) of them monovalent hypersensitivity was observed. In 13 (3.2% of the examined group) patients allergy to preservatives might have been of occupational origin. Preservatives, particularly isothiazolinones, are significant causal factors of allergic contact dermatitis, including occupational cases. Individuals sensitized to formaldehyde may react simultaneously to formaldehyde releasers, however, such reactions are relatively rare. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Occupational skin diseases in Czech healthcare workers from 1997 to 2009.
Machovcová, A; Fenclová, Z; Pelclová, D
2013-04-01
The healthcare sector ranked in second place among economic sectors in the Czech Republic, with about 11.4 % of all occupational diseases in 2009. Skin diseases constituted about 20 % of all occupational diseases. The aim of this study was to analyze the causes and trends in allergic and irritant-induced skin diseases in the healthcare sector. The data concerning occupational skin diseases (Chapter IV of the Czech List of Occupational Diseases, non-infectious skin illnesses) in the healthcare sector were analyzed from the Czech National Registry of Occupational Diseases from 1997 until 2009. The trends in the total counts and most frequent causes were evaluated. During the past 13 years, a total of 545 skin diseases were acknowledged in healthcare workers. Allergic contact dermatitis was diagnosed in 464 (85 %), irritant contact dermatitis in 71 (13 %) and contact urticaria in 10 subjects (2 %). Ninety-five percent of the patients were females. The overall incidence in individual years varied between 1.0 and 2.9 cases per 10,000 full-time employees per year. Disinfectants were the most frequent chemical agents causing more than one third of all allergic skin diseases (38 %), followed by rubber components (32 %) and cleaning agents (10 %). A general downward trend of diagnosed cases of occupational skin diseases in heath care workers in the Czech Republic over the past 13 years was demonstrated.
Occupational skin problems in construction workers.
Shah, Kartik R; Tiwari, Rajnarayan R
2010-10-01
Construction workers handle cement which has constituents to produce both irritant contact dermatitis and corrosive effects (from alkaline ingredients, such as lime) and sensitization, leading to allergic contact dermatitis (from ingredients, such as chromium). The present study has been carried out among unorganized construction workers to find the prevalence of skin problems. The present cross-sectional study was conducted in 92 construction workers of Ahmedabad and Vadodara. All the workers were subjected to clinical examination after collection of information regarding demographic characteristics, occupational characteristics and clinical history on a predesigned proforma. Of them, 47.8% had morbid skin conditions. Frictional callosities in palm were observed in 18 (19.6%) subjects while 4 (4.3%) subjects had contact dermatitis. Other conditions included dry, fissured and scaly skin, infectious skin lesion, tinea cruris, lesion and ulcers on hands and/or soles. The skin conditions were common in the age group of 20-25 years, males, those having ≥1 year exposure and those working for longer hours. Half of the workers not using personal protective equipment had reported skin-related symptoms.
An Animal Model of Trichloroethylene-Induced Skin Sensitization in BALB/c Mice.
Wang, Hui; Zhang, Jia-xiang; Li, Shu-long; Wang, Feng; Zha, Wan-sheng; Shen, Tong; Wu, Changhao; Zhu, Qi-xing
2015-01-01
Trichloroethylene (TCE) is a major occupational hazard and environmental contaminant that can cause multisystem disorders in the form of occupational medicamentosa-like dermatitis. Development of dermatitis involves several proinflammatory cytokines, but their role in TCE-mediated dermatitis has not been examined in a well-defined experimental model. In addition, few animal models of TCE sensitization are available, and the current guinea pig model has apparent limitations. This study aimed to establish a model of TCE-induced skin sensitization in BALB/c mice and to examine the role of several key inflammatory cytokines on TCE sensitization. The sensitization rate of dorsal painted group was 38.3%. Skin edema and erythema occurred in TCE-sensitized groups, as seen in 2,4-dinitrochlorobenzene (DNCB) positive control. Trichloroethylene sensitization-positive (dermatitis [+]) group exhibited increased thickness of epidermis, inflammatory cell infiltration, swelling, and necrosis in dermis and around hair follicle, but ear painted group did not show these histological changes. The concentrations of serum proinflammatory cytokines including tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and interleukin (IL)-2 were significantly increased in 24, 48, and 72 hours dermatitis [+] groups treated with TCE and peaked at 72 hours. Deposition of TNF-α, IFN-γ, and IL-2 into the skin tissue was also revealed by immunohistochemistry. We have established a new animal model of skin sensitization induced by repeated TCE stimulations, and we provide the first evidence that key proinflammatory cytokines including TNF-α, IFN-γ, and IL-2 play an important role in the process of TCE sensitization. © The Author(s) 2015.
Allergic Contact Dermatitis From Methylisothiazolinone in Residential Wall Paint.
Goodier, Molly C; Ljungberg, Linda; Persson, Christina; Engfeldt, Malin; Bruze, Magnus; Warshaw, Erin M
A 33-year-old woman presented to our clinic for suspected photoallergic contact dermatitis with a recent episode of severe, vesicular dermatitis involving exposed skin and correlating with relocation to a new home. Biopsy results showed spongiotic and lichenoid dermatitis with eosinophils. Patch test results showed a very strong (+++) reaction to methylisothiazolinone (MI), mild (+) reaction to MI/methylchloroisothiazolinone, and no reaction to benzisothiazolinone. These allergens were found in several personal products. However, the patient was suspicious of 4 wall paints recently used in her home. Semiopen patch tests to 3 Behr interior paints showed positive results. Nine controls showed negative results. High-performance liquid chromatography demonstrated MI and benzisothiazolinone in all 4 paints at concentrations ranging from 50 to 100 ppm and 290 to 340 ppm, respectively. Although MI has been reported to cause occupational airborne contact dermatitis in European household painters, to our knowledge, this is the first documented case of paint-related MI allergy in the United States.
[Occupational contact dermatitis in metal workers and gender effect].
Filon, F Larese; Marzioti, G; Fortina, A Belloni; Peserico, A; De Toni, A; Corradini, M T; Carrabba, E; Fiorito, A
2007-01-01
Contact dermatitis is more frequent among women for anatomical reasons and for extraprofessional exposure to irritants and detergents during homeworks. In addition sensitisation to contact haptens is different in sexes. The aim of our work was to evaluate the association between patch test skin sensitizations and professional exposure to metals analyzing data for gender. Of the 15.217 patients patch tested for dermatitis, 678 were metalworkers. The statistical analysis revealed a significant association between dermatitis and sensitisation to nickel in professional exposed women (OR = 1.68; LC50% 1.11-6.50) while metal sensitisation (Cr.Ni and Co) was not relevant in men: for them a significant association between dermatitis and sensitisation was found to quaternium (OR = 3.91; LC95% 1.18-12.9), to mercaptobenzothiazole (OR = 2.69; LC50% 1.11-6.50) and to ethylendiamine dichloride (OR = 2.53; LC95% 1-6.41). The authors stress the need to evaluate patch test sensitisation considering gender effects.
Leffler, C T; Milton, D K
1999-01-01
A 23-year-old spray painter developed contact dermatitis and respiratory difficulty characterized by small airways obstruction shortly after the polyfunctional aziridine cross-linker CX-100 began to be used in his workplace as a paint activator. The symptoms resolved after he was removed from the workplace and was treated with inhaled and topical steroids. Painters may have an increased risk of asthma due to exposure to a variety of agents, such as isocyanates, alkyd resins, and chromates. This case illustrates the importance of using appropriate work practices and personal protective equipment to minimize exposure. Occupational asthma is diagnosed by a history of work-related symptoms and exposure to known causative agents. The diagnosis is confirmed by serial pulmonary function testing or inhalational challenge testing. The risk of asthma attributable to occupational exposures is probably underappreciated due to underreporting and to inappropriate use of narrow definitions of exposure in epidemiologic studies of attributable risk. Images Figure 1 PMID:10379008
Intervention development in occupational research: an example from the printing industry
Brown, T P; Rushton, L; Williams, H C; English, J S C
2006-01-01
Background Intervention development research is an essential prerequisite of any study that attempts to determine whether specific interventions work to prevent work related injury and illness. Methods Focus groups (n = 5) and direct observational studies (n = 21) of printers were used to elicit key issues that would aid the development of subsequent interventions. Transcripts from these were analysed by standard qualitative methods to identify common and related themes. Results The views of managers differed significantly from those of print workers in a number of areas, and working practices did not always follow policy. The majority of printers did not perceive dermatitis to be a major problem, although many complained of dry hands. Other key results included: the lack of skin care policy in most companies; poor understanding of the nature, causes, and treatment of dermatitis; low priority of dermatitis within health and safety concerns; little or no provision of occupational health services, particularly skin checks; variability in provision of and access to appropriate skin protection; and lack of accessible washing facilities. Conclusions As a result it was decided to evaluate the implementation of four interventions: provision of (1) skin checks and treatment advice; (2) gloves of the correct type and size, and use of an after‐work cream; (3) information on dermatitis within the printing industry; and (4) development of best practice skin care policy. PMID:16556746
Occupational allergic contact dermatitis caused by coconut fatty acids diethanolamide.
Aalto-Korte, Kristiina; Pesonen, Maria; Kuuliala, Outi; Suuronen, Katri
2014-03-01
Coconut fatty acids diethanolamide [cocamide diethanolamine (cocamide DEA)] is a surface-active derivative of coconut oil that is used in industrial, household and cosmetic products. Cocamide DEA contact allergy has been reported relatively seldom. To describe cocamide DEA-positive patients in an occupational dermatology clinic. We retrieved allergic reactions to cocamide DEA from test files, and studied the occupation, exposure, concomitant allergic reactions and diagnoses of the positive patients. Of the 2572 patients tested, 25 (1%) had an allergic reaction to cocamide DEA. Nineteen patients were occupational cases, and 11 worked in the metal industry. Hand cleansers constituted the main source of sensitization (n = 17). Other sources included two dishwashing liquids, one barrier cream, and one metalworking fluid. Three patients reacted to monoethanolamine and 2 to diethanolamine. Diethanolamine is an impurity of cocamide DEA, and can be found in cocamide DEA-containing products and in commercial patch test substances, which may explain some concomitant reactions. Cocamide DEA allergy is relatively common in patients with occupational hand dermatitis, and mainly derives from hand cleansers. However, exposure to detergents, metalworking fluids and barrier creams must also be taken into account. Concomitant reactions to ethanolamines are possible. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Hamnerius, Nils; Svedman, Cecilia; Bergendorff, Ola; Björk, Jonas; Bruze, Magnus; Engfeldt, Malin; Pontén, Ann
2018-06-20
Hand eczema (HE) in healthcare workers (HCWs) is common. Besides wet work, healthcare work also implies exposure to contact allergens. To assess HE and contact allergy related to occupational exposures in HCWs. In a cross-sectional study, 311 HCWs with HE within the preceding 12 months and a control group of 114 HCWs without HE were investigated with the baseline series and a special patch test series based on substances found in the gloves, soaps, alcoholic hand disinfectants and hand creams provided at the hospitals. Contact allergy to rubber additives was significantly more common in HCWs with HE (6%) than in HCWs without HE (1%, P = .02). The corresponding percentages for fragrances were 11% and 3%, respectively (P = .004). Occupational HE was found in 193 of 311 (62%) HCWs. Of these, 22 of 193 (11%) had occupational allergic contact dermatitis, including 17 with glove-related rubber contact allergy. Contact allergy to diphenylguanidine was as common as contact allergy to thiurams. Occupational contact allergy to rubber additives was significantly associated with sick-leave related to HE. Contact allergy to rubber additives in medical gloves is the most common cause of occupational allergic contact dermatitis in HCWs. Aimed patch testing with relevant rubber additives is mandatory when HE in HCWs is investigated. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Rosmarinus officinalis L. as cause of contact dermatitis.
Miroddi, M; Calapai, G; Isola, S; Minciullo, P L; Gangemi, S
2014-01-01
Because of the widespread use of botanicals, it has become crucial for health professionals to improve their knowledge about safety problems. Several herbal medicines contain chemicals with allergenic properties responsible for contact dermatitis. Among these, one is Rosmarinus officinalis L. (rosemary), a plant used since ancient times in folk medicine; at the present time it is used worldwide as a spice and flavouring agent, as a preservative and for medicinal and cosmetic purposes. The present article aims to revise and summarise scientific literature reporting cases of contact dermatitis caused by the use of R. officinalis as a raw material or as herbal preparations. Published case reports were researched on the following databases and search engines: PUBMED, MEDLINE, EMBASE, Google Scholar, Scopus. The used keywords were: R. officinalis and rosemary each alone or combined with the words allergy, contact dermatitis, allergic contact dermatitis, sensitisation and occupational dermatitis. The published case reports show that both rosemary extracts and raw material can be responsible for allergic contact dermatitis. Two cases related to contact dermatitis caused by cross-reactivity between rosemary and thyme were also commented. The diterpene carnosol, a chemical constituent of this plant, has been imputed as a common cause for this reaction. The incidence of contact dermatitis caused by rosemary is not common, but it could be more frequent with respect to the supposed occurrence. It seems plausible that cases of contact dermatitis caused by rosemary are more frequent with respect to the supposed occurrence, because they could be misdiagnosed. For this reason, this possibility should be carefully considered in dermatitis differential diagnosis. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.
Wilke, A; Skudlik, C; Sonsmann, F K
2018-05-02
The dermatologist's procedure is a pivotal tool for early recognition of occupational contact dermatitis (OCD), for reporting OCD cases to the statutory accident insurance and for treating the diseases. The employer is in charge of implementing skin protection measures at the workplace. However, in terms of an individual prevention approach it may be necessary to propose targeted skin protection recommendations in specific patient cases. The patient's own skin protection behavior significantly contributes to regenerating and maintaining healthy skin. This behavior includes the use of occupational skin products, and in particular the correct use of appropriately selected protective gloves. Protective gloves are the most important personal protective measure in the prevention of OCD. Prevention services, occupational health and safety specialists, occupational physicians and centers specialized in occupational dermatology can support the identification of suitable protective measures. Nowadays, suitable protective gloves exist for (almost) every occupational activity and exposure. However, improper use in practice can become a risk factor by itself for the skin (e. g., incorrectly used gloves). Therefore, it is of utmost importance to identify application errors, to educate patients in terms of skin protection and to motivate them to perform an appropriate skin protection behavior. With particular focus on protective gloves, this article gives an overview of various types, materials and potentially glove-related allergens, presents strategies for reducing occlusion effects and discusses some typical application errors and solutions.
Ljubojević Hadžavdić, Suzana; Pustišek, Nives; Žužul, Kristina; Švigir, Alen
2018-06-01
Contact allergies are common cause of eczema in all age groups and are one of the most common causes of occupational disability. Contact dermatitis (CD) can be divided into irritant and allergic contact dermatitis. Distinguishing between irritant and allergic triggers of CD by clinical and histologic examinations can be challenging. The approach to patients with CD should consist of a detailed (work and leisure) history, skin examination, patch tests with allergens based on history, physical examination, education on materials that contain the allergen and adequate therapy and prevention.
Warshaw, Erin M; Wang, Michael Z; Maibach, Howard I; Belsito, Donald V; Zug, Kathryn A; Taylor, James S; Mathias, C G Toby; Sasseville, Denis; Zirwas, Matthew J; Fowler, Joseph F; DeKoven, Joel G; Fransway, Anthony F; DeLeo, Vincent A; Marks, James G; Pratt, Melanie D; Storrs, Frances J
2013-01-01
Both active and inactive ingredients in sunscreen may cause contact dermatitis. This study aimed to describe allergens associated with a sunscreen source. A cross-sectional analysis of patients patch tested by the North American Contact Dermatitis Group between 2001 and 2010 was performed. Of 23,908 patients patch tested, 219 (0.9%) had sunscreen coded as an allergen source. Patients who were male, with occupational dermatitis, or older (older than 40 years) had significantly lower rates of allergic reactions to sunscreens; the most commonly affected areas were the face and exposed sites (P < 0.0001). The top 3 most frequent allergens in sunscreens were benzophenone-3 (70.2% for 10% concentration, 64.4% for 3% concentration), DL-alpha-tocopherol (4.8%), and fragrance mix I (4.0%). Less than 40% of positive patch test reactions were detected by the North American Contact Dermatitis Group screening series of 65 to 70 allergens. A supplemental antigen series is important in detecting allergy to sunscreens.
Allergic contact hobby dermatitis from turpentine.
Barchino-Ortiz, L; Cabeza-Martínez, R; Leis-Dosil, V M; Suárez-Fernández, R M; Lázaro-Ochaita, P
2008-01-01
Turpentine is an oleoresin obtained from various species of pine. It contains a volatile oil (oil of turpentine) which is responsible for its properties and this is the form generally used. Opportunity for contact with turpentine is widespread. It is universally used as a solvent to dissolve and thin lacquers, varnishes and paints. It is also an ingredient in many liniments and cold remedies. Turpentine is regarded as both a local irritant and a sensitizer. Cases of allergic contact dermatitis in painters, mechanics, shoe repairers and home decorators have been reported. We report a case of a non-professional painter who developed a contact allergic dermatitis due to his exposure to turpentine while doing oil-painting as a hobby. Dermatitis is one of the biggest dangers of working with art materials and occupational contact dermatitis is often detected on the hands of the painters. Solvents are indispensable and turpentine is the most important and the traditional one used in oil-painting. Contact allergy to oil of turpentine was reported to have become rare in Europe but over the last few years, increased rates of turpentine sensitization have been reported.
Epidemiology of Skin Disease in an Automobile Factory*
Newhouse, Muriel L.
1964-01-01
A survey was made of a random sample of workers from the machine shops, assembly lines, and stock and store departments of an automobile factory. Among the 1,223 men seen, representing 97% of the sample, the prevalence of non-infective skin diseases was 14·5%. Skin diseases were classified into four groups: `dermatitis' and `folliculitis' of occupational origin, endogenous `eczemas', and miscellaneous skin diseases. Slightly more than half of all the skin diseases seen were considered to be occupational in origin. In this population the prevalence of skin disease was more than four times that based on patients attending the factory medical department. An unsuspected cause of allergic dermatitis was found on the assembly lines, where the incidence of dermatitis was significantly higher than among the non-production workers. The prevalence of folliculitis was significantly higher among production than non-production workers. There was no significant difference in the prevalence of `eczema' or the miscellaneous skin diseases in the various occupational groups. Among European workers fair men were more prone to skin disease than darker men. In another factory, a West Indian and Asiatic group of workers had a significantly lower prevalence of skin diseases than a group of Europeans doing similar work. Folliculitis was more prevalent among the younger workers and those recently employed in the factory; there was no obvious association between age and length of service and the occurrence of other types of skin disease. PMID:14249898
Glove Use and Glove Education in Workers with Hand Dermatitis.
Rowley, Kyle; Ajami, Daana; Gervais, Denise; Mooney, Lindsay; Belote, Amy; Kudla, Irena; Switzer-McIntyre, Sharon; Holness, D Linn
2016-01-01
Occupational skin diseases are common. The occurrence of occupational skin diseases represents a failure of primary prevention strategies that may include the use of personal protective equipment, most commonly gloves. The objective of this study was to describe current glove use and education practices related to gloves in workers being assessed for possible work-related hand dermatitis. Participants included consecutive patients being assessed for possible work-related hand dermatitis. A self-administered questionnaire obtained information on demographics, workplace characteristics and exposures, glove use, and education regarding gloves. Ninety percent of the 105 participants reported using gloves. Only 44% had received training related to glove use in the workplace. Major gaps in training content included skin care when using gloves, warning signs of skin problems, and glove size. If the worker indicated no glove training received, the majority reported they would have used gloves if such training was provided. Although the majority of workers being assessed wore gloves, the minority had received training related to glove use. Particular gaps in training content were identified. Those who had not received training noted they would likely have used gloves if training had been provided.
Anliker, Mark David; Borelli, Siegfried; Wüthrich, Brunello
2002-02-01
Protein contact dermatitis to meat is well known in butchers; spices are another source of potential contact allergy and usually are not recognized. We present a first case of contact-dermatitis to spice mix in a 39-year-old-butcher. The patient underwent skin prick testing (SPT) with standard allergens (ALK) and different meat and spice extracts (Stallergènes), scratch-patch testing with spice mix containing glutamate, paprika and other spices. Specific serum-IgE was measured with CAP-FEIA. SPT only showed an immediate-type sensitization to mugwort (+ +), as well as different spices (paprika +, curry +, cumin +) and camomile (+ + +). Scratch-patch tests were negative for different meat, but strongly positive for spice mix (+ + +) after 30 min (wheal and flare) and (+ +) after 48 h (infiltration and vesiculation). Two healthy controls were tested negative for spice mix used from that patient (scratch-patch). Specific IgE was slightly elevated for paprika 0.47 kU/L (CAP class 1), anise 0.43 kU/L, curry 0.36 kU/L and mugwort 3.83 kU/L. Sx1 atopy-multiscreen was 3.8 kU/L due to a sensitization to mugwort alone. The tests performed demonstrate an IgE-mediated contact allergy to spices but also a delayed type allergy to spice mix as a manifestation of the mugwort-spice syndrome in this individual. When testing for occupational dermatitis in butchers, protein contact allergy to spices must also be taken into consideration.
Amsler, Emmanuelle; Aerts, Olivier; Raison-Peyron, Nadia; Debons, Michèle; Milpied, Brigitte; Giordano-Labadie, Françoise; Waton, Julie; Ferrier-Le Bouëdec, Marie C; Lartigau, Isabelle; Pecquet, Catherine; Assier, Haudrey; Avenel-Audran, Martine; Bernier, Claire; Castelain, Florence; Collet, Evelyne; Crépy, Marie-Noëlle; Genillier, Nathalie; Girardin, Pascal; Pralong, Pauline; Tetart, Florence; Vital-Durand, Dominique; Soria, Angele; Barbaud, Annick
2017-09-01
Airborne allergic contact dermatitis caused by paints containing isothiazolinones has been recognized as a health hazard. To collect epidemiological, clinical and patch test data on airborne allergic contact dermatitis caused by isothiazolinone-containing paints in France and Belgium. A descriptive, retrospective study was initiated by the Dermatology and Allergy Group of the French Society of Dermatology, including methylchloroisothiazolinone (MCI)/methylisothiazolinone (MI)- and/or MI-sensitized patients who developed airborne allergic contact dermatitis following exposure to isothiazolinone-containing paint. Forty-four cases were identified, with mostly non-occupational exposure (79.5%). Of the patients, 22.5% of also had mucosal symptoms. In several cases, the dermatitis required systemic corticosteroids (27.3%), hospitalization (9.1%), and/or sick leave (20.5%). A median delay of 5.5 weeks was necessary to enable patients to enter a freshly painted room without a flare-up of their dermatitis. Approximately one-fifth of the patients knew that they were allergic to MI and/or MCI/MI before the exposure to paints occurred. Our series confirms that airborne allergic contact dermatitis caused by paints containing isothiazolinones is not rare, and may be severe and long-lasting. Better regulation of isothiazolinone concentrations in paints, and their adequate labelling, is urgently needed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
41 CFR 101-42.001 - Definitions of terms.
Code of Federal Regulations, 2010 CFR
2010-07-01
... systematically toxic by skin contact; (4) Has a permissible exposure limit (PEL) below 1000 p/m for gases and... occupational chemical dermatitis, which is any abnormality of the skin induced or aggravated by the work...
Patch test results of the dental personnel with contact dermatitis.
Kocak, Oguzhan; Gul, Ulker
2014-12-01
Dental personnel have high risk of occupational contact dermatitis. The aim of this study is to detect the materials which cause contact sensitization and the frequency of contact dermatitis by using patch tests with European standard series and dental screening series in dental personnel. Between August 2008 and July 2009, 461 dental personnel working in Ankara (Turkey) were examined and age, gender, previous history of dermatitis, area of the skin affected and clinical diagnosis were noted. About 198 (43%) of the dental personnel were diagnosed contact dermatitis. Sixty-five of the dental personnel accepted to be patch tested. Dental technicians, dentists and dental nurses constitute 69.2%, 24.6% and 6.2% of patch tested 65 patients, respectively. Positive reactions to at least one allergen were detected with European standard series at 20% and with dental series at 10.8% among the dental personnel. The most common allergens were nickel sulfate (12.3%), acrylates (6.1%) and para-tertiary-butylphenol-formaldehyde resin (4.6%). The most common acrylate was ethyleneglycol dimethacrylate (3.1%). We believe our study will be helpful to dermatologists about frequency of contact dermatitis among dental personnel and allergens that cause contact sensitivity for developing new methods to protect the personnel in dentistry against sensitization.
Larese Filon, Francesca; Bello, Dhimiter; Cherrie, John W; Sleeuwenhoek, Anne; Spaan, Suzanne; Brouwer, Derk H
2016-08-01
The paper reviews and critically assesses the evidence on the relevance of various skin uptake pathways for engineered nanoparticles, nano-objects, their agglomerates and aggregates (NOAA). It focuses especially in occupational settings, in the context of nanotoxicology, risk assessment, occupational medicine, medical/epidemiological surveillance efforts, and the development of relevant exposure assessment strategies. Skin uptake of nanoparticles is presented in the context of local and systemic health effects, especially contact dermatitis, skin barrier integrity, physico-chemical properties of NOAA, and predisposing risk factors, such as stratum corneum disruption due to occupational co-exposure to chemicals, and the presence of occupational skin diseases. Attention should be given to: (1) Metal NOAA, since the potential release of ions may induce local skin effects (e.g. irritation and contact dermatitis) and absorption of toxic or sensitizing metals; (2) NOAA with metal catalytic residue, since potential release of ions may also induce local skin effects and absorption of toxic metals; (3) rigid NOAA smaller than 45nm that can penetrate and permeate the skin; (4) non rigid or flexible NOAA, where due to their flexibility liposomes and micelles can penetrate and permeate the intact skin; (5) impaired skin condition of exposed workers. Furthermore, we outline possible situations where health surveillance could be appropriate where there is NOAA occupational skin exposures, e.g. when working with nanoparticles made of sensitizer metals, NOAA containing sensitizer impurities, and/or in occupations with a high prevalence of disrupted skin barrier integrity. The paper furthermore recommends a stepwise approach to evaluate risk related to NOAA to be applied in occupational exposure and risk assessment, and discusses implications related to health surveillance, labelling, and risk communication. Copyright © 2016 Elsevier GmbH. All rights reserved.
30 CFR 50.20-6 - Criteria-MSHA Form 7000-1, Section C.
Code of Federal Regulations, 2010 CFR
2010-07-01
... as the first day of illness. (i) Code 21—Occupational Skin Diseases or Disorders. Examples: Contact dermatitis, eczema, or rash caused by primary irritants and sensitizers or poisonous plants; oil acne; chrome...
Workers with hand dermatitis and workplace training experiences: A qualitative perspective.
Zack, Bethany; Arrandale, Victoria H; Holness, Dorothy Linn
2017-01-01
Workplace training may help to prevent contact dermatitis, a common work-related disease. Information on the characteristics of existing workplace training programs and worker perceptions of this training is limited. Fourteen workers with suspected occupational contact dermatitis participated in one-on-one, semi-structured interviews. An inductive thematic analysis approach was used to identify interview themes. Workers expressed a desire for hands-on training with content relevant to their job tasks, favored training from supervisors who had practical experience, and were conflicted about employer motivations for providing training. Few workers had received training on skin protection. In many cases, the training workers had received differed greatly from their desired training. Although, workers with contact dermatitis describe having received workplace training, some question its value and effectiveness. This perspective may be attributed not only to the content and methods of training but also the health and safety culture of the workplace. Am. J. Ind. Med. 60:69-76, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Leggat, Peter A; Smith, Derek R
2006-01-01
Dermatitis is a common problem both in the workplace and in the general community. Airline personnel represent a novel occupational group as they are also exposed to a wide range of potential chemical irritants and other aggravating factors, such as low relative humidity and airborne pollutants. Common skin irritants include dielectric fluids from electrodischarge machining, 'prepreg' materials and sealants in aircraft manufacture, kerosene and various jet-fuel components. Commercial jet fuel is a complex mixture of aliphatic and aromatic compounds, and there is potential for dermal exposure among refueling and maintenance crew. Low relative humidity appears to exacerbate dermatitis amongst aircrew, especially on longer flight durations. Pilots may also be exposed to additional skin irritants outside of the cabin environment, such as ethylene glycol, hydraulic fluid or jet fuel, all of which may be encountered during routine inspections of aircraft before and after flight. Given these factors, preventive measures must carefully consider the undoubted potential for contact with irritants and allergens, which may lead to dermatitis in airline personnel.
[Prevention of occupational dermatitis in an international perspective].
Montomoli, L; Paolucci, V; Sartorelli, P
2012-01-01
Occupational dermatitis (OD) have always been a significant part of the occupational disease with huge social and economic costs. Traditionally, the standard program of OD prevention takes place in the three phases of protection, cleansing and use of emollient creams and other products able to improve the cutaneous trophism (skincare) at the end of the shiftwork. However, in countries like Germany where protection measures and skincare were widespread, there was not a simultaneous decrease in the OD. In recent years pilot programs for the prevention of OD have been implemented with positive results. In particular the integrated approach that includes three steps of primary, secondary and tertiary prevention (Osnabrueck model) is of great interest. Primary prevention is represented by introduction of technical regulations, pre-employment counselling and specific initiatives to promote health (healthy skin campaign). In the case of initial/minor OD, secondary prevention is accomplished through the dermatological treatment of the patient and 1-2 days outpatient education initiatives/skin protection training. In severe cases of individual OD, tertiary prevention involves the hospitalization of the patient in a dermatology department. In 2009 the European network EPOS (European Initiative for the Prevention of Occupational Skin Diseases) of preventive dermatology has been organized basing on the integrated approach of primary, secondary and tertiary prevention.
Paulsen, Evy; Andersen, Klaus E
2016-02-01
Lettuce (Lactuca sativa L.) and its varieties are important vegetable crops worldwide. They are also well-known, rarely reported, causes of contact allergy. As lettuce allergens and extracts are not commercially available, the allergy may be underdiagnosed. The aims of this article are to present new data on lettuce contact allergy and review the literature. Lettuce is weakly allergenic, and occupational cases are mainly reported. Using aimed patch testing in Compositae-allergic patients, two recent Danish studies showed prevalence rates of positive lettuce reactions of 11% and 22%. The majority of cases are non-occupational, and may partly be caused by cross-reactivity. The sesquiterpene lactone mix seems to be a poor screening agent for lettuce contact allergy, as the prevalence of positive reactions is significantly higher in non-occupationally sensitized patients. Because of the easy degradability of lettuce allergens, it is recommended to patch test with freshly cut lettuce stem and supplement this with Compositae mix. As contact urticaria and protein contact dermatitis may present as dermatitis, it is important to perform prick-to-prick tests, and possibly scratch patch tests as well. Any person who is occupationally exposed to lettuce for longer periods, especially atopics, amateur gardeners, and persons keeping lettuce-eating pets, is potentially at risk of developing lettuce contact allergy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Schwensen, J F; Menné, T; Johansen, J D; Thyssen, J P
2016-10-01
Chemicals used for the manufacturing of rubber are known causes of allergic contact dermatitis on the hands. Recent European studies have suggested a decrease in thiuram contact allergy. Moreover, while an association with hand dermatitis is well established, we have recently observed several clinical cases with allergic facial dermatitis to rubber. To evaluate temporal trends of contact allergy to rubber accelerators from the European baseline series in a tertiary patch test clinic in Denmark, and examine associations with anatomical locations of dermatitis. Patch test and clinical data collected in a Danish tertiary dermatology clinic in Gentofte, Herlev, Copenhagen between 1 January 2005 and 31 December 2014 were analysed. The following rubber accelerators or mixtures in petrolatum from the European baseline patch test series were included: thiuram mix 1.0%, mercaptobenzothiazole 2.0% and mercapto mix 1.0%. The overall prevalence of contact allergy to rubber accelerators was 3.1% with no significant change during the study period (P trend = 0.667). Contact allergy to thiuram mix was the most prevalent and was significantly associated with occupational contact dermatitis, hand dermatitis, age >40 years and facial dermatitis in adjusted binary logistic regression analysis. Current clinical relevance of contact allergy to thiuram mix was 59.3%. Patients with contact allergy to mercapto mix and mercaptobenzothiazole had a concomitant reaction to thiuram mix in 35.2% (19/54) and 35.4% (17/48) of the cases respectively. Contact allergy to rubber accelerators remains prevalent. Clinicians should be aware of the hitherto unexplored clinical association with facial dermatitis. © 2016 European Academy of Dermatology and Venereology.
'Eczema school' to improve compliance in an occupational dermatology clinic.
Kalimo, K; Kautiainen, H; Niskanen, T; Niemi, L
1999-12-01
From the beginning of 1990 a trained nurse has been employed at our Department of Dermatology to give information about skin care, allergen avoidance and skin protection to the patients. To find out the possible benefit obtained by this patient education, a questionnaire was sent out to 540 patients who had been diagnosed with an occupational skin disease established at the Department of Dermatology between 1985 and 1992. It is evident that direct comparison in this kind of longitudinal follow-up must be carried out with great criticism, since changes in patients' work exposure and socioeconomical situation during the follow-up time will also affect the prognosis. In this study, 424 patients returned the questionnaire, 252 who had been examined before 1990 and 172 later. According to the answers, it appeared that during the last 12 months, the majority (65%) had suffered from dermatitis, 13% from constant and 52% from periodic symptoms. However, when the diagnosis had been irritant contact dermatitis without allergens found, the prognosis was significantly better (p<0.008) among those who had received "extra education" and none had persistent dermatitis. Patients with contact allergy to metals or synthetic resins had also managed better, as compared to those who had received traditional treatment (p<0.002, p<0.003). Other factors such as personal motivation and possibilities for work reorganization were also important for the prognosis. 60% of patients were not initially aware of the decision given by the insurance companies, although 94% of their skin diseases had been accepted as occupational dermatoses. Generally, the patients were satisfied with the extra information given by the nurse.
Jovanović, Marina; Poljacki, Mirjana
2003-01-01
Compositae dermatitis is an allergic contact dermatitis caused by plant species of the Compositae family. The first report of a cutaneous reaction to the Chrysanthemum genus was made by Howe JS in 1887. In 1895 Maiden JH reported about skin lesions among men working with Tagetes minuta. Case reports of contact allergic-ragweed dermatitis appeared in the American literature as early as 1919. The North American feverfew--Parthenium Hysterophorus was brought to India from America in 1956 and it caused thousands of cases of so-called parthenium dermatitis. Ragweed and parthenium dermatitis became prototypes for the classic, so-called "airborne" Compositae dermatitis, that affects primarily exposed skin surfaces, and produces a universal erythroderma. The frequency of contact allergy to Compositae in Europe is higher than previously believed. It occurs most frequently in middle-aged and elderly persons, but also in all age groups. During the two past decades a more equal sex ratio has been established. The prevalence varies from 0.7-1.4% in the general population, up to 4.5% among occupationally exposed persons. Compositae allergy is among the top ten contact sensitivities in Europe. In North Europe plants were the cause of 4.4% cases of occupational allergic contact dermatitis. ETIOLOGY AND PATHOGENESIS: Among cultivated Compositae plants, Chrysanthemum is considered to be a major sensitizer in Europe (60%). Among the edible types, it is lettuce--Lactuca sativa and endive Cichorium endivia (20-30%), and wild-growing feverfew--Tanace--tum parthenium (70-90%), tansy--Tanacetum vulgare (54%), and dandelion--Taraxacum officinale (65%). Sesquiterpene lactones are the main sensitizers of the Compositae family. Other components, thiophenes and acetylenes are said to elicit only phytophotodermatitis, but recent studies have demonstrated that some thiophenes and benzofuran derivates possess not only phototoxic activity, but also sensitizing properties. Photosensitivity is present in 22-75% Compositae sensitive individuals. Extracts from Compositae are known to be phototoxic in vitro. Photoreactivity of alpha-methylene-gamma-la-ctone group of sesquiterpene-lactone directed towards the DNA base thymine, thus producing intermolecular 2 + 2 photoadducts (antigen within the cell), was also thought to be related to photosensitivity. Clinical manifestations vary from generalized eczema (20-30%), eczema of hands and face (24%), hand (36-44%), or facial eczema (11-28%). 65% of patients have vesicular hand eczema. Routine patch testing with sesquiterpene lactone mix, aimed testing with Compositae extracts screening mix, Compositae plants, and with their extracts, whereas the treatment of choice is a specific allergen-immunotherapy.
Maio, Paula; Carvalho, Rodrigo; Amaro, Cristina; Santos, Raquel; Cardoso, Jorge
2012-01-01
Methylmethacrylate was first reported in 1941 as a cause of contact dermatitis. Since then, occupational contact allergies to acrylates in dentistry, orthopedic surgery, printing industry and industry have been reported, but few reports are found in the literature as a consequence of the contact with sculptured artificial acrylic nails which are increasingly popular. We describe here 3 patients with contact allergy to acrylates in artificial sculptured nails. Patch tests were performed with the Portuguese baseline series of contact allergens and an extended series of acrylates were applied. In particular, we tested three female patients with allergic contact dermatitis from sculptured acrylic nails. Two of these patients were both customers and also technical nail beauticians. Two patients developed periungual eczema; one presented only with face and eyelid dermatitis had no other lesions. The tests showed positive reaction to 2-hydroxyethylmethacrylate (2-HEMA) and 2-hydroxypropylmethacrylate (2-HPMA) in all the three patients. Our cases demonstrate the variety of clinical presentations of allergic contact dermatitis from acrylic sculptured nails. They show the need to warn patients of persistent and sometimes permanent side effects of these products. They also emphasize the importance of cosmetic ingredient labeling. PMID:25386316
Liu, Wei; Zhang, Yan-fang; Zhang, Zhi-min; Li, Pei-mao; Jiang, Xiao-dong; Zhou, Gui-feng; Liu, Jian-jun
2011-10-01
Observing the dynamic change characteristics of serum liver function indexes in occupational dermatitis medicamentosa-like of trichloroethylene patients with liver damage, we can underlie for guiding therapy, prognosis and mechanism of dermatitis medicamentosa-like of trichloroethylene patients with liver damage. We collected serum of 10 cases of occupational dermatitis medicamentosa-like of trichloro-ethylene patients with liver damage from different time points since they were hospitalized, using automatic biochemistry analyzer to detect total protein (TP), albumin (ALB), total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), albumin/globulin ratio etc 11 liver function biochemical indicators. We used Excel to establish database, professional drawing software gnuplot to draw dynamic variation diagram of each index. The variation range of 11 liver function indexes of 10 cases was TP 43.2-74.2 g/L, ALB 24.6-44.6 g/L, A/G 0.77-2.10, TBIL 3.7-268.2 umol/L, DBIL 1.0-166.0 umol/L, IBIL 2.4 -167.5 umol/L, ALT 11-5985 U/L, AST 14-5586 U/L, GGT 15-1500 U/L, ALP 35-309 U/L, S/L 0.07-1.94, respectively. TBIL, DBIL, ALT, AST, GGT, ALP concentration significantly increased, especially ALT, AST, GGT, ALT topped 5985 U/L, AST topped 5586 U/L, GGT topped 1500 U/L. But TP, ALB and S/L significantly decreased, TP lowest to 43.2 g/L, S/L lowest to 0.07. A/G basically remained unchanged, but IBIL didn't change regularly. The early liver damage in dermatitis medicamentosa-like of trichloroethylene patients was serious, and repeatedly attacked, so we should lead to enough attention to the clinical work and prevention. This also provided the basis for studying the mechanism of trichloroethylene poisoning.
Higgins, Claire L; Palmer, Amanda M; Cahill, Jennifer L; Nixon, Rosemary L
2016-10-01
Healthcare workers (HCWs) are at risk of developing occupational skin disease (OSD). To ascertain the causes of OSD in Australian HCWs in a tertiary referral clinic. A retrospective review was performed of patients assessed at the Occupational Dermatology Clinic in Melbourne from 1993 to 2014. Of 685 HCWs assessed in the clinic over a period of 22 years, 555 (81.0%) were diagnosed with OSD. The most common diagnosis was irritant contact dermatitis (ICD) (79.1%), followed by allergic contact dermatitis (ACD) (49.7%). Natural rubber latex allergy was also relatively frequent (13.0%). The major substances causing ACD were rubber glove chemicals (thiuram mix and tetraethylthiuram disulfide), preservatives (formaldehyde, formaldehyde releasers, and isothiazolinones), excipients in hand cleansers, which are hard-to-avoid weak allergens, and antiseptics. ACD caused by commercial hand cleansers occurred more frequently than ACD caused by alcohol-based hand rubs (ABHRs). Occupational ICD was mostly caused by water/wet work and hand cleansers, and environmental irritants such as heat and sweating. Understanding the causes of OSD in HCWs is important in order to develop strategies for prevention. We suggest that skin care advice should be incorporated into hand hygiene education. The use of ABHRs should be encouraged, weak allergens in skin cleansers should be substituted, and accelerator-free gloves should be recommended for HCWs with OSD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Foussereau, J; Cavelier, C
1977-01-01
Allergic contact dermatitis to N-isopropyl-N'-phenylparaphenylenediamine (IPPD) from rubber is far from being exceptional. Out of a total of 56 cases of allergic contact dermatitis to IPPD, 42 were considered as caused by occupational contacts: 17 cases were found in tyre manufacturers, 9 in car-mechanics, 9 in drivers, and 7 in various industrial branches. Out of the 56 cases, 23 also reacted allergically to mercaptobenzothiazole or to tetramethylthiuramdisulphide, or to both of these substances. In a chromatographic analysis of samples of 9 different tyre brands, IPPD was found in 8 cases.
Huang, Peiwu; Ren, Xiaohu; Huang, Zhijun; Yang, Xifei; Hong, Wenxu; Zhang, Yanfang; Zhang, Hang; Liu, Wei; Huang, Haiyan; Huang, Xinfeng; Wu, Desheng; Yang, Linqing; Tang, Haiyan; Zhou, Li; Li, Xuan; Liu, Jianjun
2014-08-17
Trichloroethylene (TCE) is an industrial solvent with widespread occupational exposure and also a major environmental contaminant. Occupational medicamentosa-like dermatitis induced by trichloroethylene (OMLDT) is an autoimmune disease and it has become one major hazard in China. In this study, sera from 3 healthy controls and 3 OMLDT patients at different disease stages were used for a screening study by 2D-DIGE and MALDI-TOF-MS/MS. Eight proteins including transthyretin (TTR), retinol binding protein 4 (RBP4), haptoglobin, clusterin, serum amyloid A protein (SAA), apolipoprotein A-I, apolipoprotein C-III and apolipoprotein C-II were found to be significantly altered among the healthy, acute-stage, healing-stage and healed-stage groups. Specifically, the altered expression of TTR, RBP4 and haptoglobin were further validated by Western blot analysis and ELISA. Our data not only suggested that TTR, RBP4 and haptoglobin could serve as potential serum biomarkers of OMLDT, but also indicated that measurement of TTR, RBP4 and haptoglobin or their combination could help aid in the diagnosis, monitoring the progression and therapy of the disease. Copyright © 2014. Published by Elsevier Ireland Ltd.
Contact allergy to epoxy resin: risk occupations and consequences.
Bangsgaard, Nannie; Thyssen, Jacob Pontoppidan; Menné, Torkil; Andersen, Klaus Ejner; Mortz, Charlotte G; Paulsen, Evy; Sommerlund, Mette; Veien, Niels Kren; Laurberg, Grete; Kaaber, Knud; Thormann, Jens; Andersen, Bo Lasthein; Danielsen, Anne; Avnstorp, Christian; Kristensen, Berit; Kristensen, Ove; Vissing, Susanne; Nielsen, Niels Henrik; Johansen, Jeanne Duus
2012-08-01
Epoxy resin monomers are strong skin sensitizers that are widely used in industrial sectors. In Denmark, the law stipulates that workers must undergo a course on safe handling of epoxy resins prior to occupational exposure, but the effectiveness of this initiative is largely unknown. To evaluate the prevalence of contact allergy to epoxy resin monomer (diglycidyl ether of bisphenol A; MW 340) among patients with suspected contact dermatitis and relate this to occupation and work-related consequences. The dataset comprised 20 808 consecutive dermatitis patients patch tested during 2005-2009. All patients with an epoxy resin-positive patch test were sent a questionnaire. A positive patch test reaction to epoxy resin was found in 275 patients (1.3%), with a higher proportion in men (1.9%) than in women (1.0%). The prevalence of sensitization to epoxy resin remained stable over the study period. Of the patients with an epoxy resin-positive patch test, 71% returned a questionnaire; 95 patients had worked with epoxy resin in the occupational setting, and, of these, one-third did not use protective gloves and only 50.5% (48) had participated in an educational programme. The 1% prevalence of epoxy resin contact allergy is equivalent to reports from other countries. The high occurrence of epoxy resin exposure at work, and the limited use of protective measures, indicate that reinforcement of the law is required. © 2012 John Wiley & Sons A/S.
[Allergic contact dermatitis to cosmetics].
Laguna, C; de la Cuadra, J; Martín-González, B; Zaragoza, V; Martínez-Casimiro, L; Alegre, V
2009-01-01
Contact dermatitis to cosmetics is a common problem in the general population, although its prevalence appears to be underestimated. We reviewed cases of allergic contact dermatitis to cosmetics diagnosed in our dermatology department over a 7-year period with a view to identifying the allergens responsible, the frequency of occurrence of these allergens, and the cosmetic products implicated. Using the database of the skin allergy department, we undertook a search of all cases of allergic contact dermatitis to cosmetics diagnosed in our department from January 2000 through October 2007. In this period, patch tests were carried out on 2,485 patients, of whom 740 were diagnosed with allergic contact dermatitis and the cause was cosmetics in 202 of these patients (170 women and 32 men), who accounted for 27.3 % of all cases. A total of 315 positive results were found for 46 different allergens. Allergens most often responsible for contact dermatitis in a cosmetics user were methylisothiazolinone (19 %), paraphenylenediamine (15.2 %), and fragrance mixtures (7.8 %). Acrylates were the most common allergens in cases of occupational disease. Half of the positive results were obtained with the standard battery of the Spanish Group for Research Into Dermatitis and Skin Allergies (GEIDAC). The cosmetic products most often implicated among cosmetics users were hair dyes (18.5 %), gels/soaps (15.7 %), and moisturizers (12.7 %). Most patients affected were women. Preservatives, paraphenylenediamine, and fragrances were the most frequently detected cosmetic allergens, in line with previous reports in the literature. Finally, in order to detect new cosmetic allergens, cooperation between physicians and cosmetics producers is needed.
The prevalence of occupational dermatitis in the UK printing industry
Livesley, E; Rushton, L; English, J; Williams, H
2002-01-01
Aims: To quantify occupational ill health resulting from dermatitis in the UK printing industry and to explore links with particular processes and activities. Methods: Approximately 2600 members of the Graphical, Paper and Media Union living in Nottinghamshire were sent a self completion questionnaire. A sample of respondents, both those who reported current skin problems and those who did not, were invited for a short dermatological examination. Results: The overall response rate was 62%. A total of 1189 respondents were directly involved in the printing industry and categorised according to work in pre-press (25%), printing (46%), or finishing (42%) processes. A total of 490 respondents (41%) self reported having a skin complaint at some time. Prevalence was highest in males (43%) and those working in printing (49%), in particular those who cleaned rollers and cylinders or who came into contact with substances containing isocyanates on a daily basis. The most commonly affected areas reported were the fingers and webs between the fingers. Twenty six per cent of the 490 reported a current problem on the hand. Reported symptoms included itching (61%), rash (58%), and dry skin (56%). Although certain printing industry substances were thought by respondents to aggravate their condition, constant washing and friction was most often cited. Reported use of protective equipment and cleansing products was generally high, particularly by printers. Clinical examination confirmed the high self reported prevalence and also identified a substantial proportion of mild cases which were not reported. The overall prevalence of occupationally related skin complaints is estimated to be 40%. Conclusions: A much higher prevalence of dermatitis has been identified than from routine surveillance schemes. The use of good quality records from unions with high membership facilitated access to workers across a range of company sites and printing processes. Validation of self reported symptoms through clinical examination was shown to be essential. The importance of non-chemical causes of dermatitis was highlighted. The findings point towards the need for the development of effective and acceptable risk reduction strategies, in particular to reduce water contact and friction. PMID:12107299
Allergic contact dermatitis caused by cocamide diethanolamine.
Mertens, Sarien; Gilissen, Liesbeth; Goossens, An
2016-07-01
Cocamide DEA (CAS no. 68603-42-9) is a non-ionic surfactant frequently used in industrial, household and cosmetic products for its foam-producing and stabilizing properties. Contact allergy has been reported quite rarely in the past, but recently several cases were published, raising the question of an increase in the frequency of allergic dermatitis caused by this substance. To describe cocamide DEA-allergic patients and their characteristics observed in our department. Medical charts of patients, investigated between 1990 and December 2015, were retrospectively reviewed for cocamide DEA-allergy. Demographic characteristics and patch test results were analyzed. Out of 1767 patients tested, 18 (1%) presented with an allergic reaction to cocamide DEA, all of them at least with hand dermatitis. Twelve patients had (past) occupational exposure to cocamide DEA. Out of the 18 patients, 15 showed (most often) multiple positive reactions and 7 also suffered from atopic dermatitis. Cocamide DEA allergy is relatively rare, despite frequent use, and an increasing trend was not observed. Reactions to cocamidopropyl betaine and cocamide MEA only occurred in some of the subjects tested. Shampoos and liquid hand soaps/cleansers dominated as sources of exposure. All patients presented with an impaired skin barrier due to atopic and/or previous contact dermatitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Contact dermatitis and patch testing for the allergist.
Fonacier, Luz; Noor, Irum
2018-06-01
To review of contact dermatitis (CD) and its key allergens and provide updates and recommendations for the practicing allergist. Through the use of various scientific search engines (eg, PubMed and MEDLINE), we reviewed literature on CD, patch tests (PTs), key allergens, occupational dermatitis, and treatment. Studies on CD, important allergens, and PTs were considered. Contact-induced dermatitis may be due to allergic CD, irritant CD, systemic CD, contact urticaria, and protein CD. Key allergens include metals (nickel, gold), topical medicaments (topical corticosteroids), and cosmetics and personal care products (fragrances and preservatives such as methyl- and methylchloro-isothiazolinone). Present relevance of a positive PT result is the combination of definite, probable, and possible relevance and should be correlated with the patient's history and physical examination. Treatment of allergic CD includes identification of relevant allergens, patient education, avoidance, and provision of alternative products the patient can use. CD is a common inflammatory skin disease and should be suspected in patients presenting with acute, subacute, or chronic dermatitis. The gold standard for diagnosing allergic CD is a PT. This article provides practical recommendations for the diagnosis and management of CD commonly seen by the allergist in their practice. Copyright © 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Occupational risk factors for hand dermatitis among professional cleaners in Spain.
Mirabelli, Maria C; Vizcaya, David; Martí Margarit, Anna; Antó, Josep Maria; Arjona, Lourdes; Barreiro, Esther; Orriols, Ramon; Gimenez-Arnau, Ana; Zock, Jan-Paul
2012-04-01
Dermatitis is an important health outcome for workers whose jobs put them in contact with irritants or sensitizing agents. We conducted an analysis of data from the Epidemiological Study on the Risk of Asthma in Cleaning Workers 2 (EPIASLI2) to assess worksites and cleaning products as risk factors for hand dermatitis among professional cleaning workers. We distributed 4993 questionnaires to employees of 37 cleaning companies, and used data from 818 (16%) respondents who provided information about skin symptoms and cleaning-related exposures. We assessed associations between the frequencies of worksite and cleaning product exposures and a symptom-based definition of hand dermatitis among current cleaning workers (n = 693) and a comparison population (n = 125). Hand dermatitis was reported by 28% of current cleaning workers, versus 18% of the comparison population, and was associated with cleaning outdoor areas and schools, and the use of hydrochloric acid [prevalence ratio (PR) 1.92, 95% confidence interval (CI) 1.22-3.02] and dust mop products (PR 1.75, 95% CI 1.11-2.75). Professional cleaning workers may not be sufficiently protected from cutaneous disease at work. Future research should further investigate the roles of multiple product exposures and personal protective equipment. © 2012 John Wiley & Sons A/S.
Occupational risk factors for hand dermatitis among professional cleaners in Spain
Mirabelli, Maria C.; Vizcaya, David; Margarit, Anna Martí; Antó, Josep Maria; Arjona, Lourdes; Barreiro, Esther; Orriols, Ramon; Gimenez-Arnau, Ana; Zock, Jan-Paul
2012-01-01
Summary Background Dermatitis is an important health outcome for workers whose jobs put them in contact with irritants or sensitizing agents. Objectives We conducted analysis of data from the Epidemiological Study on the Risk of Asthma in Cleaning Workers 2 (EPIASLI2) study to assess worksites and cleaning products as risk factors for hand dermatitis among professional cleaning workers. Materials/Methods We distributed 4 993 questionnaires to employees of 37 cleaning companies and used data from 818 (16%) respondents who provided information about skin symptoms and cleaning-related exposures. We assessed associations between the frequencies of worksite and cleaning product exposures and a symptom-based definition of hand dermatitis among current cleaning workers (n=693) and a comparison population (n=125). Results Hand dermatitis was reported by 28% of current cleaning workers, versus 18% of the comparison population, and was associated with cleaning outdoor areas and schools, and the use of hydrochloric acid (prevalence ratio [PR]: 1.92, 95% confidence interval [CI]: 1.22, 3.02) and dust mop products (PR: 1.75, 95% CI: 1.11, 2.75). Conclusions Professional cleaning workers may not be sufficiently protected from cutaneous disease at work. Future research should further investigate the roles of multiple product exposures and personal protective equipment. PMID:22268785
Camarasa, J M
1979-01-01
The present work is the first epidemiological study carried out by the Spanish Contact Dermatitis Research Group during 1977. During this year 2806 patients were studied with patch test among 30873 dermatological patients. The 60-62% of the totality had reactivity to one or more patches. Four major groups of allergens were able to consider, following the incidence in their power of sensitize. First group with strong incidence include: Nickel, Chromate, Cobalt, T.M.T.D.,P.P.D.A., Mercapto mix., and Wood tars. Second and third groups with medium incidence contain: Caines, Carbonates, Neomycin, Balsam of Peru, Mercury, Lanolin, Naphtyl mix., Formaldehyde, Benzalkonium chloride, P. P. D. A. mix, and Turpentine. Four group show very low incidence substances, as: Epoxi, Sulfonamides, Etilendiamine, Parabens, Chinoform, Colophony and Cinnamon oil. Few comments about age and occupations are included.
Satisfaction with medical treatment in patients with hand dermatitis - a cross-sectional study.
Herschel, Solveig; Schmitt, Jochen; Bauer, Andrea
2013-10-01
Despite the significant clinical and economic burden of hand dermatitis, data on patients' satisfaction with treatment and related determining factors are lacking. We performed a cross-sectional study using a standardized survey, including all patients with hand dermatitis treated between 12/2001 and 11/2008 at the Department of Dermatology, TU Dresden. Patients were asked about socio-demographic data, disease characteristics, occupational data, quality of life, treatment satisfaction and their treatment goals. Based on an a priori model, possible impact factors on treatment satisfaction were analyzed using regression modeling. Of 382 contacted patients, 215 agreed to participate in the study (133 [61.3%] female). The mean age was 42 years. 155 patients (72.1%) had had severe or very severe hand dermatitis in the past. The majority of the patients were satisfied with the medical treatment. Treatment satisfaction was determined by the impression of professional competence (p < 0.001), physicians' empathy (p < 0.001), sufficient information on course, prognosis, and treatment options (p < 0.001), the patients' self-treatment competency (p < 0.001), quality of life (p = 0.007), as well as on the severity of hand dermatitis (p < 0.001). The data point out that in the therapy of chronic hand dermatitis, along with professional competence, the physicians' empathy, provision of sufficient information about the disease, and teaching self-treatment competency play a prominent role in improving the treatment satisfaction of the patients. © The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.
Occupational and environmental health hazards in the plastics industry.
Eckardt, R E
1976-01-01
A brief description of the potential occupational health hazards encountered in the manufacture of plastics (polymers) is given. In general, these hazards are due to the monomers used to make the various plastics, to unreacted monomer contained within the finished products, and to the fillers, stabilizers, pigments, inhibitors, and initiators used in fabricating the finished products. They run the gamut from angiosarcomas of the liver due to vinyl chloride, to dermatitis and asthma-like reactions due to the initiators used with epoxy resins. PMID:140799
Notification of occupational and work-related diseases and poisonings in Malaysia, 1997-1998.
Sirajuddin, H; Roslinah, A; Rampal, K G; Kuppusamy, I; Rohna, R; Aziz, M; Aw, T C; Beach, J R
2001-03-01
In 1997, the Ministry of Health Malaysia introduced a surveillance programme for occupational and work-related diseases including poisonings for cases seen in government health facilities. Between June 1997 and November 1998, there were 36 cases of respiratory disease and 95 cases of poisoning by chemicals and pesticides notified while skin diseases were 108 cases. Respiratory diseases reported were predominantly occupational asthma (25%), pneumoconiosis (17%) and infections (39%). The commonest reported skin disease was contact dermatitis (87%). The commonest causes of occupational poisonings were paraquat (19%), organo-phosphates (16%), agro-chemicals excluding pesticides (15%) and gases (10%). The number of cases reported is still relatively few compared to data from other countries, suggesting that there is still considerable under reporting.
Positive patch test reactions to oxidized limonene: exposure and relevance.
Bråred Christensson, Johanna; Andersen, Klaus E; Bruze, Magnus; Johansen, Jeanne D; Garcia-Bravo, Begoña; Gimenez Arnau, Ana; Goh, Chee-Leok; Nixon, Rosemary; White, Ian R
2014-11-01
R-Limonene is a common fragrance terpene found in domestic and industrial products. R-Limonene autoxidizes on air exposure, and the oxidation products can cause contact allergy. In a recent multicentre study, 5.2% (range 2.3-12.1%) of 2900 patients showed a positive patch test reaction to oxidized R-limonene. To study the exposure to limonene among consecutive dermatitis patients reacting to oxidized R-limonene in an international setting, and to assess the relevance of the exposure for the patients' dermatitis. Oxidized R-limonene 3.0% (containing limonene hydroperoxides at 0.33%) in petrolatum was tested in 2900 consecutive dermatitis patients in Australia, Denmark, the United Kingdom, Singapore, Spain, and Sweden. A questionnaire assessing exposure to limonene-containing products was completed. Overall, exposure to products containing limonene was found and assessed as being probably relevant for the patients' dermatitis in 36% of the limonene-allergic patients. In Barcelona and Copenhagen, > 70% of the patients were judged to have had an exposure to limonene assessed as relevant. Oxidized R-limonene is a common fragrance allergen, and limonene was frequently found in the labelling on the patients' products, and assessed as relevant for the patients' dermatitis. A large number of domestic and occupational sources for contact with R-limonene were identified. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ito, Akiko; Nishioka, Kazue; Kanto, Hiromi; Yagami, Akiko; Yamada, Shigeki; Sugiura, Mariko; Yasunaga, Chihiro; Yoshii, Keiko; Kobayashi, Hiromi; Adachi, Atsuko; Ikezawa, Yuko; Washizaki, Kumiko; Inui, Shigeki; Miyazawa, Hitoshi; Oiso, Naoki; Nakata, Tokio; Matsunaga, Kayoko
2017-07-01
In Japan, allergic contact dermatitis caused by hair colouring agents is a considerable problem for those occupationally exposed and also for consumers. Over the last 20 years, p-phenylenediamine (PPD) has been a common allergen, with ∼7% positive patch test reactions. To investigate which ingredients caused allergic contact dermatitis related to hair dye and perming solutions in Japan, to assess whether PPD is suitable for screening for hair dye allergy, and to propose allergens for a Japanese hairdresser series. We selected 19 hair cosmetic allergens, including PPD, Bandrowski's base, cysteamine HCl, and ammonium thioglycolate. Altogether 203 patients (26 males and 177 females) with suspected contact allergy to hair colouring or perming solutions at 14 hospitals in Japan were included. The highest prevalence of positive reactions (35.1%) was for PPD. p-Methylaminophenol and o-aminophenol were often positive, both in the PPD-positive and in the PPD-negative patients. Moreover, cysteamine HCl often yielded positive test reactions. PPD is insufficient to diagnose contact allergy caused by to hair dyes. We recommend 13 allergens to be included in a Japanese hairdresser series. © 2017 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.
Occupational skin diseases in automotive industry workers.
Yakut, Yunus; Uçmak, Derya; Akkurt, Zeynep Meltem; Akdeniz, Sedat; Palanci, Yilmaz; Sula, Bilal
2014-03-01
Studies on occupational skin diseases in workers of the automotive industry are few. To investigate the prevalence of occupational skin diseases in workers of the automotive industry. Between September and December 2011, a total of 405 workers from the automotive repair industry in Diyarbakır were interviewed. They were active workers in the repair industry who had been employed for at least six months. Business owners, sellers of spare parts and accounting officers were not included. The employees were examined at their workplaces and the working conditions were observed. Detailed dermatological examination was performed. The mean age of the 405 workers who participated in the study was 27.7 ± 10.3. The mean working time of employees was 13.3 ± 10.4 years. All of the employees were male. Dermatological diseases were not detected in 144 out of 405 workers (35.6%) and at least one condition was diagnosed in 261 (64.4%). The most frequent diagnosis was callus, hyperkeratosis, clavus (27.7%), followed by nail changes (16.8%) and superficial mycoses (12.1%). Contact dermatitis was seen at a rate of 5.9%. Traumatic lesions such as hyperkeratotic lesions and nail changes were found most frequently. Traumatic lesions were common among individuals who did not use gloves. Most nail changes were localized leuconychia, a finding not reported in the studies on automotive industry workers. In accordance with the literature, irritant contact dermatitis was observed in patients with a history of atopy and who had been working for a long time. Occupational skin diseases comprise an important field in dermatology, deserving much attention. Further studies on occupational dermatology are necessary.
[Occupational dermatitis in construction and public workers].
Frimat, Paul
2002-09-01
Construction workers perform a large variety of duties concerned with building, repairing, and wrecking buildings, bridges, dams, roads, railways and so on. The work may include mixing, pouring and spreading concrete, asphalt, gravel and other materials. Despite the increasing mechanization of construction and the more frequent use of precast concrete sections, contact with wet cement still occurs, particularly in small jobs. The work is hard physical labor, often under difficult conditions, including hot, cold, and wet weather. Occupational diseases of the skin in the construction have paralleled industrial development.
Health-hazard evaluation report HETA 85-441-1765, New Boston Coke Corporation, New Boston, Ohio
DOE Office of Scientific and Technical Information (OSTI.GOV)
O'Malley, M.A.
1986-12-01
In response to a request from the Industrial Commission of Ohio, worker complaints of skin disease at the New Boston Coke Corporation, New Boston, Ohio were investigated. The request was based on seven reports of dermatitis thought to be associated with steam exposure during coke quenching. Quench water had a pH of 8.85 and contained phenol, ammonia, calcium-oxide, and suspended particulates (82% organic compounds); no irritant threshold levels were found for these compounds. Skin tests in rabbits showed a minimal irritant capacity for quench water. Medical records did not reveal the origin of dermatitis. Active skin lesions were characterized asmore » nummular eczema or atopic dermatitis, which were not thought to be of occupational origin. The author concludes that coke-quenching steam does not pose a skin hazard, but certain work activities may aggravate existing skin conditions. Recommendations include elimination of abrasive cleansing agents, use of skin moisturizers after washing, and prompt medical evaluation of skin complaints.« less
Airborne irritant contact dermatitis due to synthetic fibres from an air-conditioning filter.
Patiwael, Jiska A; Wintzen, Marjolein; Rustemeyer, Thomas; Bruynzeel, Derk P
2005-03-01
We describe 8 cases of occupational airborne irritant contact dermatitis in intensive care unit (ICU) employees caused by synthetic (polypropylene and polyethylene) fibres from an air-conditioning filter. Not until a workplace investigation was conducted, was it possible to clarify the unusual sequence of events. High filter pressure in the intensive care air-conditioning system, maintained to establish an outward airflow and prevent microorganisms from entering the ward, probably caused fibres from the filter to become airborne. Upon contact with air-exposed skin, fibres subsequently provoked skin irritation. Test periods in the ICU with varying filter pressures, in an attempt to improve environmental conditions, led to even higher filter pressure levels and more complaints. The sometimes-very-low humidity might have contributed to development of skin irritation. The fact that most patients recovered quickly after treatment with emollients and changing the filters made it most likely that the airborne dermatitis was of an irritant nature.
Occupational skin disease in the construction industry.
Bock, M; Schmidt, A; Bruckner, T; Diepgen, T L
2003-12-01
Construction workers have a substantial risk of developing irritant and/or allergic contact dermatitis. Unfortunately, however, there is little population-based epidemiological data relating to occupational skin diseases (OSD) in the European construction industry that allow assessment of preventive measures. In this investigation, the yearly incidence rates and causes of OSD in the construction industry were analysed on the basis of our register in Northern Bavaria. From 1990 until 1999, all incidences of OSD in the construction industry were recorded prospectively. This enables the calculation of incidence rates of OSD in relation to the employed population in Northern Bavaria as recorded by the German Federal Employment Office. In the construction industry, a total of 335 OSD were registered. These comprise 9.0% of all OSD in the register. We classified them into four relevant groups: (A) tile setters and terrazzo workers (incidence per 10 000 employees = 19.9); (B) painters (7.8); (C) construction and cement workers (5.2); and (D) wood processors (2.6). The overall incidence was 5.1 per 10 000 employees over 10 years, which is a little below average for the entire register (6.7). Of these, 43.6% were at least 40 years old. Allergic contact dermatitis (61.5%) occurred more often than irritant contact dermatitis (44.5%). Potassium dichromate caused roughly half of all cases of sensitization found to be occupationally relevant in the construction industry (152 cases) followed by epoxy resin (40) and cobalt chloride (32). The results indicate that potassium dichromate is still the most important allergen in the construction industry of Northern Bavaria; there has been no significant decline during the 1990s. This contrasts with the Scandinavian countries, where the prevalence of potassium dichromate sensitization declined following the reduction of chromium VI levels resulting from the addition of ferrous sulphate to cement. Within the construction industry, tile setters and terrazzo workers have a strikingly high incidence of OSD.
Sensitization to Rubber Accelerators in Northeastern Italy: The Triveneto Patch Test Database.
Buttazzo, Silvia; Prodi, Andrea; Fortina, Anna Belloni; Corradin, Maria Teresa; Larese Filon, Francesca
2016-01-01
Natural and synthetic rubbers containing rubber accelerators are well-known causes of occupational skin disease. Allergic contact dermatitis caused by rubber gloves is frequent and has almost exclusively been attributed to contact sensitization to accelerators. This study aimed to evaluate the frequency of rubber accelerators sensitization in the population living in northeastern Italy, to find time trend and a correlation with occupations, and to investigate co-sensitization between rubber accelerators. A population of 23,774 subjects was patch tested in 6 cities in northeastern Italy in the years 1996 to 2012 using carba mix 3%, thiuram mix 1%, benzothiazole (MBT) mix 1%, and isopropyl phenyl paraphenylamine diamine (IPPD) mix 0.6%. The overall frequency of carbamates, MBT, thiurams, and IPPD mix sensitization was 3.4%, 0.65%, 1.75%, and 0.83%, respectively. On a logistic regression analysis (control group: white-collar workers), we found a statistically significant association to carbamates (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.03-1.7) and thiurams (OR, 1.6; 95% CI, 1.1-2.3) for health care workers. Thiuram sensitivity was also significantly associated with dermatitis in maids and restaurant workers (OR, 2.2; 95% CI, 1.4-3.6), hairdressers (OR, 3.6; 95% CI, 1.8-7.1), shop assistants (OR, 2.9; 95% CI, 1.2-6.8), construction workers (OR, 2.7; 95% CI, 1.7-4.1), mechanics (OR, 2.1; 95% CI, 1.3-3.4), and professional drivers (OR, 2.6; 95% CI, 1.2-5.9). In conclusion, our results demonstrated that rubber accelerators have an important role in allergic contact dermatitis in the northeast of Italy and their sensitization is associated significantly with occupations that wear gloves or use chemical substances. Between rubber accelerators tested, carbamates sensitization is prevalent and increasing during considered years.
Pesonen, Maria; Kuuliala, Outi; Suomela, Sari; Aalto-Korte, Kristiina
2016-12-01
Amines in epoxy hardeners are significant causes of occupational allergic contact dermatitis among workers who use epoxy resin systems. To describe a novel group of contact allergens: N-(2-phenylethyl) derivatives of the reactive amine 1,3-benzenedimethanamine (1,3-BDMA). We describe the clinical examinations and exposure of 6 patients with occupational contact allergy to derivatives of 1,3-BDMA. Of the 6 patients, 4 were spray painters who used epoxy paints, 1 was a floor layer who handled a variety of epoxy coatings, and 1 was a worker in epoxy hardener manufacture. We were able to confirm exposure to epoxy hardeners that contained derivatives of 1,3-BDMA in 5 of the 6 sensitized patients. Despite the close structural resemblance between derivatives of 1,3-BDMA and m-xylylenediamine (MXDA), only 3 patients reacted positively to MXDA. Concomitant contact allergy to diglycidyl ether of bisphenol A resin was seen in 2 of the 6 patients. Because of the lack of a commercially available patch test substance, the diagnosis of contact allergy to derivatives of 1,3-BDMA requires patch testing with either the epoxy hardener product or a hardener ingredient that contains the derivatives of 1,3-BDMA. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Food-Related Contact Dermatitis, Contact Urticaria, and Atopy Patch Test with Food.
Walter, Alexandra; Seegräber, Marlene; Wollenberg, Andreas
2018-06-07
A wide variety of foods may cause or aggravate skin diseases such as contact dermatitis, contact urticaria, or atopic dermatitis (AD), both in occupational and private settings. The mechanism of action underlying allergic disease to food, food additives, and spices may be immunologic and non-immunologic. The classification and understanding of these reactions is a complex field, and knowledge of the possible reaction patterns and appropriate diagnostic test methods is essential. In addition, certain foods may cause worsening of atopic dermatitis lesions in children. The atopy patch test (APT) is a well-established, clinically useful tool for assessing delayed type reactions to protein allergens in patients and may be useful to detect protein allergens relevant for certain skin diseases. The APT may even detect sensitization against allergens in intrinsic atopic dermatitis patients, who show negative skin prick test and negative in vitro IgE test results against these allergens. Native foods, SPT solutions on filter paper, and purified allergens in petrolatum have been used for APT. The European Task Force on Atopic Dermatitis (ETFAD) has worked on standardizing this test in the context of AD patients, who are allergic to aeroallergens and food. This recommended, standardized technique involves test application at the upper back of children and adults; use of large, 12-mm Finn chambers; avoidance of any pre-treatment such as tape stripping or delipidation; standardized amounts of purified allergens in petrolatum; and use of the standardized ETFAD reading key. The APT may not be the best working or best standardized of all possible skin tests, but it is the best test that we currently have available in this niche.
Hassan, Iffat; Kamili, Afifa; Rasool, Farhan; Nehvi, Firdous; Rather, Parvaiz; Yasmin, Salwee; Pampori, Rafiq A; Jabeen, Yasmeen; Yaseen, Atiya; Bashir, Safia; Naaz, Saima
2015-01-01
Saffron, a bulbous perennial plant belonging to Iridaceae family, is the most expensive cultivated herb that is widely used for industrial and nonindustrial purposes. However, besides its attractive and valuable properties, contact dermatitis due to saffron is an uncommon reported entity. The aims of this study were to determine the clinical pattern patch-testing profile of contact dermatitis in saffron workers and to identify the most common allergens/sensitizers. One hundred ten saffron workers were patch-tested with 39 allergens, which included Indian standard series antigens, plant series antigens, and extracts from different parts of saffron flower. The allergens in Indian standard series accounted for 52.44% of positive reactions. Plant series and different parts of saffron accounted for 47.56% of the positive reactions. Among those patients with positive responses to the supplemental saffron allergens, 83.3% were of present or past relevance. The data observed in the present study confirm that the saffron dermatitis is a distinct clinical entity with characteristic clinical presentation and has a strong significance as an occupational allergen in those handling this plant. Patch testing with different parts of saffron flower has a role to play in finding out the etiological cause.
Tandem Repeated Irritation Test (TRIT) Studies and Clinical Relevance: Post 2006.
Reddy, Rasika; Maibach, Howard
2018-06-11
Single or multiple applications of irritants can lead to occupational contact dermatitis, and most commonly irritant contact dermatitis (ICD). Tandem irritation, the sequential application of two irritants to a target skin area, has been studied using the Tandem Repeated Irritation Test (TRIT) to provide a more accurate representation of skin irritation. Here we present an update to Kartono's review on tandem irritation studies since 2006 [1]. We surveyed the literature available on PubMed, Embase, Google Scholar, and the UCSF Dermatology library databases since 2006. The studies included discuss the tandem effects of common chemical irritants, organic solvents, occlusion as well as clinical relevance - and enlarge our ability to discern whether multiple chemical exposures are more or less likely to enhance irritation.
Accidental poisoning with detomidine and butorphanol.
Hannah, N
2010-09-01
This is a case report concerning a veterinarian who spilled detomidine and butorphanol on dermatitic hands while sedating a horse. This resulted in acute poisoning from which the patient spontaneously recovered with supportive management. Veterinarians often suffer from occupational dermatitis and handle strong sedatives with no gloves while working around unpredictable animals. Thus, this group is at risk of accidental self-poisoning from this method.
Occupational acral dermatitis and where the twain shall meet.
Wolf, Ronni; Parish, Lawrence Charles; Tüzün, Yalçın
This contribution, which is somewhat of a departure from the usual format, will focus on dermatologic conditions that are consequences of the patients' choices of employment, hobby, or even other forms of recreation. Most of the cutaneous changes involve the hands and feet, and each is labeled according to the anatomic location. Copyright © 2017 Elsevier Inc. All rights reserved.
Occupational sensitization to epoxy resins in Northeastern Italy (1996-2010).
Prodi, Andrea; Rui, Francesca; Fortina, Anna Belloni; Corradin, Maria Teresa; Filon, Francesca Larese
2015-01-01
One of the main health concerns of epoxy resins is their role as skin sensitizer. This sensitization is not uncommon, because the prevalence ranges around 1-12% of the general population. Perform a cross sectional study in a patch test population from Northeastern Italy to investigate the prevalence of epoxy resins sensitization among patients with suspected contact dermatitis. Subsequently, relate findings to patients' occupation and evaluate time trend of prevalence. The final study database included 19 088 consecutive patients, tested from 1996 to 2010 in Northeastern Italy. The overall prevalence of epoxy resins sensitization was 0·89%. Dermatitis most frequently involved hands (40·25%). In both sexes, we find a significant correlation in mechanics, woodworkers, and chemical industry workers; and in males only, among farmers and fishers, construction workers, and unemployed. We found significant increase of sensitization in construction workers in the analyzed period. The overall prevalence of sensitization to epoxy resins in Northeastern Italy is in line with other European countries, but we found an increased risk of sensitization in some professions and an increasing trend of prevalence in construction workers. Better preventive actions are strongly advised in higher risk professions, with particular attentions towards building sector.
Acrylate-induced allergic contact dermatitis in a car windscreen repairer.
Fremlin, G; Sansom, J
2014-10-01
We report a case of an allergic skin reaction to ultraviolet-cured acrylates in a windscreen repair worker. The patient presented with a 6 month history of fingertip dryness, vesicles and desquamation. He had worked as a self-employed car windscreen repairer for 19 years. Previous management with vinyl glove protection and treatment with clobetasol propionate ointment had produced little improvement. He was patch tested to the British Society for Cutaneous Allergy standard and preservatives series and to the two acrylates used in his work environment, identified using safety data sheets, methyl methacrylate 2% pet and 2-hydroxyethylmethacrylate (2-HEMA) 2% pet. A positive reaction was seen at Day 4 to 2-HEMA, but all other patch tests were negative. An occupational allergic contact dermatitis to 2-HEMA was diagnosed. The patient was given avoidance advice and advised to use nitrile gloves. Although he was unable to give up his current work, he has continued his job using nitrile gloves with marked improvement. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Kaufman, J D; Cohen, M A; Sama, S R; Shields, J W; Kalat, J
1998-07-01
This study sought to characterize occupational dermatoses and cutaneous hazards. Workers' compensation claims filed for skin disease in the Washington State Fund were analyzed for 1989 through 1993; incidence rates for industries and employers were calculated, and cutaneous hazards associated with the highest rates were identified. A total of 7445 claims were filed for skin disorders, principally contact dermatitis; 675 (9.1%) involved more than 3 missed work-days. The rate of accepted skin disorder claims was 1.0 per 1000 full-time employee-years. The highest incidence rates (4.6 to 30.7 accepted claims per 1000 full-time employee-years) were in certain manufacturing industries (plastics related, concrete products, aircraft parts, sporting goods, and boat building), wholesale farm product raw materials, automotive glass replacement, and beauty shops. Seven of the 10 employers with the highest incidence rates (19.6 to 85.5 accepted claims per 1000 full-time employee-years) used fiber-reinforced plastics (composites) and exposed workers to epoxy and other resin systems associated with contact dermatitis. Workers' compensation data identify known and emerging workplace cutaneous hazards and show promise for targeting prevention efforts.
Kaufman, J D; Cohen, M A; Sama, S R; Shields, J W; Kalat, J
1998-01-01
OBJECTIVES: This study sought to characterize occupational dermatoses and cutaneous hazards. METHODS: Workers' compensation claims filed for skin disease in the Washington State Fund were analyzed for 1989 through 1993; incidence rates for industries and employers were calculated, and cutaneous hazards associated with the highest rates were identified. RESULTS: A total of 7445 claims were filed for skin disorders, principally contact dermatitis; 675 (9.1%) involved more than 3 missed work-days. The rate of accepted skin disorder claims was 1.0 per 1000 full-time employee-years. The highest incidence rates (4.6 to 30.7 accepted claims per 1000 full-time employee-years) were in certain manufacturing industries (plastics related, concrete products, aircraft parts, sporting goods, and boat building), wholesale farm product raw materials, automotive glass replacement, and beauty shops. Seven of the 10 employers with the highest incidence rates (19.6 to 85.5 accepted claims per 1000 full-time employee-years) used fiber-reinforced plastics (composites) and exposed workers to epoxy and other resin systems associated with contact dermatitis. CONCLUSIONS: Workers' compensation data identify known and emerging workplace cutaneous hazards and show promise for targeting prevention efforts. PMID:9663152
Romano, C; Carosso, A; Bosio, D; Chiesa, A; Gullino, A; Turrini, A
2003-01-01
Aim of the study was to verify the reliability in clinical practice of patch testing with "standard" series and additional series of haptens for the diagnosis of occupational and non-occupational allergic contact dermatitis, evaluating positive reactions and relating those reactions to professional categories. A total of 392 out of 937 patients (41.8%) showed at least one positive reaction to "standard" series testing; the hapten most frequently noted as the cause of positive reaction was nickel sulphate. Professional categories that showed positive reactions to "standard" series most frequently were clerks, hairdressers and hospital auxiliary workers. Among 897 patients tested with nonstandard allergens, only 124 (13.8%) elicited at least one positive reaction, ammonium persulphate being the most frequently positive hapten. A dominant percentage of positive results was seen in hairdressers and cleaning personnel. No positive reactions were observed in a large number of haptens, tested more than 200 times. Haptens of "standard series" elicited a higher number of positive reaction than the additional series, even though there was a high specificity of few additional series haptens in some professional categories. Data suggest some caution in systematically testing additional series, despite a higher accuracy and diagnostic efficacy in some job categories.
Maternal employment and atopic dermatitis in children: a prospective cohort study.
Wang, I J; Wen, H J; Chiang, T L; Lin, S J; Chen, P C; Guo, Y L
2013-04-01
Considering the early onset of atopic dermatitis (AD), which most often arises in the first year of life, risk factors occurring very early in life must be considered. Little is known about the effects of maternal occupational exposure on the development of atopic disorders in children. The aim of this study was to evaluate associations between maternal employment and childhood AD. We used multistage stratified systematic sampling to recruit 24,200 mother-newborn pairs from the Taiwan national birth register. Information on maternal occupation categories, work stress, working time, shift work and potential confounders during pregnancy was gathered by questionnaires after birth. At 3 years of age, information on the development of AD was assessed by home interviews. Multiple logistic regression analysis was performed to estimate the association of maternal employment and AD. Overall, 11,962 out of 19,381 mothers (61·7%) worked during pregnancy. The children of mothers who worked during pregnancy had an increased risk of AD compared with those whose mothers did not work [odds ratio (OR) 1·38, 95% confidence interval (CI) 1·25-1·53]. The children of mothers with a professional or technical occupation had a higher risk of AD (OR 1·64, 95% CI 1·44-1·87). The risk of AD was found to increase with maternal work stress during pregnancy in a dose-response manner (P(trend)<0·01). The mothers of children with AD had a longer working time than those without AD (P<0·0001). However, no significant association between AD and maternal shift work was found. Working in professional or technical occupations increased the risk of childhood AD in addition to work stress during pregnancy. © 2013 The Authors. BJD © 2013 British Association of Dermatologists.
Dermatoses among automobile mechanics in Mansoura, Egypt.
Abou-ElWafa, Hala Samir; Albadry, Ahmed A; El-Gilany, Abdel-Hady; Ismael, Ahmed Fawzi
2018-01-02
This cross-sectional study was carried out in Mansoura, Egypt to assess the prevalence of occupational dermatoses and their possible risk factors on a convenience sample of car mechanics. Sociodemographic and occupational data were collected, and clinical examination was done. Prevalence of skin diseases was 45.4% and that of exclusively occupational skin diseases was 9.2%. Irritant contact dermatitis, eczema, and tar/oil acne were the most common types (4.6%, 3.1%, 3.1%, respectively). The logistic regression analysis revealed that the risk of occupational dermatoses increased significantly with lack of use of personal protective equipment, longer duration of work, and presence of workplace chemicals (adjusted odds ratio [95% CI] were 7.2 [2.7, 19.0], 4.3 [1.7, 10.9], and 3.7 [1.3, 10.5], respectively). Health education and safety measures are essential for prevention and control of hazardous workplace practices and exposure.
Agarwal, Uma Shankar; Besarwal, Raj Kumar; Gupta, Rahul; Agarwal, Puneet; Napalia, Sheetal
2014-01-01
Hand eczema is often a chronic, multifactorial disease. It is usually related to occupational or routine household activities. Exact etiology of the disease is difficult to determine. It may become severe enough and disabling to many of patients in course of time. An estimated 2-10% of population is likely to develop hand eczema at some point of time during life. It appears to be the most common occupational skin disease, comprising 9-35% of all occupational diseases and up to 80% or more of all occupational contact dermatitis. So, it becomes important to find the exact etiology and classification of the disease and to use the appropriate preventive and treatment measures. Despite its importance in the dermatological practice, very few Indian studies have been done till date to investigate the epidemiological trends, etiology, and treatment options for hand eczema. In this review, we tried to find the etiology, epidemiology, and available treatment modalities for chronic hand eczema patients. PMID:24891648
Kieć-Swierczyńska, Marta; Chomiczewska, Dorota; Krecisz, Beata
2010-01-01
Wet work is one of the most important risk factors of occupational skin diseases. Exposure of hands to the wet environment for more than 2 hours daily, wearing moisture-proof protective gloves for a corresponding period of time or necessity to wash hands frequently lead to the disruption of epidermal stratum corneum, damage to skin barrier function and induction of irritant contact dermatitis. It may also promote penetration of allergens into the skin and increase the risk of sensitization to occupational allergens. Exposure to wet work plays a significant role in occupations, such as hairdressers and barbers, nurses and other health care workers, cleaning staff, food handlers and metalworkers. It is more common among women because many occupations involving wet work are female-dominated. The incidence of wet-work-induced occupational skin diseases can be reduced by taking appropriate preventive measures. These include identification of high-risk groups, education of workers, organization of work enabling to minimize the exposure to wet work, use of personal protective equipment and skin care after work.
Essential Oils, Part IV: Contact Allergy.
de Groot, Anton C; Schmidt, Erich
2016-01-01
Nearly 80 essential oils (including 2 jasmine absolutes) have caused contact allergy. Fifty-five of these have been tested in consecutive patients suspected of contact dermatitis, and nine (laurel, turpentine, orange, tea tree, citronella, ylang-ylang, sandalwood, clove, and costus root) showed greater than 2% positive patch test reactions. Relevance data are generally missing or inadequate. Most reactions are caused by application of pure oils or high-concentration products. The clinical picture depends on the responsible product. Occupational contact dermatitis may occur in professionals performing massages. The (possible) allergens in essential oils are discussed. Several test allergens are available, but patients should preferably be tested with their own products. Co-reactivity with other essential oils and the fragrance mix is frequent, which may partly be explained by common ingredients. Patch test concentrations for essential oils are suggested.
Alfonso, J H; Bauer, A; Bensefa-Colas, L; Boman, A; Bubas, M; Constandt, L; Crepy, M N; Goncalo, M; Macan, J; Mahler, V; Mijakoski, D; Ramada Rodilla, J M; Rustemeyer, T; Spring, P; John, S M; Uter, W; Wilkinson, M; Giménez-Arnau, A M
2017-06-01
Skin diseases constitute up to 40% of all notified occupational diseases in most European countries, predominantly comprising contact dermatitis, contact urticaria, and skin cancer. While insufficient prevention of work-related skin diseases (WRSD) is a top-priority problem in Europe, common standards for prevention of these conditions are lacking. To develop common European standards on prevention and management of WRSD and occupational skin diseases (OSD). Consensus amongst experts within occupational dermatology was achieved with regard to the definition of minimum evidence-based standards on prevention and management of WRSD/OSD. By definition, WRSDs/OSDs are (partially or fully) caused by occupational exposure. The definition of OSD sensu stricto additionally includes diverging national legal requirements, with an impact on registration, prevention, management, and compensation. With the implementation of the classification of WRSD/OSD in the International Classification of Diseases (ICD) 11th Revision in future, a valid surveillance and comparability across countries will be possible. Currently, WRDS and OSD are still under-reported. Depending on legislation and regulations, huge differences exist in notification procedures in Europe, although notification is crucial to prevent chronic and relapsing disease. Facilities for early diagnosis, essential for individual patient management, should be based on existing guidelines and include a multidisciplinary approach. Patch testing is essential if contact dermatitis persists or relapses. Workplace exposure assessment of WRSD/OSD requires full labelling of product ingredients on material safety data sheets helping to identify allergens, irritants and skin carcinogens. Comparable standards in primary, secondary and tertiary prevention must be established in Europe to reduce the burden of WRSD/OSD in Europe. The adoption of common European standards on prevention of WRSD/OSD will contribute to reduce the incidence of OSD and their socio-economic burden. © 2017 European Academy of Dermatology and Venereology.
Occupational allergic contact dermatitis from epoxy resin in a golf club repairman.
Isaksson, Marléne; Möller, Halvor; Pontén, Ann
2008-01-01
A golfer presented with facial and hand eczema. He had exacerbations of his hand eczema prior to golf tournaments. Being an authorized golf club repairman, he had been working with a two-part glue containing an epoxy resin (ER) based on diglycidyl ether of bisphenol A (DGEBA) and the hardener diethylenetriamine (DETA) for approximately 4 years before he developed any skin problems. He was patch-tested with the standard, which contains an ER based on DGEBA (DGEBA-R), epoxy (containing DETA), and rubber glove series and had positive reactions to DGEBA-R only. Other work materials (a latex glove, a golf glove made of leather, and part of the handle of his own golf club "as is" and in a methyl tert-butyl ether extract) were tested, with negative results. Allergic contact dermatitis from ER affects the skin by direct contact; the dermatitis is usually localized to the hands and forearms. If the face and eyelids are involved, the dermatitis may be due to exposure to airborne hardeners or reactive diluents, exposure to airborne dust from residual monomers, or ectopic allergic reactions. Our repairman had sandpapered an old glued surface, which may have led to possible airborne dust formation, thus explaining the facial eczema. Therefore, a worker with contact allergy to ER may continue working provided the skin is protected from contamination.
Home gardening may be a risk factor for contact dermatitis to Alstroemeria.
Tavares, Beatriz; Loureiro, Graça; Pereira, Celso; Chieira, Celso
2006-01-01
Occupational allergy among florists and people who work in cut flower production of Alstroemeria cultivars (Peruvian lily or Inca lily) has been previously reported. The allergen involved in sensitization is tulipalin A (alpha-methylene-gamma-butyrolactone). We describe the case of a 65-year-old woman who developed severe dermatitis on her right thumb, index and middle fingers and less severe dermatitis on her left palm and front of forearm with occasional itching of the neck and face after taking up home gardening activities, including cutting flowers such as Alstroemeria. The patient and three healthy individuals were submitted to epicutaneous tests with the European standard series, the plant series, and stem portions of three suspected ornamental plants (Alstroemeria, Lilium and Zantedeschia), garlic, and onion. Patch tests performed in our patient, revealed an extreme reaction (+ + +) to Alstroemeria and alpha-methylene-gamma-butyrolactone, a strong reaction (+ +) to propolis and wood tar mix, a weak reaction (+) to balsam of Peru, an irritant reaction to garlic and negative results to diallyl disulfide and the other components investigated. Patch tests performed in the healthy individuals revealed negative. We stress the importance of Alstroemeria as a cause of allergic contact dermatitis not only in workers involved in the flower trade, but also in other people that come into contact with this plant in their leisure activities.
Going Dotty: a practical guide for installing new hand hygiene products.
Bush, Kathryn; Mah, Manuel W; Meyers, Gwyneth; Armstrong, Pamela; Stoesz, Janice; Strople, Sally
2007-12-01
This report distills our experiences coordinating the installation of a new commercial line of hand hygiene products in a large, integrated health care region in Western Canada into a practical guide that can benefit infection control professionals. Some key considerations while managing such a large hand hygiene products installation are stakeholder collaboration, management of occupational hand dermatitis, housekeeping support, and communication.
Rustemeyer, T; Frosch, P J
1996-02-01
In Germany, occupational skin disease (OSD) in dental technicians (DT) has been steadily rising in recent years and causing considerable costs for medical care and rehabilitation. Our objective in this study was to: (i) examine affected workers; (ii) perform patch tests to identify causative agents; (iii) develop strategies of prevention. 7 dental laboratories were inspected as to materials used, working habits, safety regulations, etc. A computer data base was developed for products (trade name, active ingredient, additives, etc.). A questionnaire regarding development of OSD was sent out to 1132 dental technicians (45 questions). 55 DT with suspected OSD were examined and patch tested with the standard series, an extensive series of methacrylates, and own materials. Working conditions, and knowledge of potential hazards, varied greatly in the laboratories visited. The safety data sheets of working materials were of little use and required supplementation by the computer data base, which provided rapid access to allergological information (e.g., type of acrylate, concentration). In the questionnaire (173 answers), 36% reported skin lesions attributed to work and 1/3 suspected plastic materials as their primary cause. Among the 55 DT examined, allergic contact dermatitis was diagnosed in 63.6% and irritant contact dermatitis in 23.6%. Most of the allergens identified (74%) were found in plastic materials (methyl methacrylate (MMA), 9 patients (16%); 2-hydroxyethyl methacrylate (2-HEMA), 18 patients (33%); ethyleneglycol dimethacrylate (EGDMA), 15 patients (27%)). In 16 patients, multiple sensitizations to various methacrylates were found. The fingertips were primarily involved in allergic contact dermatitis (93%), whereas in irritant contact dermatitis, the dorsa of the fingers (especially of the dominant hand) were affected (80%). 9 patients also showed lesions on the face, neck and forearms. The main irritant factors included wet work, contact with plaster, mechanical friction and thermal changes. Based on experience with DT, various preventive measures have been tried and found to be effective (reduction of skin contact, 4H Gloves, etc.). In conclusion, better knowledge of OSD in dental laboratories (in physicians, DT and their employers) would lead to a reduced rate of new cases.
Li, Haishan; Dai, Yufei; Huang, Hanlin; Li, Laiyu; Leng, Shuguang; Cheng, Juan; Niu, Yong; Duan, Huawei; Liu, Qingjun; Zhang, Xing; Huang, Xianqing; Xie, Jinxin; Feng, Zhiming; Wang, Juncai; He, Jiaxi; Zheng, Yuxin
2007-01-01
Background Trichloroethylene (TCE) is used extensively as an industrial solvent and has been recognized as one of the major environmental pollutants. To date, > 200 cases of TCE-induced hypersensitivity dermatitis among exposed workers have been reported worldwide, and TCE exposure has become one of the critical occupational health issues in Asia. Objectives The study aimed to identify genetic susceptible biomarkers associated with the TCE-induced hypersensitivity dermatitis in genes located in the human leukocyte antigen (HLA) region. Methods From 1998 to 2006, 121 cases with TCE-induced hypersensitivity dermatitis and 142 tolerant controls were recruited into the population-based case–control study. We determined HLA alleles B, DRB1, DQA1, and DQB1, by sequence-based typing. p-Values were corrected for comparisons of multiple HLA alleles. In addition, we compared and analyzed the structure character of amino acid residues of HLA molecules found in participants. Results We obtained complete genotyping data of 113 cases and 142 controls. The allele HLA-B*1301 was present in 83 (73.5%) of 113 patients compared with 13 (9.2%) of 142 tolerant workers (odds ratio = 27.5; 95% confidence interval, 13.5–55.7; corrected p = 1.48 × 10−21). In addition, the HLA-B*44 alleles were present in 6.2% (7/113) of patients, but were absent in TCE-tolerant workers. Residue 95 shared by HLA-B*1301 and HLA-B*44 molecules formed a different pocket F than other residues. Conclusions The allele HLA-B*1301 is strongly associated with TCE-induced hypersensitivity dermatitis among exposed workers and might be used as a biomarker to predict high risk individuals to TCE. PMID:18007983
Information profiles on potential occupational hazards: benzoin
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1981-03-01
Information on potential occupational hazards from exposure to benzoin was reviewed. Topics discussed included chemical and physical properties, production, uses, manufacturers and distributors, manufacturing processes, occupational exposure, and biological effects. The annual production of benzoin is approximately 90,000 pounds per year with an historical growth rate of about 6% per year. In carcinogenesis studies, the incidence of lymphomas and leukemia in dosed male rats increased with dose level, but not significantly. Mice demonstrated a significant increase in the incidence of lymphomas and leukemias at low dose levels. Bioassays have indicated that benzoin is not carcinogenic to male or female F344-ratsmore » or B6C3F1-mice. No evidence of mutagenicity, teratogenicity, or reproductive effects was found in animal studies. Allergic contact dermatitis has been reported in humans.« less
Formation of formaldehyde and peroxides by air oxidation of high purity polyoxyethylene surfactants.
Bergh, M; Magnusson, K; Nilsson, J L; Karlberg, A T
1998-07-01
Ethoxylated alcohols are non-ionic surfactants. The majority are used in household cleaners, laundry products, toiletries and in industrial and institutional cleaners. In previous studies, an ethoxylated non-ionic surfactant of technical quality showed allergenic activity in guinea pig experiments. Chemical analysis revealed a content of formaldehyde, a well-known contact allergen, and peroxides in the surfactant. Most cases of occupational contact dermatitis are considered to be of irritant origin, caused by contact with water and surfactants, but if allergenic autoxidation products can be formed, allergic contact dermatitis cannot be excluded. The sensitizing potential of a chemically defined high purity ethoxylated alcohol was investigated and oxidation under various storage and handling conditions was studied for this and a homologous product. The pure surfactant showed no significant allergenic activity on predictive testing in guinea pigs. When ethoxylated alcohols were stored in the refrigerator, their deterioration was limited. At room temperature, their content of peroxides and formaldehyde increased with time. Levels of formaldehyde above those capable of causing positive patch test reactions were found. Since such surfactants have wide applications, resulting exposure to formaldehyde could be more frequent than is generally realized, contributing to persistence of dermatitis in individuals allergic to formaldehyde.
Occupational sensitization to epoxy resins in Northeastern Italy (1996–2010)
Prodi, Andrea; Rui, Francesca; Fortina, Anna Belloni; Corradin, Maria Teresa; Filon, Francesca Larese
2015-01-01
Background: One of the main health concerns of epoxy resins is their role as skin sensitizer. This sensitization is not uncommon, because the prevalence ranges around 1–12% of the general population. Objectives: Perform a cross sectional study in a patch test population from Northeastern Italy to investigate the prevalence of epoxy resins sensitization among patients with suspected contact dermatitis. Subsequently, relate findings to patients’ occupation and evaluate time trend of prevalence. Methods: The final study database included 19 088 consecutive patients, tested from 1996 to 2010 in Northeastern Italy. Results: The overall prevalence of epoxy resins sensitization was 0·89%. Dermatitis most frequently involved hands (40·25%). In both sexes, we find a significant correlation in mechanics, woodworkers, and chemical industry workers; and in males only, among farmers and fishers, construction workers, and unemployed. We found significant increase of sensitization in construction workers in the analyzed period. Conclusions: The overall prevalence of sensitization to epoxy resins in Northeastern Italy is in line with other European countries, but we found an increased risk of sensitization in some professions and an increasing trend of prevalence in construction workers. Better preventive actions are strongly advised in higher risk professions, with particular attentions towards building sector. PMID:25633931
Keegel, Tessa; Erbas, Bircan; Cahill, Jennifer; Noonan, Amanda; Dharmage, Shyamali; Nixon, Rosemary
2007-06-01
The aims of this study were to compare treatment and referral practices between general practitioners (GPs) and dermatologists and to evaluate predictors for occupational contact dermatitis (OCD) disease severity measured in terms of worker impairment. Data were collected from 181 patients recruited for a larger study of OCD. Information about treatment recommendations and usual referral practices are reported for 123 patients. Data from patients, diagnosed with work-related skin disease, were modelled for severity of worker impairment. GPs were more likely to treat a patient independently, referring if the patient did not improve, whereas dermatologists were more likely to refer for patch testing on initial presentation. Dermatologists were more likely to recommend gloves and GPs were more likely to recommend soap avoidance/substitution. 2 GPs and no dermatologists reported recommending the best practice combination of moisturizers, topical corticosteroids and soap substitutes. When adjusted for all variables including age, sex, duration and diagnostic subgroup, workers with atopy as a cofactor had the most severe impairment. This study suggests that in Australia, patients with suspected OCD are initially managed within general practice, few clinicians recommend best practice treatments for OCD, and that atopy is associated with severity. These findings have implications for health resource allocation, clinician education, and the pre-employment counselling of atopic patients.
Skin exposure: Assessing the hazard in the workplace
NASA Technical Reports Server (NTRS)
Cummins, Kevin
1994-01-01
An outline of the Occupational Safety and Health Agency's concerns of skin exposure to hazardous chemicals is presented, followed by the corresponding slide narrations. Specifically, dermatitis and skin absorption as compared to lung absorption are addressed. Lung versus skin exposure is examined for glycol ethers and acrylamide. Examples of skin exposure include PBC's in transformers, toluene and xylene from autobody work, polynuclear aromatics (PNA's) among Coke oven workers, toluene diisocyanate (TDI), and occupational chemical exposures in an academic medical center. Permeation through gloves in the semiconductor industry is addressed as evidence for the need to assess the effectiveness of PPE (Personal Protective Equipment). This leads to the revisions of the PPE standard and the Safety and Health Program standard.
Irritant contact dermatitis in warehouse employees.
Ashworth, J; Rycroft, R J; Waddy, R S; Irvine, D
1993-02-01
A detailed survey of skin complaints amongst 114 airline employees working in a new warehouse revealed 26 cases of skin problems which originated during the 2 1/2 year operation. A clinical survey of broadly the same population confirmed 14 cases from 98 employees as chronic irritant contact dermatitis of the hands. The work involved the reception, unpackaging, inspection, repackaging and dispatch of aircraft parts. The source of the skin irritation was not to be found in the work itself. Rather, the presence among the employees of two severe cases of non-occupational eczema, combined with the idea that incoming aircraft parts from foreign countries might be 'dirty' in some way, had caused a heightened perception of a risk of skin disease, and the frequency of hand washing had increased as a result. Over-frequent hand washing in a few employees had resulted in precisely what the warehouse staff had been trying to avoid.
Topical tar: Back to the future
DOE Office of Scientific and Technical Information (OSTI.GOV)
Paghdal, K.V.; Schwartz, R.A.
2009-08-15
The use of medicinal tar for dermatologic disorders dates back to the ancient times. Although coal tar is utilized more frequently in modern dermatology, wood tars have also been widely employed. Tar is used mainly in the treatment of chronic stable plaque psoriasis, scalp psoriasis, atopic dermatitis, and seborrheic dermatitis, either alone or in combination therapy with other medications, phototherapy, or both. Many modifications have been made to tar preparations to increase their acceptability, as some dislike its odor, messy application, and staining of clothing. One should consider a tried and true treatment with tar that has led to clearingmore » of lesions and prolonged remission times. Occupational studies have demonstrated the carcinogenicity of tar; however, epidemiologic studies do not confirm similar outcomes when used topically. This article will review the pharmacology, formulations, efficacy, and adverse effects of crude coal tar and other tars in the treatment of selected dermatologic conditions.« less
Skin: Major target organ of allergic reactions to small molecular weight compounds
DOE Office of Scientific and Technical Information (OSTI.GOV)
Merk, Hans F.; Baron, Jens M.; Neis, Mark M.
2007-11-01
Skin is a major target organ for allergic reactions to small molecular weight compounds. Drug allergic reactions may be life-threatening such as in the case of anaphylactic reactions or bullous drug reactions and occur in about 5% of all hospitalized patients. Allergic contact dermatitis has an enormous influence on the social life of the patient because it is the most frequent reason for occupational skin diseases and the treatment and prevention of this disease cost approximately Euro 3 billion per year in Germany. The different proposed pathophysiological pathways leading to a drug eruption are discussed in this paper. All majormore » enzymes which are involved in the metabolism of xenobiotica were shown to be present in skin. Evidence supporting the role of metabolism in the development of drug allergy and allergic contact dermatitis is demonstrated in the example of sulphonamides and fragrances.« less
Incidence rates of occupational diseases in the Dutch construction sector, 2010-2014.
van der Molen, Henk F; de Vries, Sanne C; Stocks, S Jill; Warning, Jan; Frings-Dresen, Monique H W
2016-05-01
To estimate incidence and trends in incidence of occupational diseases (ODs) in the Dutch construction sector. In a dynamic prospective cohort over a 5-year period (2010-2014), ODs assessed by occupational physicians (OPs) participating in a voluntary construction workers health surveillance (WHS) were reported to the Netherlands Centre for Occupational Diseases (NCOD). ODs were defined as a disease with a specific clinical diagnosis (International Classification of Diseases) that was predominantly caused by work-related factors as assessed by an OP. Annual incidences were determined for the total number of ODs and six frequently occurring OD groups. Trends in incidence were estimated using a multilevel negative binominal regression model. In 2014 the incidence of all OD was 12 964 per 100 000 workers and there was no significant change in incidence between 2010 and 2014 (3%; 95% CI -2% to +9%). Hearing loss (8125 per 100 000 workers) and musculoskeletal disorders (2081 per 100 000 workers) were the most frequently occurring ODs. Noise-induced hearing loss (+7%; 95% CI 1% to 13%) and contact dermatitis (+19%; 95% CI 6% to 33%) showed increasing trends. There was no statistically significant change in the incidence of low back pain, arthrosis, repetitive strain injuries, distress/burnout and chronic obstructive pulmonary disease/asthma. In total, 13% of workers participating in WHS in the Dutch construction industry during 2014 had an OD diagnosed and reported by an OP. Over a 5-year period the annual incidence of reported ODs showed a statistically non-significant increase. Incidences in noise-induced hearing loss and contact dermatitis showed statistically significant increasing trends, 7% and 19%, respectively. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
von Grote, Erika C; Palaniswarmy, Kiruthi; Meckfessel, Matthew H
2016-12-01
Occupational irritant contact dermatitis (ICD) affecting the hands is a common and difficult-to-manage condition. Occupations that necessitate contact with harsh chemicals, use of alcohol-based disinfectants, and frequent hand washing elevate the risk of ICD. Management strategies that do not adequately prevent accumulated damage and repair skin, can develop into chronic dermatoses which negatively impact work productivity and quality of life. A 2-step skin-care regimen (Excipial Daily Protection Hand Cream (EP) and Excipial Rapid Repair Hand Cream (ER), Galderma Laboratories, L.P.) has been developed as a daily-use management strategy to protect and repair vulnerable hands. The protective barrier cream is formulated with aluminum chlorohydrate and designed for pre-exposure application to enhance the skin's natural protective barrier and minimize excessive moisture while wearing protective gloves. The repair cream, a lipid-rich formulation, is intended for post-exposure application to rehydrate and facilitate the skin's natural healing process. The results of 3 clinical studies highlighted in this review demonstrate how the use of a 2-step skin-care regimen offers a greater protective effect against ICD than the use of barrier cream alone, and also how the formulation of the barrier cream used in these studies helps minimize the occlusion effect caused by gloves and does not interfere with the antibacterial efficacy of an alcohol-based hand sanitizer. This 2-step skin-care regimen is effectively designed to manage and minimize the risk of ICD development in a variety of patients and provides clinicians an additional tool for helping patients manage ICD. J Drugs Dermatol. 2016;15(12):1504-1510.
Wei, Junxiang; Gerlich, Jessica; Vogelberg, Christian; von Mutius, Erika; Windstetter, Doris; Genuneit, Jon; Weinmayr, Gudrun; Nowak, Dennis; Radon, Katja
2016-04-01
Patients with atopic dermatitis (AD) are at high risk of chronic hand eczema. In this prospective cohort study, we assessed the influence of pre-hire-onset AD on the first job choice. We also analysed the potential association between AD and usage of preventive measures in high-risk occupations. Subjects (aged 19-24 years) who were followed from childhood until the second Study on Occupational Allergy Risks and indicated a job were included (n = 1566). We defined AD as doctor-diagnosed AD and symptoms of an itchy rash during the past 12 months before the study. Pre-hire-onset AD was having AD prior to the first job. Preventive measure usage was self-reported gloves use or use of ointment or moisturizer. We performed multiple imputations to deal with missing values and analysed associations using logistic regression models adjusted for several potential confounders. Risk categories of the first job did not differ between participants with pre-hire-onset AD and those without (odds ratio 1.05, 95 % confidence interval 0.59-1.87). AD status was not statistically significantly associated with usage of preventive measures (1.22, 0.56-2.64). Conversely, having received job counselling (2.76, 1.15-6.63) and a family history of AD (2.09, 1.01-4.31) were associated with a higher use of such measures. We could not confirm a healthy hire effect in this cohort of young adults. Although subjects with AD in high-risk occupations do not seem to use more preventive measures than their non-affected peers, job counselling seems to be an effective approach to encourage secondary prevention.
North American Contact Dermatitis Group patch test results: 2009 to 2010.
Warshaw, Erin M; Belsito, Donald V; Taylor, James S; Sasseville, Denis; DeKoven, Joel G; Zirwas, Matthew J; Fransway, Anthony F; Mathias, C G Toby; Zug, Kathryn A; DeLeo, Vincent A; Fowler, Joseph F; Marks, James G; Pratt, Melanie D; Storrs, Frances J; Maibach, Howard I
2013-01-01
Patch testing is an important diagnostic tool for determination of substances responsible for allergic contact dermatitis. This study reports the North American Contact Dermatitis Group (NACDG) patch testing results from January 1, 2009, to December 31, 2010. At 12 centers in North America, patients were tested in a standardized manner with a screening series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends were analyzed using χ2 statistics. A total of 4308 patients were tested. Of these, 2614 (60.7%) had at least 1 positive reaction, and 2284 (46.3%) were ultimately determined to have a primary diagnosis of allergic contact dermatitis. Four hundred twenty-seven (9.9%) patients had occupationally related skin disease. There were 6855 positive allergic reactions. As compared with the previous reporting period (2007-2008), the positive reaction rates statistically decreased for 20 allergens (nickel, neomycin, Myroxylon pereirae, cobalt, formaldehyde, quaternium 15, methydibromoglutaronitrile/phenoxyethanol, methylchlorisothiazolinone/methylisothiazolinone, potassium dichromate, diazolidinyl urea, propolis, dimethylol dimethylhydantoin, 2-bromo-2-nitro-1,3-propanediol, methyl methacrylate, ethyl acrylate, glyceryl thioglycolate, dibucaine, amidoamine, clobetasol, and dimethyloldihydroxyethyleneurea; P < 0.05) and statistically increased for 4 allergens (fragrance mix II, iodopropynyl butylcarbamate, propylene glycol, and benzocaine; P < 0.05). Approximately one quarter of tested patients had at least 1 relevant allergic reaction to a non-NACDG allergen. Hypothetically, approximately one quarter of reactions detected by NACDG allergens would have been missed by TRUE TEST (SmartPractice Denmark, Hillerød, Denmark). These results affirm the value of patch testing with many allergens.
The LLNA: A Brief Review of Recent Advances and Limitations
Anderson, Stacey E.; Siegel, Paul D.; Meade, B. J.
2011-01-01
Allergic contact dermatitis is the second most commonly reported occupational illness, accounting for 10% to 15% of all occupational diseases. This highlights the importance of developing rapid and sensitive methods for hazard identification of chemical sensitizers. The murine local lymph node assay (LLNA) was developed and validated for the identification of low molecular weight sensitizing chemicals. It provides several benefits over other tests for sensitization because it provides a quantitative endpoint, dose-responsive data, and allows for prediction of potency. However, there are also several concerns with this assay including: levels of false positive responses, variability due to vehicle, and predictivity. This report serves as a concise review which briefly summarizes the progress, advances and limitations of the assay over the last decade. PMID:21747867
Methylisothiazolinone testing at 2000 ppm: a prevalent sensitizer for allergic contact dermatitis.
Ham, Kaiya; Posso-De Los Rios, Claudia J; Gooderham, Melinda
2015-01-01
Methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) have been identified as potent allergens. The optimal MI concentration for patch testing for reaction to these agents has not yet been identified, but it has been suggested that testing MI at 2000 ppm may reduce false-negative reactions. The aim of this study was to report allergic reactions to MI and MCI/MI detected in a community dermatology practice setting in Ontario, Canada. The patch test records of patients with suspected allergic contact dermatitis seen between October 2007 and June 2014 were reviewed. We compared positive patch testing before and after December 2011 when a higher MI concentration was used (2000 ppm aqueous) in addition to the baseline series MCI/MI at 100 ppm. A total of 794 patient records were reviewed. There were 38 true-positive reactions to MI or MCI/MI. Of these 38 patients, 26 (68%) were female. We detected an overall increase in the rate of positive patch testing to MCI/MI, MI alone, or both from 3.13% to 7.45% when MI concentration was introduced at 2000 ppm aqueous. Occupational differences existed between sexes. The addition of MI at 2000 ppm to our screening series effectively increased the detection of MI-induced allergic contact dermatitis.
Chen, Yu-Xin; Cheng, Hai-Yan; Li, Lin-Feng
2017-03-01
Little is known about the epidemiology of contact dermatitis (CD) in the Chinese clothing industry. This study aimed to investigate the prevalence and some risk factors of contact dermatitis among clothing manufacturing employees in Beijing.This cross-sectional study was conducted by interview using self-administered questionnaires and skin examination between May and August in 2016. Five-hundred twenty-nine employees who had worked at sewing, ironing, and as managers at 12 clothing manufacturing factories were studied.The overall 1-year prevalence of CD among the clothing employees was 28.5% (151/529 employees), with significantly higher prevalence among ironing workers (50%) and sewers (31.7%) compared with managers (12.7%; P < 0.001, n = 529). A significant association was noticed between the 1-year prevalence of CD and types of occupation (sewers and ironing workers versus managers, respectively), exposure to garment materials (leather and feather), dry skin, allergic rhinitis, age, and smoking.Among employees in Chinese clothing industry, sewers and ironing workers had a higher 1-year prevalence of CD than managers. It is noteworthy that exposure to leather and feather materials and the types of manual work are associated with CD, as well as dry skin and allergic rhinitis.
Prevalence and risk factors of contact dermatitis among clothing manufacturing employees in Beijing
Chen, Yu-Xin; Cheng, Hai-Yan; Li, Lin-Feng
2017-01-01
Abstract Little is known about the epidemiology of contact dermatitis (CD) in the Chinese clothing industry. This study aimed to investigate the prevalence and some risk factors of contact dermatitis among clothing manufacturing employees in Beijing. This cross-sectional study was conducted by interview using self-administered questionnaires and skin examination between May and August in 2016. Five-hundred twenty-nine employees who had worked at sewing, ironing, and as managers at 12 clothing manufacturing factories were studied. The overall 1-year prevalence of CD among the clothing employees was 28.5% (151/529 employees), with significantly higher prevalence among ironing workers (50%) and sewers (31.7%) compared with managers (12.7%; P < 0.001, n = 529). A significant association was noticed between the 1-year prevalence of CD and types of occupation (sewers and ironing workers versus managers, respectively), exposure to garment materials (leather and feather), dry skin, allergic rhinitis, age, and smoking. Among employees in Chinese clothing industry, sewers and ironing workers had a higher 1-year prevalence of CD than managers. It is noteworthy that exposure to leather and feather materials and the types of manual work are associated with CD, as well as dry skin and allergic rhinitis. PMID:28328819
Solvent Orange 60 is a potent contact sensitizer in occupational and everyday life.
Linauskienė, Kotryna; Zimerson, Erik; Antelmi, Annarita; Bruze, Magnus; Hagvall, Lina; Hamnerius, Nils; Hauksson, Inese; Ryberg, Kristina; Isaksson, Marléne
2018-05-30
Solvent Orange (SO) 60 is a perinone-type dye that is often used in plastic materials such as spectacle frames and has been shown to cause contact allergy. The first case of SO 60 allergic contact dermatitis caused by spectacle frames was reported in 1999, and the second in 2011. We have recently seen 10 patients, of whom 6 developed dermatitis in the retroauricular/temporal area after wearing plastic spectacles. To report the cause of the dermatitis in the 10 patients and to describe our first case with occupational SO 60 contact allergy. In this retrospective study, patch test results of 10 patients, tested with the Swedish baseline series and our specific spectacle and/or plastic series, including SO 60 1.0% pet., in 2011-2017, were analysed and compared with data published earlier. Ten patients, 2 males and 8 females, aged 43 to 71 years, reacted positively to SO 60 1.0% pet., namely, 4 pensioners, 2 nurses, 1 office worker, 1 teacher, 1 shop assistant, and 1 unemployed person. Four of the patients had an atopic history. Patch test reactions varied from + to +++; some had spread >20 cm outside the test area, and consisted of erythematous, infiltrated skin with papules. Retesting of patient no. 1 with serial dilutions of SO 60 in acetone to pinpoint his level of reactivity showed positive reactions down to 1 ppm. Three patients reacted to the extracts of their earpieces. Gas chromatography-mass spectrometry was used to confirm the presence of SO 60 in 2 earpieces. SO 60 should be included in any spectacle patch test series that may be used. If there is a strong suspicion of contact allergy to SO 60 before patch testing, lowering the test concentration from 1.0% to 0.01% should be considered. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
North American Contact Dermatitis Group patch test results for 2007-2008.
Fransway, Anthony F; Zug, Kathryn A; Belsito, Donald V; Deleo, Vincent A; Fowler, Joseph F; Maibach, Howard I; Marks, James G; Mathias, C G Toby; Pratt, Melanie D; Rietschel, Robert L; Sasseville, Denis; Storrs, Frances J; Taylor, James S; Warshaw, Erin M; Dekoven, Joel; Zirwas, Matthew
2013-01-01
The North American Contact Dermatitis Group (NACDG) tests patients with suspected allergic contact dermatitis to a broad series of screening allergens and publishes periodic reports. The aims of this study were to report the NACDG patch-testing results from January 1, 2007, to December 31, 2008, and to compare results to pooled test data from the previous 2 and 10 years to analyze trends in allergen sensitivity. Standardized patch testing with 65 allergens was used at 13 centers in North America. χ analysis was used for comparisons. A total of 5085 patients were tested; 11.8% (598) had an occupationally related skin condition, and 65.3% (3319) had at least 1 allergic patch test reaction, which is identical to the NACDG data from 2005 to 2006. The top 15 most frequently positive allergens were nickel sulfate (19.5%), Myroxylon pereirae (11.0%), neomycin (10.1%), fragrance mix I (9.4%), quaternium-15 (8.6%), cobalt chloride (8.4%), bacitracin (7.9%), formaldehyde (7.7%), methyldibromoglutaronitrile/phenoxyethanol (5.5%), p-phenylenediamine (5.3%), propolis (4.9%), carba mix (4.5%), potassium dichromate (4.1%), fragrance mix II (3.6%), and methylchloroisothiazolinone/methylisothiazolinone (3.6%). There were significant increases in positivity rates to nickel, methylchloroisothiazolinone/methylisothiazolinone, and benzophenone-3. During the same period of study, there were significant decreases in positivity rates to neomycin, fragrance mix I, formaldehyde, thiuram mix, cinnamic aldehyde, propylene glycol, epoxy resin, diazolidinyl urea, amidoamine, ethylenediamine, benzocaine, p-tert-butylphenol formaldehyde resin, dimethylol dimethyl hydantoin, cocamidopropyl betaine, glutaraldehyde, mercaptobenzothiazole, tosylamide formaldehyde resin, budesonide, disperse blue 106, mercapto mix, and chloroxylenol. Twenty-four percent (1221) had a relevant positive reaction to a non-NACDG supplementary allergen; and 180 of these reactions were occupationally relevant. Periodic analysis, surveillance, and publication of multicenter study data sets document trends in allergen reactivity incidence assessed in the patch test clinic setting and provide information on new allergens of relevance.
[Risks and health problems caused by the use of video terminals].
Tamez González, Silvia; Ortiz-Hernández, Luis; Martínez-Alcántara, Susana; Méndez-Ramírez, Ignacio
2003-01-01
To evaluate the association between video display terminal (VDT) use and health hazards, occupational risks, and psychosocial factors, in newspaper workers. A cross-sectional study was conducted in 1998 in a representative sample (n = 68) drawn from a population of 218 VDT operators in Mexico City. Data were collected using a self-administered questionnaire. Data were confirmed by performing physical examinations. The research hypothesis was that both the current and cumulative use of VDT are associated with visual, musculoskeletal system, and skin illnesses, as well as with fatigue and mental or psychosomatic disorders. Occupational health hazards were assessed (visual problems, postural risks, sedentary work, computer mouse use, excessive heat, and overcrowding), as well as psychosocial factors related to work organization (psychological demands, work control, and social support). Prevalence ratios were adjusted for confounding variables like age, sex and schooling. Women were more likely than men to have upper extremity musculoskeletal disorders (MSD), dermatitis, and seborrheic eczema. VDT use was associated with neuro-visual fatigue, upper extremity MSD, dermatitis, and seborrheic eczema. Computer mouse use and postural risks were significantly associated with health problems. Psychosocial factors were mainly associated with mental problems, psychosomatic disorders, and fatigue. Intense use of video screens has been found to cause musculoskeletal disorders of the hand. The diversification of tasks and control of labor processes itself had a protective effect against psychosomatic disorders and pathological fatigue.
Recent advances in occupational dermatitis.
Holness, Dorothy Linn
2013-04-01
This review examined recent advances in occupational contact dermatitis (OCD). Both genetic and environmental factors contribute to OCD. There is continuing growth in our understanding of the genetic factors, particularly related to filaggrin mutations. In spite of increased understanding of irritant exposures, the prevalence of hand eczema in workers with wet work exposures remains high at approximately 20%. Patch test database surveillance systems have documented reductions in the occurrence of sensitivity to some allergens such as chromium wherein regulatory efforts have reduced workplace exposures. These surveillance data have also documented increases in sensitivity to several allergens in particular trades, serving as an effective system to identify new exposure situations or new allergens. The impact of OCD on quality of life and mental health conditions, employment and financial aspects is increasingly documented. Progress in understanding the underreporting of OCD and the underlying reasons continues. Several groups have developed robust multidisciplinary secondary and tertiary prevention programmes and the evaluations demonstrate promise. Although several recent systematic reviews have documented the evidence for various prevention strategies, there is increasing understanding of the gaps in prevention practices in actual workplaces. Understanding of the underlying genetic and environmental agents contributing to OCD is increasing. In spite of progress with reducing exposure to some allergens, the prevalence of OCD continues to be high, particularly related to wet work. New prevention programmes are being developed and evaluated and hold promise for improved outcomes.
Fundamentals of the knowledge about chemical additives present in rubber gloves.
Oliveira, Hegles Rosa de; Alchorne, Alice de Oliveira de Avelar
2011-01-01
One of the most frequent causes of allergic contact dermatitis of occupational origin are rubber additives, which are present in Personal Protective Equipment (PPE). The most allergenic additives of natural and synthetic gloves are thiurams, carbamates and mercapto group. To investigate the state of knowledge about the chemical additives used in the manufacture of synthetic rubber gloves. This was a qualitative research study in which professionals working in the manufacture, research, prescription and commercialization of gloves answered an open questionnaire. 30 individuals were interviewed: 4 researchers in occupational medicine, 5 occupational physicians, 2 occupational safety technicians, a rubber workers' union physician, an occupational safety engineer, a pro duction engineer of rubber gloves, 4 importers of gloves, a manufacturer of gloves, 3 businessmen who sell PPE, 3 salesclerks working in stores that sell PPE, 2 businessmen who own stores that sell products for allergic individuals, and 3 dermatologists. Knowledge of the chemical composition of rubber gloves is scant. The labeling of gloves, with the description of their chemical composition, would facilitate choosing the best type of glove for each person. This low-cost action to businesses would be a gain from the standpoint of public health, with huge repercussions for users of rubber gloves.
Zirwas, Matthew J; Hamann, Dathan; Warshaw, Erin M; Maibach, Howard I; Taylor, James S; Sasseville, Denis; DeKoven, Joel G; Fransway, Anthony F; Mathias, C G Toby; Zug, Kathryn A; DeLeo, Vincent A; Fowler, Joseph F; Marks, James G; Pratt, Melanie D; Belsito, Donald V
Preservative sensitivity patterns evolve with changing use patterns in products. During the last decade, the use of methylisothiazolinone (MI) at higher concentrations in both leave-on and rinse-off products has significantly increased. This is the first North American Contact Dermatitis Group reporting cycle that includes both methylchloroisothiazolinone (MCI)/MI and MI data. The aim of this study was to report the prevalence of isothiazolinone allergy (MCI/MI and MI) in the North American Contact Dermatitis Group patch-test population from January 1, 2013, to December 31, 2014. At 13 centers in North America, 4860 patients were patch tested in a standardized manner with a series of 70 allergens, including MCI/MI 0.01% aqueous (aq) and MI 0.2% aq. Three hundred five patients (6.3%) had a positive reaction to MCI/MI; this is a significant increase from the previous cycle (5.0%, 2011-2012; P = 0.011). Five hundred twenty-one patients (10.7%) had a positive reaction to MI. These 2 isothiazolinones were among the most common preservative allergens in the 2013 to 2014 cycle; 11.9% of patch-tested individuals were allergic to 1 or both isothiazolinones. Individuals with MCI/MI and MI allergy were significantly more likely to have occupationally related skin disease (P < 0.0001) and hand dermatitis (P < 0.0001, P = 0.0474). The epidemic of isothiazolinone sensitivity documented in Europe is now in North America. Patch testing with only MCI/MI 0.01% aq will miss approximately half of isothiazolinone allergy cases, whereas testing with only MI 0.2% aq will miss approximately 10% of isothiazolinone allergy cases.
Patch test results in patients with allergic contact dermatitis in the Podlasie region
Bacharewicz, Joanna; Pawłoś, Anna
2013-01-01
Introduction The aim of the study was to provide current data on the incidence of allergy to various contact allergens in patients with allergic contact eczema and the analysis of selected socio-demographic data of the patients. Material and methods The study included 1532 patients (1010 women and 522 men) treated for allergic contact dermatitis at the Department of Dermatology and Venereology and at the Dermatology Outpatient Clinic in Bialystok in 2007–2011. The assessment of selected demographic data and skin lesions was based on the MOAHFLA index, while the results of patch tests were analyzed with modified Baseline European Series consisting of 31 allergens. Results In the group of patients with eczema, 34.1% were men, and 55% of all respondents were people over 40 years of age. The occupational character of skin lesions was found in 22.5%. Most frequently (38.9%) skin lesions were localized on the hands, rarely involved legs (3.98%). Atopic dermatitis was diagnosed in 4.5% of patients. The ten most frequent allergens were: nickel sulfate (24%), cobalt chloride (15.3%), fragrance mix (8.25%), potassium dichromate (6.8%), balsam of Peru (5.5%), neomycin (4.42%), paraphenylenediamine (3.85%), Quatermium-15 (2.1%), detreomycin (1.83%) and budesonide (1.44% of tested patients). Conclusions Frequent allergy to detreomycin indicates the need of patch testing for this allergen of all examined patients with allergic contact dermatitis. The increased frequency of the nickel allergy is a worrying problem and indicates the need for education about the risk factors for nickel allergy development and the implementation of appropriate legal regulations. PMID:24493997
Madan, Ira; Parsons, Vaughan; Cookson, Barry; English, John; Lavender, Tina; McCrone, Paul; Murphy, Caroline; Ntani, Georgia; Rushton, Lesley; Smedley, Julia; Williams, Hywel; Wright, Alison; Coggon, David
2016-03-17
Hand dermatitis can be a serious health problem in healthcare workers. While a range of skin care strategies and policy directives have been developed in recent years to minimise the risk, their effectiveness and cost-effectiveness remain unclear. Evidence now suggests that psychological theory can facilitate behaviour change with respect to improved hand care practices. Therefore, we will test the hypothesis that a behavioural change intervention to improve hand care, based on the Theory of Planned Behaviour and implementation intentions, coupled with provision of hand moisturisers, can produce a clinically useful reduction in the occurrence of hand dermatitis, when compared to standard care, among nurses working in the UK National Health Service (NHS) who are particularly at risk. Secondary aims will be to assess impacts on participants' beliefs and behaviour regarding hand care. In addition, we will assess the cost-effectiveness of the intervention in comparison with normal care. We will conduct a cluster randomised controlled trial at 35 NHS hospital trusts/health boards/universities, focussing on student nurses with a previous history of atopic disease or hand eczema and on nurses in intensive care units. Nurses at 'intervention-light' sites will be managed according to what would currently be regarded as best practice, with provision of an advice leaflet about optimal hand care to prevent hand dermatitis and encouragement to contact their occupational health (OH) department early if hand dermatitis occurs. Nurses at 'intervention-plus' sites will additionally receive a behavioural change programme (BCP) with on-going active reinforcement of its messages, and enhanced provision of moisturising cream. The impact of the interventions will be compared using information collected by questionnaires and through standardised photographs of the hands and wrists, collected at baseline and after 12 months follow-up. In addition, we will assemble relevant economic data for an analysis of costs and benefits, and collect information from various sources to evaluate processes. Statistical analysis will be by multi-level regression modelling to allow for clustering by site, and will compare the prevalence of outcome measures at follow-up after adjustment for values at baseline. The principal outcome measure will be the prevalence of visible hand dermatitis as assessed by the study dermatologists. In addition, several secondary outcome measures will be assessed. This trial will assess the clinical and cost effectiveness of an intervention to prevent hand dermatitis in nurses in the United Kigdom. ISRCTN53303171 : date of registration, 21 June 2013.
The impact of occupational health service network and reporting system in Taiwan.
Chu, Po-Ching; Fuh, Hwan-Ran; Luo, Jiin-Chyuan; Du, Chung-Li; Chuang, Hung-Yi; Guo, How-Ran; Liu, Chiu-Shong; Su, Chien-Tien; Tang, Feng-Cheng; Chen, Chun-Chieh; Yang, Hsiao-Yu; Guo, Yue Leon
2013-01-01
Underreporting occupational disease cases has been a long-standing problem in Taiwan, which hinders the progress in occupational health and safety. To address this problem, the government has founded the Network of Occupational Diseases and Injuries Service (NODIS) for occupational disease and injury services and established a new Internet-based reporting system. The aims of this study are to analyze the possible influence of the NODIS, comprised of Center for Occupational Disease and Injury Services and their local network hospitals, on compensable occupational diseases and describe the distribution of occupational diseases across occupations and industries from 2005 to 2010 in Taiwan. We conducted a secondary analysis of two datasets, including the NODIS reporting dataset and the National Labor Insurance scheme's dataset of compensated cases. For the NODIS dataset, demographics, disease distribution, and the time trends of occupational diseases were analyzed. The data of the Labor Insurance dataset was used to calculate the annual incidence of compensated cases. Furthermore, the annual incidence of reported occupational diseases from the NODIS was further compared with the annual incidence of compensable occupational diseases from the compensated dataset during the same period. After the establishment of the NODIS, the two annual incidence rates of reported and compensable occupational disease cases have increased by 1.2 and 2.0 folds from 2007 to 2010, respectively. The reason for this increased reporting may be the implementation of the new government-funded Internet-based system. The reason for the increased compensable cases may be the increasing availability of hospitals and clinics to provide occupational health services. During the 2008-2010 period, the most frequently reported occupational diseases were carpal tunnel syndrome, lumbar disc disorder, upper limb musculoskeletal disorders, and contact dermatitis. The new network and reporting system was successful in providing more occupational health services, providing more workers with compensation for occupational diseases, and reducing underreporting of occupational diseases. Therefore, the experience in Taiwan could serve as an example for other newly developed countries in a similar situation.
Contact allergy to preservatives. Analysis of IVDK data 1996-2009.
Schnuch, A; Lessmann, H; Geier, J; Uter, W
2011-06-01
Preservatives are well-known and important contact allergens. To examine the frequency of sensitization to preservatives, including time trends. Retrospective analysis of data on patch testing of preservatives contained in the standard series and special series collected by the IVDK during 1996-2009. Some 120,000 and 80,000 patients were tested with the baseline and the preservative series, respectively. Sensitization frequencies of the standard series allergens all ranged above 1%: methyldibromoglutaronitrile (MDBGN) 2·36-4·5%, methy(chloro)isothiazolinone (MCI/MI) 2·22%, formaldehyde 1·54%, paraben mix 1·33% and Bronopol® 1·25%. Regarding the special preservative series, 1·54% reacted positive to methylisothiazolinone (MI), and < 1% to the other preservatives. Concomitant reactions to formaldehyde in formaldehyde releasers ranged from 15% to almost 50%, and 67% of MI positives reacted to MCI/MI. As indicated by the MOAHLFA index, sensitization to MI, iodopropynylbutyl carbamate (IPBC) and quaternium 15 was associated more often with occupational dermatitis, whereas sensitization to imidazolidinyl urea and diazolidinyl urea was associated with face dermatitis, indicating cosmetic exposure. Epidemiologically relevant decreases (> 10%) were seen in chloroacetamide, benzyl alcohol and MDBGN. Epidemiologically relevant increases were noted in IPBC, sodium benzoate and MI. Preservatives are still important contact allergens. The introduction of new preservatives should consider the specific characteristics of occupational and of nonoccupational (cosmetic, household) exposure, and preventive measures should aim equally at both areas. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.
Cutaneous and respiratory symptoms among professional cleaners.
Lynde, Carrie B; Obadia, Maya; Liss, Gary M; Ribeiro, Marcos; Holness, D Linn; Tarlo, Susan M
2009-06-01
Occupational dermatitis is very common and has a large economic impact. Cleaners are at an increased risk for both work-related cutaneous and respiratory symptoms. To compare the prevalence of occupational cutaneous symptoms among professional indoor cleaners to other building workers (OBW) and to determine associations with exposures and with respiratory symptoms among cleaners. A questionnaire completed by indoor professional cleaners and OBW to compare rash and respiratory symptoms between these groups examined workplace factors such as training, protective equipment and work tasks. In total, 549 of the 1396 professional cleaners (39%) and 593 of the 1271 OBW (47%) completed questionnaires. The prevalence of rash was significantly higher in the cleaners compared to the OBW. For male cleaners, 21% (86/413) had a rash in the past 12 months compared to only 11% (13/115) of OBW (P < 0.05). The rashes experienced by the cleaners were more likely to be on their hands and worse at work. Cleaners washed their hands significantly more often than OBW. Cleaners with a rash were less likely to have received workplace training regarding their skin and were more likely to find the safety training hard to understand. Cleaners with a rash within the past year were significantly more likely to have work-related asthma symptoms than cleaners without a rash (P < 0.001). This study demonstrates a strong link between work-related symptoms of asthma and dermatitis among cleaners. Effective preventive measures, such as the use of protective skin and respiratory equipment, should be emphasized.
Occupational dermatoses reported in Brazil from 2007 to 2014*
Lise, Michelle Larissa Zini; Feijó, Fernando Ribas; Lise, Michael Laurence Zini; Lise, Claudia Ribeiro Zini; de Campos, Luis Carlos Elejalde
2018-01-01
Background Occupational diseases are very prevalent in the world, especially in developing countries. Occupational dermatoses are responsible for most of these cases. However, epidemiological studies are rare in Brazil. Objectives To verify the panorama of occupational skin diseases in Brazil describing frequencies of work-related dermatoses and their sociodemographic and occupational patterns. Methods We used retrospective data from the Notifiable Diseases Information System, (from 2007-2014) tabulated with the Tab program for Windows - TabWin12. We used intentional non-probability sampling and sequential selection, considering all notified occupational dermatoses. Results All cases of occupational dermatoses referred to in the period were analyzed (n = 4710). Males and the age group of 35-49 years were the most affected. The most affected body area was the upper limb (34.2%) and the hand (25.4%). The "causative agent" field in the forms was not filled in 69.4% of cases, with chrome as the most prevalent cause reported (11.8%). ICD-10 codes more prevalent were L23, L24, and L25, corresponding to 34.2% of the sample. In total, 29% of patients needed to take a sick leave. No cases evolved to death and there were 0.2% of total as permanent disability. Study limitations The amount of missing information for various items in the system draws attention. Conclusions Treatment of patients with occupational dermatitis include the identification and removal of the causative agent and specific treatment of the disease. Diagnosis delay in cases of occupational dermatoses brings social and financial consequences to the work and life of workers. PMID:29641693
Goebel, Carsten; Diepgen, Thomas L; Blömeke, Brunhilde; Gaspari, Anthony A; Schnuch, Axel; Fuchs, Anne; Schlotmann, Kordula; Krasteva, Maya; Kimber, Ian
2018-06-01
Occupational exposure of hairdressers to hair dyes has been associated with the development of allergic contact dermatitis (ACD) involving the hands. p-Phenylenediamine (PPD) and toluene-2,5-diamine (PTD) have been implicated as important occupational contact allergens. To conduct a quantitative risk assessment for the induction of contact sensitization to hair dyes in hairdressers, available data from hand rinsing studies following typical occupational exposure conditions to PPD, PTD and resorcinol were assessed. By accounting for wet work, uneven exposure and inter-individual variability for professionals, daily hand exposure concentrations were derived. Secondly, daily hand exposure was compared with the sensitization induction potency of the individual hair dye defined as the No Expected Sensitization Induction Levels (NESIL). For PPD and PTD hairdresser hand exposure levels were 2.7 and 5.9 fold below the individual NESIL. In contrast, hand exposure to resorcinol was 50 fold below the NESIL. Correspondingly, the risk assessment for PPD and PTD indicates that contact sensitization may occur, when skin protection and skin care are not rigorously applied. We conclude that awareness of health risks associated with occupational exposure to hair dyes, and of the importance of adequate protective measures, should be emphasized more fully during hairdresser education and training. Copyright © 2018 Elsevier Inc. All rights reserved.
Somatic symptoms among cosmetologists compared to women in other occupations.
Gallicchio, Lisa; Miller, Susan R; Greene, Teresa; Zacur, Howard; Flaws, Jodi A
2011-04-01
Although the literature pertaining to the cosmetology occupation and specific health effects, such as asthma, dermatitis, and reproductive function, has grown substantially, little information is available about whether cosmetologists are at increased risk of other symptoms compared to women working in other occupations. Thus, the purpose of this study was to determine if cosmetologists of reproductive age are at increased risk of self-reported symptoms compared to women of the same age working in other occupations. Data were analyzed from 450 cosmetologists and 511 women in other occupations, aged 21-55 years, in the Baltimore metropolitan region who responded to a mailed survey that ascertained detailed data on symptoms as well as usual work tasks. The data showed that cosmetologists were at increased risk of memory and sleep disturbances, muscle weakness, throat irritation, and hot flashes compared to women of the same age working in other occupations after adjustment for confounders, including cigarette smoking. Among the cosmetologists, handling cleaning supplies; hair bleaching; use of straighteners, texturizers, or permanent chemicals; and several nail care work tasks were associated with one or more of the queried symptoms. Findings from this study suggest that, compared to noncosmetologists, cosmetologists are at increased risk for a number of symptoms reported to be associated with decreased quality of life. These symptoms may also reflect chronic exposure to chemicals that have been shown to be related to more severe long-term health outcomes.
Assessing occupational exposure to sea lamprey pesticides.
Ceballos, Diana M; Beaucham, Catherine C; Kurtz, Kristine; Musolin, Kristin
2015-01-01
Sea lampreys are parasitic fish found in lakes of the United States and Canada. Sea lamprey is controlled through manual application of the pesticides 3-trifluoromethyl-4-nitrophenol (TFM) and Bayluscide(TM) into streams and tributaries. 3-Trifluoromethyl-4-nitrophenol may cause irritation and central nervous system depression and Bayluscide may cause irritation, dermatitis, blisters, cracking, edema, and allergic skin reactions. To assess occupational exposures to sea lamprey pesticides. We developed a wipe method for evaluating surface and skin contamination with these pesticides. This method was field tested at a biological field station and at a pesticide river application. We also evaluated exposures using control banding tools. We verified TFM surface contamination at the biological station. At the river application, we found surfaces and worker's skin contaminated with pesticides. We recommended minimizing exposures by implementing engineering controls and improved use of personal protective equipment.
Almutawa, Fahad
2017-01-01
Introduction Contact dermatitis is a relatively common dermatosis reported among several population groups from all around the globe. However, the data from Kuwait is unavailable. Patch tests are essential for the diagnosis of contact sensitization. Aim To determine a relative frequency and pattern of sensitizers to different allergens in patients of suspected contact dermatitis in Kuwait and, also to study the role of the commonest sensitizer in detail. Material and methods Patch tests were performed in 2461 consecutive patients with a clinical diagnosis of contact dermatitis seen at our hospital between September 1, 2014 and August 31, 2015. Out of the total of 1381 (56.1%) patients with positive patch test results to at least one allergen, 546 (22.2%) patients with a single positive reaction to nickel only (single largest sensitizer) were selected as the study population for further detailed analysis. Results At least one positive patch test reaction was found in 1381 (56.12%) patients. Nickel was found to be the most common sensitizer seen in 546 (40%) patients. The mean age was 37.3 ±13.8 years and the mean duration of disease was 27.3 ±13.8 months. Most (387/546) patients sensitized were females. The forearms/hands and wrists were the most prevalent sites (52.56% of the participants). In 58.91% of women, dermatitis was more often confined to other sites, mostly ears and the neck due to earrings and necklaces. Just more than half of the number (51.09%) of nickel allergic patients were found in the age group of 15–25 years. Hairdressers/beauticians were the most affected group followed by house workers (housewives, cleaners, housekeepers). Conclusions Nickel is the single most common sensitizer found in our patients, and female sex, young age, occupation with long hours of contact to nickel are high risk factors. We recommend that a directive, which limits the release of nickel from products with extended skin contact, be approved in Kuwait. PMID:28670248
Kuijpers, D I M; Hillen, F; Frank, J A
2006-08-01
A 24-year-old female working in the Department of Pathology of a University Hospital developed an acute peri-ocular eczema clearly being related to her daily work at the microscope. Patch testing revealed delayed type hypersensitivity against the black rubber mix, N-isopropyl-N'-phenyl paraphenylenediamine, N-cyclohexyl-N'-phenyl paraphenylenediamine and the rubber ring situated on the ocular of the respective microscope. This is the first report, to our knowledge, on peri-orbital allergic contact eczema because of sensitization with rubber components of a microscope.
Treatment and prevention of paronychia using a new combination of topicals: report of 30 cases.
Gianni, C
2015-08-01
Moderate and chronic paronychia is a common disease affecting the hand. Treatment can be effective but the affection is often recurrent, especially as an occupational disease. Moreover, this condition may be complicated by a Candida spp or by bacterial infections. Therefore, general preventive measures can be useful in maintaining health. The aim of this study was to investigate the efficacy and tolerability of a new combination of topical medications in the treatment and prevention of moderate and chronic paronychia. This formulation includes an insulating polymer (Syn-cell barrier), two topical antifungals (octopirox and climbazole) and a molecule with anti-inflammatory activity (corticoid-like repair). Thirty adult subjects (age, 16-78 years; 24 females and 6 males) affected by moderate or chronic paronychia, with or without nail alterations, were evaluated. Included in the study were patients with allergic contact dermatitis (8), irritant contact dermatitis (19), psoriatic paronychia (2 patients), lichen planus of the nails (1 patient). Sometimes Candida spp or bacteria overlapped with paronychia (16 patients positive for Candida spp and 4 patients with bacterial paronychia), sometimes infectious paronychia was not associated with dermatitis of the hands. All 30 subjects were treated with a new cream formulation, three applications per day for 2 months. In 8 patients with proven and severe candidiasis of the nails, oral fluconazole 100 mg was added for 20 days. All patients with bacterial perionyxis took clarithromycin 500 mg twice daily for six days. Patients were then followed for 8 weeks. After two months of treatment, 26 patients responded to therapy. In particular, the treatment evaluation at the end of the follow-up period showed a clinical cure in 46.6% (14 patients), improvement in 40% (12 patients), and failure in 13.4% (4 patients). There was a side effect (moderate skin irritation) in 2 patients, but the drug was not discontinued. Results of the present study, based on its safety, effectiveness and innovative features, indicate that this combination of topical cream may be considered as a new alternative for treatment and prevention of paronychia, especially in case of occupational hand disease where prolonged treatment and continuous prevention are needed.
Duarte, Ida; Mendonça, Rodolfo Ferreira; Korkes, Karen Levy; Lazzarini, Rosana; Hafner, Mariana de Figueiredo Silva
2018-01-01
Background Metals are common agents of allergic contact dermatitis, occupational or not, with decreasing incidence over the last years in some countries that have regulated the amount of nickel in objects. Objectives To analyze and compare with previous studies the profile of metal sensitization between 2003-2015. Methods Patients who underwent patch testing between 2003-2015 were evaluated retrospectively regarding the sensitization rates to metals, the associations between them, the relationship with profession and epidemiology. Results Of the 1,386 patients tested, 438 (32%) had positive test to some metal, similar results to the 404/1,208 (33%) of the previous study (1995-2002) performed at the same service (p=0.32). The frequency of nickel (77%), cobalt (32%) and chromium (29%) changed slightly (p=0.20). Most cases of sensitization to chromium were related to the occupation (64%), in contrast to nickel and cobalt (p<0.0001). There was a predominance of females among those sensitized to metal in both studies (p=0.63) and the age group of 20-49 years old (p=0.11); the number of fair-skinned individuals increased (p<0.001), as well as the lesions in the cephalic segment (50.5%; p<0.0001) and hands (45%; p<0.0001), which are not the most frequent location anymore. The number of cleaners decreased (39% vs. 59%; p<0.0001), which still lead in front of bricklayers/painters, which increased (14% vs. 9%; p=0.013). The frequency of wet work reduced (65% vs. 81%; p<0.0001). Study limitations The study included a single population group; only patients with positive tests to metals were considered - the others were not evaluated for the possibility of false negatives. Conclusion The sensitization to metals, occupational or not, has been significant over the last 21 years, with few epidemiological changes. PMID:29641698
Duarte, Ida; Mendonça, Rodolfo Ferreira; Korkes, Karen Levy; Lazzarini, Rosana; Hafner, Mariana de Figueiredo Silva
2018-01-01
Metals are common agents of allergic contact dermatitis, occupational or not, with decreasing incidence over the last years in some countries that have regulated the amount of nickel in objects. To analyze and compare with previous studies the profile of metal sensitization between 2003-2015. Patients who underwent patch testing between 2003-2015 were evaluated retrospectively regarding the sensitization rates to metals, the associations between them, the relationship with profession and epidemiology. Of the 1,386 patients tested, 438 (32%) had positive test to some metal, similar results to the 404/1,208 (33%) of the previous study (1995-2002) performed at the same service (p=0.32). The frequency of nickel (77%), cobalt (32%) and chromium (29%) changed slightly (p=0.20). Most cases of sensitization to chromium were related to the occupation (64%), in contrast to nickel and cobalt (p<0.0001). There was a predominance of females among those sensitized to metal in both studies (p=0.63) and the age group of 20-49 years old (p=0.11); the number of fair-skinned individuals increased (p<0.001), as well as the lesions in the cephalic segment (50.5%; p<0.0001) and hands (45%; p<0.0001), which are not the most frequent location anymore. The number of cleaners decreased (39% vs. 59%; p<0.0001), which still lead in front of bricklayers/painters, which increased (14% vs. 9%; p=0.013). The frequency of wet work reduced (65% vs. 81%; p<0.0001). The study included a single population group; only patients with positive tests to metals were considered - the others were not evaluated for the possibility of false negatives. The sensitization to metals, occupational or not, has been significant over the last 21 years, with few epidemiological changes.
Meza, Francisco; Chen, Lilia; Hudson, Naomi
2013-12-01
Each year, 1.2 million metalworkers are exposed to metalworking fluids (MWFs), which can cause dermal and respiratory disease. The National Institute for Occupational Safety and Health (NIOSH) conducted a health hazard evaluation of MWF exposures at an aircraft engine manufacturing facility. The objectives were to determine employee exposures to endotoxin and MWFs in the air, characterize symptoms experienced by employees working with MWFs, compare them to symptoms of employees unexposed to MWFs, and make recommendations for reducing exposures based on results. Four hundred seven workers were categorized as MWF exposed or MWF unexposed and completed questionnaires. Estimated prevalence ratios (PR) of dermatitis, asthma, and work-related asthma (WRA) symptoms were calculated. Airborne concentrations of MWF and endotoxin were measured, and work practices observed. MWF exposed workers had a significantly higher prevalence of dermatitis on wrists/forearms (PR 2.59; 95% CI 1.22, 5.46), asthma symptoms (PR 1.49; 95% CI 1.05, 2.13), and WRA symptoms (PR 2.10; 95% CI 1.22, 3.30) than unexposed workers. Airborne concentrations of MWF were below the NIOSH recommended exposure limit (REL) for MWF aerosols (thoracic particulate mass). Despite MWF exposures below the NIOSH REL, exposed workers had a higher prevalence of asthma, WRA, and dermatitis symptoms than unexposed workers. Recommendations to reduce exposure included configuring mist collectors to automatically turn on when the machine is in use, and enforcing enclosure use. © 2013 Wiley Periodicals, Inc.
Meza, Francisco; Chen, Lilia; Hudson, Naomi
2015-01-01
Background Each year, 1.2 million metalworkers are exposed to metalworking fluids (MWFs), which can cause dermal and respiratory disease. The National Institute for Occupational Safety and Health (NIOSH) conducted a health hazard evaluation of MWF exposures at an aircraft engine manufacturing facility. The objectives were to determine employee exposures to endotoxin and MWFs in the air, characterize symptoms experienced by employees working with MWFs, compare them to symptoms of employees unexposed to MWFs, and make recommendations for reducing exposures based on results. Methods 407 workers were categorized as MWF exposed or MWF unexposed and completed questionnaires. Estimated prevalence ratios (PR) of dermatitis, asthma, and work-related asthma (WRA) symptoms were calculated. Airborne concentrations of MWF and endotoxin were measured, and work practices observed. Results MWF exposed workers had a significantly higher prevalence of dermatitis on wrists/forearms (PR 2.59; 95% CI 1.22, 5.46), asthma symptoms (PR 1.49; 95% CI 1.05, 2.13) and WRA symptoms (PR 2.10; 95% CI 1.22, 3.30) than unexposed workers. Airborne concentrations of MWF were below the NIOSH recommended exposure limit (REL) for MWF aerosols (thoracic particulate mass). Conclusions Despite MWF exposures below the NIOSH REL, exposed workers had a higher prevalence of asthma, WRA, and dermatitis symptoms than unexposed workers. Recommendations to reduce exposure included configuring mist collectors to automatically turn on when the machine is in use, and enforcing enclosure use. PMID:24122918
Evaluation of Occupational Exposure of Glazers of a Ceramic Industry to Cobalt Blue Dye
KARGAR, Fatemeh; SHAHTAHERI, Seyed Jamaleddin; GOLBABAEI, Farideh; BARKHORDARI, Abolfazl; RAHIMI-FROUSHANI, Abbas; KHADEM, Monireh
2013-01-01
Background: Cobalt is one of the most important constituent present in ceramic industries. Glazers are the relevant workers when they are producing blue colored ceramic, causing occupational exposure to such metal. Through this study, urinary cobalt was determined in glazers in a ceramic industry when they were producing blue-colored ceramic glazes. Methods: In this case-control study, spot urine samples were collected from 49 glazers at the start and end of work shifts (totally 98 samples) in 2011. Control group were well matched for age, height, and weight. A solid phase extraction system was used for separation and preconcentration of samples followed by analysis by inductively coupled plasma-atomic emission spectroscopy (ICP-AES). All participants filled out a self administered questionnaire comprises questions about duration of exposure, work shift, use of mask, skin dermatitis, kind of job, ventilation system, overtime work, age, weight, and height. The lung function tests were performed on each control and cobalt exposed subjects. Analysis of covariance (ANCOVA) was used to evaluate the obtained results. Results: Urinary levels of cobalt were significantly higher in the glazers compared to the control group. There were significant differences at urinary concentration of cobalt at the start and end of the work shift in glazers. Spirometric parameters were significantly lower in the glazers compared to the control group. Among the variables used in questionnaire the significant variables were dermatitis skin, mask, ventilation, and overtime work. Conclusion: This study verified existence of cobalt in the urine glazers, showing lower amount than the ACGIH standard. PMID:26056641
Betts, Catherine J; Dearman, Rebecca J; Heylings, Jon R; Kimber, Ian; Basketter, David A
2006-09-01
There is compelling evidence that contact allergens differ substantially (by 4 or 5 orders of magnitude) with respect to their inherent skin-sensitizing potency. Relative potency can now be measured effectively using the mouse local lymph node assay (LLNA) and such data form the basis of risk assessment and risk management strategies. Such determinations also facilitate distinctions being drawn between the prevalence of skin sensitization to a particular contact allergen and inherent potency. The distinction is important because chemicals that are implicated as common causes of contact allergy are not necessarily potent sensitizers. One example is provided by nickel that is undoubtedly a common cause of allergic contact dermatitis, but is a comparatively weak sensitizer in predictive tests. In an attempt to explore other examples of contact allergens where there may exist a discrepancy between prevalence and potency, we describe here analyses conducted with methyl methacrylate (MMA). Results of LLNA studies have been interpreted in the context of historical clinical data on occupational allergic contact dermatitis associated with exposure to MMA.
Assessing occupational exposure to sea lamprey pesticides
Ceballos, Diana M; Beaucham, Catherine C; Kurtz, Kristine; Musolin, Kristin
2015-01-01
Background: Sea lampreys are parasitic fish found in lakes of the United States and Canada. Sea lamprey is controlled through manual application of the pesticides 3-trifluoromethyl-4-nitrophenol (TFM) and BayluscideTM into streams and tributaries. 3-Trifluoromethyl-4-nitrophenol may cause irritation and central nervous system depression and Bayluscide may cause irritation, dermatitis, blisters, cracking, edema, and allergic skin reactions. Objectives: To assess occupational exposures to sea lamprey pesticides. Methods: We developed a wipe method for evaluating surface and skin contamination with these pesticides. This method was field tested at a biological field station and at a pesticide river application. We also evaluated exposures using control banding tools. Results: We verified TFM surface contamination at the biological station. At the river application, we found surfaces and worker’s skin contaminated with pesticides. Conclusion: We recommended minimizing exposures by implementing engineering controls and improved use of personal protective equipment. PMID:25730600
Occupational contact dermatitis I: incidence and return to work pressures.
Emmett, Edward A
2002-03-01
Since the passage of the United States Occupational Safety and Health Act (OSHA) in 1970, there have been extensive changes in United States workplaces that should have served to enhance the prevention of occupational skin disease (OSD). Analysis of skin diseases reported to OSHA (OSHA recordables) shows that the number of OSDs declined steadily from 1974 to 1983 to about half the previous annual incidence. After 1984, there was a modest resurgence peaking in 1994, with a subsequent decline. A similar but somewhat greater decline in the late 1990s has been observed for occupational respiratory diseases, diseases caused by toxic agents and for poisonings. Likely explanations for the trends in OSD are discussed; the initial decline probably reflected an improvement in workplace conditions, the later resurgence and decline may have been attributable to changes in recording behaviors and in worker's compensation. The decline in recorded OSD since 1996 has been fairly uniform in most major industrial sectors but has been less marked in agriculture, forestry, and fishing so that this sector has replaced manufacturing in recording the highest incidence rate. In 1999, the incidence rate of recorded OSD was 0.49 per 1,000 workers, which appears to grossly under report the true incidence. OSD now constitutes about 10% of all occupational disease cases. Currently, there is increasing emphasis in corporate and occupational medicine on reducing costs and maintaining productivity as well as in preventing occupational injuries and diseases. This is shown by the trend for a greater proportion of workers with occupational conditions to return to modified duty positions rather than to be completely off work. Implications of this phenomena for management of OSD are discussed. Copyright 2002, Elsevier Science (USA). All rights reserved.
Flexural eczema versus atopic dermatitis.
Jacob, Sharon E; Goldenberg, Alina; Nedorost, Susan; Thyssen, Jacob P; Fonacier, Luz; Spiewak, Radoslaw
2015-01-01
Flexural eczema and atopic dermatitis are frequently synonymized. As respiratory atopy is rarely tested for and found in these patients, systematically equating a flexural distribution of dermatitis with atopic dermatitis may too frequently result in misclassified diagnoses and potentially missed opportunity for intervention toward improving patients' symptoms and quality of life. We present a critical review of the available evidence for the atopic dermatitis diagnosis and discuss the similarities between atopic dermatitis and allergic contact dermatitis. Because neither flexural predilection nor atopy is specific for atopic dermatitis, we conclude that the term atopic dermatitis is a misnomer and propose an etymologic reclassification of atopic dermatitis to "atopy-related" dermatitis. Allergic contact dermatitis can induce an atopic dermatitis-like phenotype, and thus, flexural dermatitis cannot be assumed as atopic without further testing. Patch testing should at least be considered in cases of chronic or recurrent eczema regardless of the working diagnosis.
Job-related diseases and occupations within a large workers' compensation data set.
Leigh, J P; Miller, T R
1998-03-01
The objective of this report is to describe workers' job-related diseases and the occupations associated with those diseases. The methods include aggregation and analysis of job-related disease and occupation data from the Bureau of Labor Statistics' Supplementary Data System (SDS) for 1985 and 1986--the last years of data available with workers' compensation categories: death, permanent total, permanent partial, and temporary total and partial. Diseases are ranked according to their contribution to the four workers' compensation (WC) categories and also ranked within occupations according to the number of cases. Occupations are ranked according to their contribution to specific diseases within one of the four categories. The following diseases comprise the greatest numbers of deaths: heart attacks, asbestosis, silicosis, and stroke. Within the permanent total category, the diseases with the greatest contributions are heart attack, silicosis, strokes, and inflammation of the joints. For the permanent partial category, they are hearing loss, inflammation of joints, carpal tunnel syndrome, and heart attacks. For the temporary total and partial category, they are: inflammation of joints, carpal tunnel syndrome, dermatitis, and toxic poisoning. Hearing loss or inflammation of joints are associated with more than 300 occupations. Circulatory diseases comprise a larger share of job-related diseases than is generally acknowledged. Occupations contributing the most heart attack deaths are truck drivers, managers, janitors, supervisors, firefighters, and laborers. Ratios of numbers of deaths to numbers of disabilities are far higher for illnesses than injuries. Occupations that are consistent in their high ranking on most lists involving a variety of conditions include nonconstruction laborers, janitors, and construction laborers. The large SDS, though dated, provides a tentative national look at the broad spectrum of occupational diseases as defined by WC and the occupations associated with those diseases in 1985 and 1986. Some description of the spectrum of diseases encountered today is possible especially for occupations, such as those mentioned above for which employment has expanded in the 1990s.
Potential Health Effects Associated with Dermal Exposure to Occupational Chemicals
Anderson, Stacey E; Meade, B Jean
2014-01-01
There are a large number of workers in the United States, spanning a variety of occupational industries and sectors, who are potentially exposed to chemicals that can be absorbed through the skin. Occupational skin exposures can result in numerous diseases that can adversely affect an individual’s health and capacity to perform at work. In general, there are three types of chemical–skin interactions of concern: direct skin effects, immune-mediated skin effects, and systemic effects. While hundreds of chemicals (metals, epoxy and acrylic resins, rubber additives, and chemical intermediates) present in virtually every industry have been identified to cause direct and immune-mediated effects such as contact dermatitis or urticaria, less is known about the number and types of chemicals contributing to systemic effects. In an attempt to raise awareness, skin notation assignments communicate the potential for dermal absorption; however, there is a need for standardization among agencies to communicate an accurate description of occupational hazards. Studies have suggested that exposure to complex mixtures, excessive hand washing, use of hand sanitizers, high frequency of wet work, and environmental or other factors may enhance penetration and stimulate other biological responses altering the outcomes of dermal chemical exposure. Understanding the hazards of dermal exposure is essential for the proper implementation of protective measures to ensure worker safety and health. PMID:25574139
Potential health effects associated with dermal exposure to occupational chemicals.
Anderson, Stacey E; Meade, B Jean
2014-01-01
There are a large number of workers in the United States, spanning a variety of occupational industries and sectors, who are potentially exposed to chemicals that can be absorbed through the skin. Occupational skin exposures can result in numerous diseases that can adversely affect an individual's health and capacity to perform at work. In general, there are three types of chemical-skin interactions of concern: direct skin effects, immune-mediated skin effects, and systemic effects. While hundreds of chemicals (metals, epoxy and acrylic resins, rubber additives, and chemical intermediates) present in virtually every industry have been identified to cause direct and immune-mediated effects such as contact dermatitis or urticaria, less is known about the number and types of chemicals contributing to systemic effects. In an attempt to raise awareness, skin notation assignments communicate the potential for dermal absorption; however, there is a need for standardization among agencies to communicate an accurate description of occupational hazards. Studies have suggested that exposure to complex mixtures, excessive hand washing, use of hand sanitizers, high frequency of wet work, and environmental or other factors may enhance penetration and stimulate other biological responses altering the outcomes of dermal chemical exposure. Understanding the hazards of dermal exposure is essential for the proper implementation of protective measures to ensure worker safety and health.
1978-04-01
deaths, no weight losses, and no abnormal hematological findings (8). b. Rabbits In groups of rabbits intermittently exposed to diesel fumes, Samal et al...lymphocyto- penia; watery bone marrow; dermatitis rabbits diesel fuel and motor reduced antibody produc- Samal I_ ,., oil fumes (100:6 mix- tion to...Laboratory Report No. 46, 1945. 91. Samal , U. C., R. Saran, R. K. Sanyal: Effects of inhaled fumes on immunological response of rabbits. Indian J Physiol
Classification and possible bacterial infection in outpatients with eczema and dermatitis in China
Wang, Xin; Shi, Xiao-Dong; Li, Lin-Feng; Zhou, Ping; Shen, Yi-Wei
2017-01-01
Abstract Little is known about the classification and bacterial infection in outpatients with eczema and dermatitis in China. To investigate the prevalence of eczema and dermatitis in outpatients of dermatology clinics in China, examine classification and proportion of common types of dermatitis and the possible bacterial infection, and analyze the possible related factors. Outpatients with eczema or dermatitis from 39 tertiary hospitals of 15 provinces in mainland China from July 1 to September 30, 2014, were enrolled in this cross-sectional and multicenter study. Among 9393 enrolled outpatients, 636 patients (6.7%) were excluded because of incomplete information. The leading subtypes of dermatitis were unclassified eczema (35.5%), atopic dermatitis (13.4%), irritant dermatitis (9.2%), and widespread eczema (8.7%). Total bacterial infection rate was 52.3%, with widespread eczema, stasis dermatitis, and atopic dermatitis being the leading three (65.7%, 61.8%, and 61.4%, respectively). Clinically very likely bacterial infection has a significant positive correlation with disease duration, history of allergic disease, history of flexion dermatitis, and severe itching. Atopic dermatitis has become a common subtype of dermatitis in China. Secondary bacterial infection is common in all patients with dermatitis, and more attentions should be paid on this issue in other type of dermatitis apart from atopic dermatitis. PMID:28858126
Wang, Xin; Shi, Xiao-Dong; Li, Lin-Feng; Zhou, Ping; Shen, Yi-Wei
2017-09-01
Little is known about the classification and bacterial infection in outpatients with eczema and dermatitis in China.To investigate the prevalence of eczema and dermatitis in outpatients of dermatology clinics in China, examine classification and proportion of common types of dermatitis and the possible bacterial infection, and analyze the possible related factors.Outpatients with eczema or dermatitis from 39 tertiary hospitals of 15 provinces in mainland China from July 1 to September 30, 2014, were enrolled in this cross-sectional and multicenter study. Among 9393 enrolled outpatients, 636 patients (6.7%) were excluded because of incomplete information.The leading subtypes of dermatitis were unclassified eczema (35.5%), atopic dermatitis (13.4%), irritant dermatitis (9.2%), and widespread eczema (8.7%). Total bacterial infection rate was 52.3%, with widespread eczema, stasis dermatitis, and atopic dermatitis being the leading three (65.7%, 61.8%, and 61.4%, respectively). Clinically very likely bacterial infection has a significant positive correlation with disease duration, history of allergic disease, history of flexion dermatitis, and severe itching.Atopic dermatitis has become a common subtype of dermatitis in China. Secondary bacterial infection is common in all patients with dermatitis, and more attentions should be paid on this issue in other type of dermatitis apart from atopic dermatitis.
Penagos, Homero; Ruepert, Clemens; Partanen, Timo; Wesseling, Catharina
2004-09-01
Irritant contact dermatitis and allergic contact dermatitis (ACD) are frequent among agricultural workers and require targeted interventions. Patch testing is necessary for differential diagnosis, but patch testing with pesticides is uncommon. This study explores the frequency of ACD and sensitization to pesticides among highly exposed banana plantation workers. Frequently and recently used pesticides on banana plantations in Divala, Panama, were documented. A pesticide patch test tray specific for this population was prepared. A structured interview was administered to 366 participants, followed by a complete skin examination. The pesticide patch test series, as well as a standard patch test series, was applied to 37 workers with dermatoses likely to be pesticide related and to 23 control workers without dermatoses. The pesticide patch tests identified 15 cases (41%) of ACD (20 positive reactions) among the 37 workers diagnosed with pesticide dermatosis. Three controls had allergic reactions to pesticides (4 positive reactions). The pesticides were carbaryl (5 cases), benomyl (4 cases), ethoprophos (3), chlorothalonil (2), imazalil (2), glyphosate (2), thiabendazole (2), chlorpyrifos (1), oxyfluorfen (1), propiconazole (1), and tridemorph (1). Ethoprophos and tridemorph had not been previously identified as sensitizers. Thus, the prevalence of ACD was 0.03 (15 of 366). On the basis of observed prevalences of positive patch-test reactions among the subgroups with and without dermatoses, we estimated that > or = 16% of the entire population may be sensitized to pesticides. Sensitization to pesticides among banana plantation workers is a frequent occupational health problem. Pesticide patch test trays should be used in assessing skin diseases in highly exposed workers.
Kitazawa, Koji; Sotozono, Chie; Sakamoto, Masako; Sasaki, Miho; Hieda, Osamu; Yamasaki, Toshihide; Kinoshita, Shigeru
2016-01-01
Objectives To investigate bacterial flora of clinically healthy conjunctiva and nasal cavity among patients prior to refractive surgery, as well as the characteristics of patients with methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Design Observational and cross-sectional study. Setting A single-centre study in Japan. Participants 120 consecutive patients pre-refractive surgery. Primary and secondary outcome measures methods Samples were obtained from the right conjunctival sac and the nasal cavity of 120 consecutive patients prior to refractive surgery and were then measured for the levels of the minimum inhibitory concentration (MIC) of antibiotics. Patients were interviewed regarding their occupation, family living situation and any personal history of atopic dermatitis, asthma, smoking or contact lens wear. Results Propionibacterium acnes (P. acnes) (32.5%) and Staphylococcus epidermidis (4.2%) were detected from the conjunctival sac. S. epidermidis was the most commonly isolated (68.3%) in the nasal cavity. Of the 30 patients (25.0%) with colonisation by S. aureus, 2 patients, both of whom were healthcare workers with atopic dermatitis, were found to be positive for MRSA in the nasal cavity. A history of contact lens wear, asthma or smoking, as well as patient gender and age, was not associated with MRSA colonisation. Conclusions There were only 2 patients who were colonised with MRSA, both of whom were healthcare workers with atopic dermatitis. P. acnes was predominantly found in the conjunctival sac. Further study is needed to investigate the involvement between nasal and conjunctival flora, and risk factors for infectious complications. PMID:27160843
Kamijima, Michihiro; Wang, Hailan; Yamanoshita, Osamu; Ito, Yuki; Xia, Lihua; Yanagiba, Yukie; Chen, Cishan; Okamura, Ai; Huang, Zhenlie; Qiu, Xinxiang; Song, Xiangrong; Cai, Tingfeng; Liu, Lili; Ge, Yichen; Deng, Yingyu; Naito, Hisao; Yoshikawa, Tetsushi; Tohyama, Mikiko; Li, Laiyu; Huang, Hanlin; Nakajima, Tamie
2013-12-01
Trichloroethylene (TCE) is an industrial solvent which can cause severe generalized dermatitis, i.e., occupational TCE hypersensitivity syndrome. Reactivation of latent human herpesvirus 6 (HHV6) can occur in such patients, which has made TCE known as a causative chemical of drug-induced hypersensitivity syndrome (DIHS). This study aimed to clarify HHV6 status, cytokine profiles and their association with rash phenotypes in patients with TCE hypersensitivity syndrome. HHV6 DNA copy numbers, anti-HHV6 antibody titers, and cytokines were measured in blood prospectively sampled 5-7 times from 28 hospitalized patients with the disease. The patients (19 had exfoliative dermatitis (ED) and 9 had non-ED type rash) generally met the diagnostic criteria for DIHS. Viral reactivation defined as increases in either HHV6 DNA (≥100 genomic copies/10(6) peripheral blood mononuclear cells) or antibody titers was identified in 24 (89%) patients. HHV6 DNA, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-5, IL-6 and IL-10 concentrations were remarkably higher in the patients than in the healthy workers (p<0.01). Positive correlations between HHV6 DNA, TNF-α, IFN-γ, IL-6 and IL-10 were significant (p<0.05) except for that between HHV6 DNA and IFN-γ. An increase in HHV6 DNA was positively associated with an increase in TNF-α on admission (p<0.01). HHV6 DNA, the antibody titers, TNF-α and IL-10 concentrations were significantly higher in ED than in the non-ED type (p<0.05). Reactivated HHV6 and the increased cytokines could be biomarkers of TCE hypersensitivity syndrome. The higher-level reactivation and stronger humoral responses were associated with ED-type rash. Copyright © 2013 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.
Bensefa-Colas, L; Telle-Lamberton, M; Faye, S; Bourrain, J-L; Crépy, M-N; Lasfargues, G; Choudat, D; Momas, I
2015-12-01
Occupational contact urticaria (OCU) is an occupational contact dermatitis that can cause serious health consequences and disability at work. To describe OCU and its temporal trends by the main causal agents and activity sectors in a nationwide scheme in France. Using data from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P), we described OCU reported during the period 2001-10 and analysed the temporal trends of OCU and OCU attributed to the most frequent agents over the study period. Trends analyses were supported by reporting odds ratios using a logistic regression model with reference to 2001, or with time as a continuous variable. During the study period, 251 cases of OCU were reported in RNV3P, half of which were due to natural rubber latex, in particular in the health and social work activity sector (HSW). The number of these cases declined significantly over the study period (19% per year), and particularly after 2006. Conversely, the other causes of OCU did not decrease. Using surveillance data from a French national network, this study has found that there was a significant decline in OCU due to natural rubber latex, particularly in the HSW, when powdered latex gloves were banned from French hospitals. Our results show the effectiveness of this preventive measure, and suggest that this practice should be extended to other sectors. © 2015 British Association of Dermatologists.
Kieć-Swierczyńska, Marta; Krecisz, Beata
2003-01-01
Of the 5604 patients examined in 1984-2001 for suspected occupational dermatitis, 160 persons (2.8%) showed allergy to epoxy resins plastics. Allergy was more frequent in men (4.9%) than in women (1.2%); in 154 persons, allergy was of occupational etiology (in a group of 160 patients with allergy to epoxy resins, the following proportions were observed: bricklayers, platelayers--17.5%; fitters, turners, machinist millers--13.8%; plastics molders--13.1%; laminators--11.3%; electrical equipment assemblers--10.6%; painters--10.0%). Having compared the frequency of allergy to components of epoxy resins in the years 1984-1993 and 1994-2001, it was found that allergy to resin, reactive diluents and plasticizers was on increase, whereas allergy to amines and acid anhydrides hardeners was on decrease. In a group of 13 chemical compounds entering into the composition of epoxy resins, epoxy resin contributed to the largest number of positive patch tests (77.5% of epoxy-allergic persons). This was followed by triethylenetetramine (23.1%), ethylenediamine (13.1%), phthalic anhydride (8.1%), diethylenetetramine (6.9%) and phenylglycidylether (6.2%). In addition, three patients reacted to both epoxy resin and cycloaliphatic resin.
[Contact dermatitis caused by acrylates among 8 workers in an elevator factory].
Pérez-Formoso, J L; de Anca-Fernández, J; Maraví-Cecilia, R; Díaz-Torres, J M
2010-05-01
Acrylates are widely used low-molecular-weight substances, initially introduced in industry in the 1930s and subsequently applied also in medicine and the home. One of their main features is the ability to undergo polymerization. The most commonly used acrylic compounds are cyanoacrylates, methacrylates, and acrylates. To confirm suspicion of occupational disease in a group of workers in an elevator factory. We studied 8 patients with dermatitis of the hands and finger pads. In their work, the patients came into contact with acrylates. Patch testing was applied with an acrylate panel (BIAL-Aristegui, Bilbao, Spain). Seven of the patients (87. 5%) had a positive result with 1% ethylene glycol dimethacrylate. Positive were also observed for 2% hydroxyethyl methacrylate (5 patients, 62. 5%), 1% triethylene glycol dimethacrylate (4 patients, 50%), 10% ethyl methacrylate monomer (3 patients, 37. 5%), 10% methyl methacrylate monomer (2 patients, 25%), 1% ethyl acrylate (1 patient, 12. 5%), and 0. 1% acrylic acid (1 patient, 12. 5%). We highlight the strong sensitizing capacity of acrylates and the importance of taking all necessary preventive measures in industries where these substances are used. Such measures should include avoidance of contact with the product in cases where sensitization has been confirmed.
Occupational contact dermatitis to a limonene-based solvent in a histopathology technician.
Foti, Caterina; Zambonin, Carlo G; Conserva, Anna; Casulli, Claudia; D'Accolti, Lucia; Angelini, Gianni
2007-02-01
Recently, D-limonene-based solvents are used as a safe alternative to xylene for histological and cytological application to dissolve paraffin. We report the case of a histopathology technician with a recalcitrant hand contact dermatitis strictly related to the use of a limonene-based solvent agent. Patch tests with SIDAPA (Italian Society of Allergological, Professional and Environmental Dermatology) standard series, limonene-based solvent used by the patient and D- and L-limonene (both oxidized and nonoxidized form) and with Giemsa and methylene blue stains were performed. Patch testing gave positive results to oxidized D- and L-limonene. The patient retired from work and promptly improved and healed the hand eczema. Subsequently, the potential occurrence of limonene oxidation products in the incriminated preparation was investigated using gas chromatography-mass spectrometry. While patch test showed positive reaction to oxidized limonene, chemical analysis failed to detect oxidized limonene in the preparations used by the patient. Considering the strict relation between the use of the preparations and the appearance of symptoms, we can assume that oxidized limonene may be produced during the handling of limonene-based products, especially in the presence of oxidants stains, frequently used in histological laboratories.
Recruitment strategies for a hand dermatitis prevention programme in the food industry.
Kaatz, Martin; Ladermann, Regina; Stadeler, Martina; Fluhr, Joachim Wilhelm; Elsner, Peter; Bauer, Andrea
2008-09-01
An interdisciplinary 'Skin Disease Prevention Programme (SDPP) in the baking, hotel, and catering industries' was established. However, only 30% of the eligible employees suffering from occupational hand dermatitis (OHD) participated in the programme. The aim of the present study was to increase the participation rate in the SDPP from 30% to 50% by specific recruitment strategies. Two hundred and twenty five baker and catering trade employees suffering from OHD were included in a prospective controlled intervention study. The employees were invited to take part in the SDPP using (i) a standard invitation letter (n = 40), (ii) a newly developed, personalized, and targeted invitation letter (n = 52), (iii) the new invitation letter and a case report (n = 75), and (iv) the new invitation letter, the case report, and the additional information (n = 58). The commitment of the employees to join the SDPP increased significantly from 30% to 54% (P < 0.02) in the group receiving the new personalized targeted invitation letter. Neither the additional case report nor the supplementation with additional information concerning the SDPP did further increase the recruitment. The strategy to personalize and target the new invitation letter was successful to influence the employees' commitment to participate in the SDPP.
... most common types are atopic dermatitis (often called eczema) and contact dermatitis. Atopic Dermatitis (Eczema) Eczema is a chronic ... contact with your skin, they may cause a rash called contact dermatitis. There are two kinds of contact dermatitis: ...
Marine and Other Aquatic Dermatoses
Sridhar, Surg Capt. Jandhyala; Deo, Surg Cdr. Rajeev
2017-01-01
Occupational and recreational aquatic activity predisposes our population to a wide variety of dermatoses. Sunburn, urticaria, jellyfish stings, and contact dermatitis to rubber equipment are common allergies that are encountered in the aquatic environment. Among the infections, tinea versicolor, intertrigo, and verruca vulgaris are widespread. Swimmer's itch may occur due to skin penetration by schistosome cercariae, while free-floating nematocysts of marine coelenterates may precipitate seabather's eruption. “Suit squeeze” due to cutaneous barotrauma and lymphoedematous peau d’orange due to decompression are rare, described entities. This review serves as a ready reckoner for Indian dermatologists and medical practitioners to identify and manage these conditions. PMID:28216728
Kaneko, Ryosuke; Sato, Atsuko; Hamada, Shun; Yagi, Takeshi; Ohsawa, Ichiro; Ohtsuki, Mamitaro; Kobayashi, Eiji; Hirabayashi, Masumi; Murakami, Takashi
2016-08-01
Childhood-onset dermatitis is one of the most common skin disorders in children. Although various mouse models that mirror aspects of dermatitis have become available, there is still a need for an animal model that develops dermatitis in childhood and is more suitable for performing tissue transplantation experiments. There is emerging evidence that peripheral blood T lymphocytes from patients with dermatitis have significantly increased telomerase activity. Here, we developed telomerase reverse transcriptase (TERT)-expressing transgenic (Tg) rats that spontaneously developed eczematous skin inflammation in childhood. Newborn TERT-Tg rats developed visible dermatitis in 56 % of cases, and the skin lesions microscopically showed spongiosis and acanthosis with infiltration of lymphocytes, eosinophils and mast cells. TERT-Tg rats with dermatitis exhibited increased CD4 (2.5-fold) and CD8 (fivefold) T cell numbers compared with dermatitis-free TERT-Tg rats. Stronger TERT activity was observed in the peripheral lymphocytes of dermatitis-positive TERT-Tg rats than those of dermatitis-free TERT-Tg rats. RT-PCR analysis revealed that IL-4 was markedly elevated in the spleen of dermatitis-positive TERT-Tg rats, and that interferon-gamma was increased in the dermatitis lesions. Moreover, skin grafting of TERT-Tg rats with dermatitis onto T cell-deficient nude rats demonstrated that the inflamed skin lesions could not be maintained. Taken together, the results suggest that TERT activation in T lymphocytes is one of the potential predisposing factors for dermatitis. Moreover, our results demonstrated that the TERT-Tg rats mirror aspects of human childhood-onset dermatitis and that these animals represent a potential animal model system for studying childhood-onset dermatitis.
Atopic dermatitis phenotypes and the need for personalized medicine
Cabanillas, Beatriz; Brehler, Ann-Christin; Novak, Natalija
2017-01-01
Purpose of review To describe recent developments in therapies which target the molecular mechanisms in atopic dermatitis. Recent findings Current advances in the understanding of the molecular basis of atopic dermatitis are leading to the stratification of different atopic dermatitis phenotypes. New therapies offer the option to target-specific molecules involved in the pathophysiology of atopic dermatitis. Current new therapies under investigation aim to modulate specific inflammatory pathways associated with distinctive atopic dermatitis phenotypes, which would potentially translate into the development of personalized, targeted-specific treatments of atopic dermatitis. Summary Despite the unmet need for well tolerated, effective, and personalized treatment of atopic dermatitis, the current standard treatments of atopic dermatitis do not focus on the individual pathogenesis of the disease. The development of targeted, phenotype-specific therapies has the potential to open a new promising era of individualized treatment of atopic dermatitis. PMID:28582322
Hamann, Dathan; Ridpath, Alyson; Fernandez Faith, Esteban
2018-06-26
Consort dermatitis refers to an allergic contact dermatitis caused by transfer from an intimate contact to a sensitized patient. Although close contact with other humans most commonly provokes consort dermatitis, pets have been the source in a minority of cases. We present a unique case of transfer dermatitis from a patient's cat litter to her forearms. Pediatric dermatologists should be aware of the possibility of consort or "transfer" allergic contact dermatitis from pets. © 2018 Wiley Periodicals, Inc.
Quality of life in patients with allergic contact dermatitis.
Kadyk, Deana L; McCarter, Kevin; Achen, Fritz; Belsito, Donald V
2003-12-01
Allergic contact dermatitis (ACD), a common dermatological disorder, often results in ongoing disease and disability. However, relatively little has been published quantifying the quality of life (QoL) of patients with ACD. This study was conducted to investigate the impact of ACD on QoL and explore prognostic factors that influence outcomes. A total of 428 subjects with ACD were, at varying times after diagnosis, mailed a QoL questionnaire modified from Skindex-16 to include an additional 5 items pertaining to occupational impact. The QoL scores were correlated with subject demographics, disease characteristics, and management techniques to ascertain factors that impact QoL in subjects with ACD. The response rate was 35%, with 149 subjects returning the postal survey. Responders reported being bothered most by itching, skin irritation, and persistence of the condition. Of the four scales included in the QoL questionnaire, the emotions scale had the worst composite QoL score, followed by symptoms, functioning, and occupational impact. Patients with ACD of the face were significantly more bothered by the appearance of their skin. Hand involvement and occupationally related ACD were associated with worse QoL scores within the occupational impact and functioning scales. Subjects that had changed jobs because of ACD had more severe QoL impairment than any other group analyzed, with significantly worse scores on 17 of the 21 QoL items. A history of atopic eczema seemed to impart improved outcomes on patients with ACD, and these subjects were less worried about being fired from their jobs. Subjects diagnosed by patch testing more than 36 months after disease onset seemed to have worse QoL scores than those diagnosed earlier in the natural history of the disease. Patients diagnosed by patch testing within the last 6 months had the worst QoL scores, while the best outcomes were reported in subjects patch tested 6 to 12 months ago. A slight decline in QoL was observed 12 months after patch testing, but scores did not diminish back to the level seen immediately after diagnosis. ACD has an appreciable effect on QoL, especially when it affects the hands, the face, or is occupationally related. Of the four scales included in our study, the emotions scale suffered the greatest effect. Emotional impact is therefore an important measure of QoL in ACD patients. Outcomes in patients with ACD were improved by early diagnosis and subjects enjoyed their best QoL at 6 to 12 months after patch testing. However, individuals who elected to change jobs because of their skin condition reported significantly worse QoL than those who retained their current positions.
Alonso, E; Ausín, A; Elices, A; Moreno-Escobosa, M; Ibáñez, M; Laso, M
2001-01-01
baker's asthma is a well-known occupational lung disease which usually develops in adults. We report the case of a two years old boy who suffered from asthma, urticaria and atopic dermatitis for twelve months, whose symptoms were associated to visits to his grandfather's bakery. skin prick tests (SPT) were made to dust mites, moulds, flours, alfa-amylase and egg. It was also determined total IgE and specific IgE antibodies to alfa-amylase and flours. Subsequently, a challenge test was carried out with wheat flour. The SPTs were positive to flours, alfa-amylase and egg. The determination of specific IgE antibodies showed 2.64 kU/L to wheat, 0.79 kU/L to glyadin and 2.98 kU/L to alfa-amylase. The patient developed asthma and rhinitis after manipulating wheat flour for 10 min. we demonstrated a type I hypersensitivity to wheat flour and alfa-amylase in a two years old child by SPT, specific IgE antibodies and challenge test. This case in the childhood equivalent of occupational baker's asthma.
2017-12-18
Moderate-to-Severe Atopic Dermatitis; Dermatitis, Dermatitis Atopic; Eczema, Skin Diseases, Skin; Diseases Genetic, Genetic; Diseases Inborn, Skin; Disease, Eczematous Skin; Hypersensitivity, Immediate; Hypersensitivity, Immune System Diseases; Dermatitis, Atopic
Bretterklieber, Agnes; Painsi, Clemens; Avian, Alexander; Wutte, Nora; Aberer, Elisabeth
2014-09-02
Systemic sclerosis (SSc) is a rare and potentially life threatening autoimmune disorder. The burden of disease compared to other dermatoses is unknown. The purpose of this study was to assess both the quality of life in patients with SSc and the variables that are associated with poor quality of life. Forty-one patients with systemic sclerosis (29 limited, 2 diffuse, 10 undifferentiated forms) were assessed with respect to their health status and compared to published data for the normal population, SSc patients from other studies, and patients with chronic skin diseases. For the most part, our SSc patients had better outcomes in all 8 dimensions of the SF-36 than SSc patients from other studies, and poorer scores than the healthy population and those with occupational contact dermatitis, ichthyosis, non-melanoma skin cancer, contact dermatitis, atopic eczema, chronic nail disease, vitiligo, health care workers with work-related disease, and those with other chronic skin diseases, but significantly better scores for mental health than those with nail disease, vitiligo, and health-care workers. Patients with atopic dermatitis, psoriasis and pemphigus had significantly poorer mean scores in social function and mental health than SSc patients. Patients with pemphigus were also significantly impaired in their physical and emotional roles. Patients with systemic lupus erythematosus (SLE) had the significantly poorest mean scores for QoL in all 8 domains except bodily pain and emotional role. Besides SLE, SSc is one of the most severe chronic dermatologic diseases in terms of reduced QoL. Since SSc cannot be cured, treatment strategies should include therapeutic interventions such as psychotherapy, social support, physiotherapy, and spiritual care. Their beneficial effects could be studied in future.
Arima, Kazuhiko; Gupta, Shaloo; Gadkari, Abhijit; Hiragun, Takaaki; Kono, Takeshi; Katayama, Ichiro; Demiya, Sven; Eckert, Laurent
2018-04-01
Atopic dermatitis is a chronic inflammatory skin disease. The objective of this study was to characterize the burden of atopic dermatitis in Japanese adult patients relative to the general population. Japanese adults (≥18 years) with a self-reported diagnosis of atopic dermatitis and adult controls without atopic dermatitis/eczema/dermatitis were identified from the 2013 Japan National Health and Wellness Survey. Atopic dermatitis patients were propensity-score matched with non-atopic dermatitis controls (1:2 ratio) on demographic variables. Patient-reported outcome data on comorbidities, mood and sleep disorders, health-related quality of life, work productivity and activity impairment, and health-care resource utilization were analyzed in atopic dermatitis patients and matched controls. A total of 638 Japanese adult patients with atopic dermatitis were identified, of whom 290 (45.5%) rated their disease as "moderate/severe" and 348 (54.5%) as "mild". The analysis cohort comprised 634 atopic dermatitis patients and 1268 matched controls. Atopic dermatitis patients reported a significantly higher prevalence of arthritis, asthma, nasal allergies/hay fever, anxiety, depression and sleep disorders compared with controls (all P < 0.001). Atopic dermatitis patients also reported a significantly poorer health-related quality of life, higher overall work and activity impairment, and higher health-care resource utilization (all P < 0.001). Self-rated disease severity was not associated with disease burden, except for a significantly higher overall work and activity impairment. In conclusion, Japanese adult patients with atopic dermatitis reported a substantial disease burden relative to adults without atopic dermatitis, suggesting an unmet need for effective strategies targeting disease management. © 2018 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.
Lakshmi, Chembolli; Srinivas, C. R.; Pillai, Suma B.; Shanthakumari, S.
2011-01-01
Parthenium dermatitis is a widespread and distressing dermatoses in rural and urban India caused by the air borne allergen of the Compositae weed Parthenium hysterophorus. Parthenium dermatitis has been thought to be mediated solely by type IV hypersensitivity, but recently a combined immediate (type I) and delayed (type IV) hypersensitivity mechanism has been postulated in the initiation and perpetuation of parthenium dermatitis, especially in sensitized subjects with an atopic diathesis. Initially, the exposed sites of the body are involved. Later in the course of the disease, unexposed sites may get involved. Various clinical presentations have been described in parthenium dermatitis. Typically, it presents as an air borne contact dermatitis (ABCD) involving the eyelids and nasolabial folds Other presentations include a photodermatitis (essentially a pseudo photodermatitis), atopic dermatitis, seborrheic dermatitis, exfoliative dermatitis, hand dermatitis. Photosensitive lichenoid dermatitis and prurigo nodularis are rarer presentations. Uncommon presentations have been described in parthenium dermatitis. They include prurigo nodularis-like lesions and photosensitive lichenoid eruption. Three cases are presented, two of whom presented as polymorphic-like lesions and one as prurigo nodularis. All three patch tested positive to parthenium on Day 2. Prick testing was positive in two of the three patients. Parthenium dermatitis mimicking polymorphic light eruption has not been reported. Histopathology revealed vasculitis in the lesional skin in two of the patients. Although leukocytoclastic vasculitis has been reported earlier from the prick-tested site, this is the first report demonstrating the presence of vasculitis in lesional skin of parthenium dermatitis. PMID:23130236
Diet and Dermatitis: Food Triggers
Schlichte, Megan
2014-01-01
Given increasing awareness of the link between diet and health, many patients are concerned that dietary factors may trigger dermatitis. Research has found that dietary factors can indeed exacerbate atopic dermatitis or cause dermatitis due to systemic contact dermatitis. In atopic dermatitis, dietary factors are more likely to cause an exacerbation among infants or children with moderate-to-severe atopic dermatitis relative to other populations. Foods may trigger rapid, immunoglobulin E-mediated hypersensitivity reactions or may lead to late eczematous reactions. While immediate reactions occur within minutes to hours of food exposure, late eczematous reactions may occur anywhere from hours to two days later. Screening methods, such as food allergen-specific serum immunoglobulin E tests or skin prick tests, can identify sensitization to specific foods, but a diagnosis of food allergy requires specific signs and symptoms that occur reproducibly upon food exposure. Many patients who are sensitized will not develop clinical findings upon food exposure; therefore, these tests may result in false-positive tests for food allergy. This is why the gold standard for diagnosis remains the double-blind, placebo-controlled food challenge. In another condition, systemic contact dermatitis, ingestion of a specific food can actually cause dermatitis. Systemic contact dermatitis is a distinct T-cell mediated immunological reaction in which dietary exposure to specific allergens results in dermatitis. Balsam of Peru and nickel are well-known causes of systemic contact dermatitis, and reports have implicated multiple other allergens. This review seeks to increase awareness of important food allergens, elucidate their relationship with atopic dermatitis and systemic contact dermatitis, and review available diagnostic and treatment strategies. PMID:24688624
Patch Test Negative Generalized Dermatitis.
Spiker, Alison; Mowad, Christen
2016-01-01
Allergic contact dermatitis is a common condition in dermatology. Patch testing is the criterion standard for diagnosis. However, dermatitis is not always caused by an allergen, and patch testing does not identify a culprit in every patient. Generalized dermatitis, defined as eczematous dermatitis affecting greater than 3 body sites, is often encountered in dermatology practice, especially patch test referral centers. Management for patients with generalized dermatitis who are patch test negative is challenging. The purpose of this article is to outline an approach to this challenging scenario and summarize the paucity of existing literature on patch test negative generalized dermatitis.
... ulcers; Ulcers - venous; Venous ulcer; Venous insufficiency - stasis dermatitis; Vein - stasis dermatitis ... veins. Some people with venous insufficiency develop stasis dermatitis. Blood pools in the veins of the lower ...
... dermatitis URL of this page: //medlineplus.gov/ency/article/001455.htm Perioral dermatitis To use the sharing features on this page, please enable JavaScript. Perioral dermatitis is a skin disorder resembling acne ...
Use of aromatherapy products and increased risk of hand dermatitis in massage therapists.
Crawford, Glen H; Katz, Kenneth A; Ellis, Elliot; James, William D
2004-08-01
To determine the 12-month prevalence of hand dermatitis among massage therapists, to investigate a potential association between hand dermatitis and the use of aromatherapy products, and to study potential associations with other known risk factors for hand dermatitis. Mailed survey. Philadelphia, Pa. Members of a national massage therapy organization who live in the greater Philadelphia region. Self-reported and symptom-based prevalences of hand dermatitis. The number of respondents was 350 (57%). The 12-month prevalence of hand dermatitis in subjects was 15% by self-reported criteria and 23% by a symptom-based method. In multivariate analysis, statistically significant independent risk factors for self-reported hand dermatitis included use of aromatherapy products in massage oils, lotions, or creams (odds ratio, 3.27; 95% confidence interval, 1.53-7.02; P =.002) and history of atopic dermatitis (odds ratio, 8.06; 95% confidence interval, 3.39-19.17; P<.001). The prevalence of hand dermatitis in massage therapists is high. Significant independent risk factors include use of aromatherapy products in massage oils, creams, or lotions and history of atopic dermatitis.
Houle, Marie-Claude; Holness, D Linn; Dekoven, Joel; Skotnicki, Sandy
2012-01-01
Allergic contact dermatitis (ACD) to epoxy resins is one of the major causes of occupationally induced ACD. Testing of custom epoxy materials from the workplace is often performed to diagnose ACD. The objective of this study was to investigate the additive value of patch testing custom-made epoxy materials. We retrospectively analyzed outcomes of 24 patients who were tested to custom epoxy resin materials between January 2002 and July 2011. For 11 patients (46%), the testing of their materials from work had no additional value (negative results). For 13 patients (54%), there was an additional value of testing custom allergens. Of those, 7 patients (54%) had positive reactions to custom epoxy materials that reinforced the test results found with the commercially available allergens, and 6 (46%) patients had positive reactions only to custom epoxy materials. Therefore, for 6 patients (25%), there was a definite additive value of testing custom epoxy materials because the allergy was discovered with custom testing and not with the commercially available allergens. Because of the high percentage (54%) of patients with additive value of patch testing custom epoxy materials, we think that the inclusion of actual workplace epoxy materials should be strongly considered when patch testing patients with occupational epoxy exposure.
Setting Occupational Exposure Limits for Chemical Allergens—Understanding the Challenges
Dotson, G. S.; Maier, A.; Siegel, P. D.; Anderson, S. E.; Green, B. J.; Stefaniak, A. B.; Codispoti, C. D.; Kimber, I.
2015-01-01
Chemical allergens represent a significant health burden in the workplace. Exposures to such chemicals can cause the onset of a diverse group of adverse health effects triggered by immune-mediated responses. Common responses associated with workplace exposures to low molecular weight (LMW) chemical allergens range from allergic contact dermatitis to life-threatening cases of asthma. Establishing occupational exposure limits (OELs) for chemical allergens presents numerous difficulties for occupational hygiene professionals. Few OELs have been developed for LMW allergens because of the unique biological mechanisms that govern the immune-mediated responses. The purpose of this article is to explore the primary challenges confronting the establishment of OELs for LMW allergens. Specific topics include: (1) understanding the biology of LMW chemical allergies as it applies to setting OELs; (2) selecting the appropriate immune-mediated response (i.e., sensitization versus elicitation); (3) characterizing the dose (concentration)-response relationship of immune-mediated responses; (4) determining the impact of temporal exposure patterns (i.e., cumulative versus acute exposures); and (5) understanding the role of individual susceptibility and exposure route. Additional information is presented on the importance of using alternative exposure recommendations and risk management practices, including medical surveillance, to aid in protecting workers from exposures to LMW allergens when OELs cannot be established. PMID:26583909
Occupational asthma due to turpentine in art painter--case report.
Dudek, Wojciech; Wittczak, Tomasz; Swierczyńska-Machura, Dominika; Walusiak-Skorupa, Jolanta; Pałczyński, Cezary
2009-01-01
Turpentine is a fluid obtained by distillation of wood resins containing mixture of terpens. It can act as an irritant and sensitiser. Most common health problem among workers exposed to turpentine is contact dermatitis. Little is know about turpentine to cause type I hypersensitivity reaction. We present a case of a 27-year old art painter using turpentine as a thinner for oil-based paints. She developed asthmatic reactions after 5 years of working with turpentine. A number of clinical procedures were performed, including clinical examination, routine laboratory tests, total serum IgE, skin prick tests to common aeroallergens, metal salts, oil-based paints and balsamic turpentine, resting spirometry test, histamine challenge, and a single-blind, placebo-controlled specific inhalation challenge with balsamic turpentine. Clinical findings and laboratory test results were normal but a significant bronchial hyperreactivity was found. During the specific challenge, dyspnoea and decreased forced expiratory volume (FEV1) were observed in late phase of asthmatic reaction. An increased proportion of eosinophils in induced sputum could also be noted 24 h after the challenge. Positive clinical response to the specific challenge as well as the morphological changes found in induced sputum served as the basis for diagnosing occupational asthma. To our knowledge, this is the first well-documented case of turpentine-induced occupational asthma.
Chromium released from leather - II: the importance of environmental parameters.
Mathiason, Frederik; Lidén, Carola; Hedberg, Yolanda S
2015-05-01
Approximately 1-3% of the adult population in Europe are allergic to chromium (Cr). A new restriction in Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) based on the ISO 17075 standard has recently been adopted in the EU to limit Cr(VI) in consumer and occupational leather products to < 3 mg/kg. To investigate the influence of storage conditions [relative humidity, temperature, ultraviolet (UV) irradiation, and duration] on Cr release, and to assess several parameters relevant for occupational exposure (repeated exposure, wear, alkaline solutions, and sequential wet and dry exposures). A leather of relevance for work gloves was investigated for its release of Cr(III) and Cr(VI) under these different experimental conditions. Relative humidity (water content in leather) during storage prior to Cr extraction was the single most important parameter. Cr(VI) levels could vary from non-detectable to levels significantly exceeding the restriction limit, depending on the relative humidity. Leather contact with alkaline solution and UV irradiation during storage could increase the Cr(VI) levels in subsequent extractions. The amount of Cr(VI) in leather is not an intrinsic property, but is influenced by environmental conditions of relevance for occupations and skin exposure. © 2015 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.
... long time. True False False: This is called contact dermatitis, which is often due to nickel. Question 9 ... dermatitis. True False True: This is called Irritant contact dermatitis which is more common than allergic contact dermatitis. ...
Stoma dermatitis: prevalent but often overlooked.
Agarwal, Shilpa; Ehrlich, Alison
2010-01-01
Peristomal dermatoses commonly afflict the area around stoma openings in ostomy patients. These complications, however, are often unreported by patients and remain untreated for years, thus affecting maintenance and recovery from the surgery. These dermatoses can have chemical, mechanical, irritant, bacterial, immunologic, or disease-related etiologies. Examples of common forms of dermatitis that occur peristomally include fecal or urine irritant contact dermatitis, chronic papillomatous dermatitis, mechanical dermatitis, and allergic contact dermatitis. This article summarizes various skin irritations that can occur after an ostomy and also reviews previously published reports of peristomal allergic contact dermatitis. In addition, the clinical importance of identifying these dermatoses (most important, their effects on the patient's quality of life), risk factors for the skin irritations, the importance of patch testing, treatment of stoma dermatitis, and the importance of patient education and patient-doctor communication are also discussed.
Cohen, Philip R
2014-01-01
Follicular contact dermatitis clinically presents as individual papules that include a central hair follicle. Pathologic features involve the follicle and the surrounding dermis: spongiosis and vesicle formation of the follicular epithelium associated with perifollicular and perivascular lymphocytic inflammation. Using the PubMed database, an extensive literature search was performed on follicular contact dermatitis and neomycin. Relevant papers were reviewed and the clinical and pathologic features, the associated chemicals (including a more detailed description of neomycin), the hypothesized pathogenesis, and the management of follicular contact dermatitis were described. Several agents-either as allergens or irritants-have been reported to elicit follicular contact dermatitis. Several hypotheses have been suggested for the selective involvement of the follicles in follicular contact dermatitis: patient allergenicity, characteristics of the agent, vehicle containing the agent, application of the agent, and external factors. The differential diagnosis of follicular contact dermatitis includes not only recurrent infundibulofolliculitis, but also drug eruption, mite infestation, viral infection, and dermatoses that affect hair follicles. The primary therapeutic intervention for follicular contact dermatitis is withdrawal of the causative agent; treatment with a topical corticosteroid preparation may also promote resolution of the dermatitis. In conclusion, follicular contact dermatitis may be secondary to allergens or irritants; topical antibiotics, including neomycin, may cause this condition. Several factors may account for the selective involvement of the hair follicle in this condition. Treatment of the dermatitis requires withdrawal of the associated topical agent; in addition, topical corticosteroids may be helpful to promote resolution of lesions. PMID:25516854
Occupation and work-related ill-health in UK construction workers.
Stocks, S J; Turner, S; McNamee, R; Carder, M; Hussey, L; Agius, R M
2011-09-01
Construction workers are at increased risk of work-related ill-health (WRI) worldwide. To compare the incidence of medically reported WRI in occupations within the UK construction industry according to job title. We calculated standardized incidence rate ratios (SRRs) using WRI cases for individual job titles returned to The Health and Occupation Reporting network by clinical specialists and UK population denominators. We counted frequencies of reported causal exposures or tasks reported by clinical specialists, occupational physicians and general practitioners. We found significantly increased incidence of WRI compared with other workers in the same major Standard Occupational Classification, i.e. workers with similar levels of qualifications, training, skills and experience, for skin neoplasia in roofers (SRR 6.3; 95% CI: 3.1-13.1), painters and decorators (2.1; 95% CI: 1.2-3.6) and labourers in building and woodworking trades (labourers, 6.6; 95% CI: 3.2-13.2); contact dermatitis in metal workers (1.4; 95% CI: 1.1-1.7) and labourers (1.6; 95% CI: 1.1-2.3); asthma in welders (3.8; 95% CI: 2.8-5.0); musculoskeletal disorders in welders (1.7; 95% CI: 1.1-2.8), road construction operatives (6.1; 95% CI: 3.8-9.6) and labourers (2.5; 95% CI: 1.7-3.7); long latency respiratory disease (mesothelioma, pneumoconiosis, lung cancer, non-malignant pleural disease) in pipe fitters (4.5; 95% CI: 3.2-6.2), electrical workers (2.7; 95% CI: 2.4-3.2), plumbing and heating engineers (2.3; 95% CI: 1.9-2.7), carpenters and joiners (2.7; 95% CI: 2.3-3.1), scaffolders (12; 95% CI: 8-18) and labourers (3.3; 95% CI: 2.6-4.1). UK construction industry workers have significantly increased risk of WRI. These data in individual construction occupations can be used to inform appropriate targeting of occupational health resources.
Kilo, Sonja; Zonnur, Nina; Uter, Wolfgang; Göen, Thomas; Drexler, Hans
2015-10-01
Occupational exposure to carbon disulfide (CS2) leads to inhalative and dermal uptake and thereby to internal exposure. In order to prevent occupational contact dermatitis, gloves and skin protection creams are used at the workplace. The aim of the study was the evaluation of the influence of personal skin protection and irritation on the internal exposure to CS2 of employees in the viscose industry. One hundred and eighty-two male CS2-exposed employees were included in the study and were examined regarding working conditions, use of personal protective measures und skin status. Personal air monitoring and biological monitoring was performed and the 'relative internal exposure' (RIE, internal exposure in relation to external exposure) calculated. A multiple regression analysis calculated the influence of skin protection and irritation on CS2 uptake. Usage of skin protection creams and gloves (and both in combination) while working was associated with a significantly higher RIE indicating a higher dermal penetration of CS2. Equally, irritated skin and younger age was associated with a higher internal burden. Gloves and skin protection creams are useful for preventing occupational skin diseases. However, when handling skin-resorptive substances like CS2, they can increase internal exposure or skin irritation. Therefore, we recommend the careful consideration of benefits and risks of protective creams and gloves at the workplace. © The Author 2015. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.
Hazards of domestic pets. Ringworm and other skin conditions.
Keep, J M
1977-12-01
Domestic pets may be responsible for a number of skin eruptions in man. Whilst ringworm due to Microsporum canis is one of the most common of these conditions in this country, trichophyton infection, flea bite dermatitis, cheyletiella dermatitis, canine scabies and traumatic dermatitis are by no means rare. Less frequently encountered conditions include creeping eruption, favus, fowl-mite dermatitis and allergic dermatitis.
Acute radiation dermatitis in breast cancer patients: challenges and solutions
Kole, Adam J; Kole, Lauren; Moran, Meena S
2017-01-01
Nearly all women who receive radiotherapy (RT) for breast cancer experience some degree of radiation dermatitis. However, evidence describing the appropriate management of radiation dermatitis is often lacking or contradictory. Here, we summarize the available literature regarding radiation dermatitis causes, the presentation and timing of symptoms, methods for dermatitis assessment and prevention, and review evidence-based management strategies. PMID:28503074
Biro, Kathrin; Thaçi, Diamant; Ochsendorf, Falk R; Kaufmann, Roland; Boehncke, Wolf-Henning
2003-08-01
Dexpanthenol is popular in treating various dermatoses and in skin care, but few controlled clinical trials have been performed. We investigated the efficacy of dexpanthenol in skin protection against irritation in a randomized, prospective, double-blind, placebo-controlled study. 25 healthy volunteers (age 18-45 years) were treated for the inner aspect of both forearms with either Bepanthol Handbalsam containing 5% dexpanthenol or placebo x2 daily for 26 days. From day 15-22, sodium lauryl sulfate (SLS) 2% was applied to these areas x2 daily. Documentation comprised sebumetry, corneometry, pH value and clinical appearance (photographs). 21 volunteers completed the study, 3 were excluded because of non-compliance and 1 experienced a non-study-related, severe, adverse event. Only corneometry yielded a statistically significant difference, with decreased values following SLS challenge at the placebo sites (P < 0.05). Intraindividual comparisons showed superior results at the dexpanthenol-treated sites in 11 cases and in only 1 case at the placebo site. 6 volunteers experienced an irritant contact dermatitis, with more severe symptoms at the placebo site in 5 cases. In conclusion, dexpanthenol exhibits protective effects against skin irritation. The initiation of a study to evaluate the efficacy of dexpanthenol in preventing irritant occupational contact dermatitis under real workplace conditions is validated.
Shvartsbeyn, Marianna; Tuchinda, Papapit; Gaitens, Joanna; Squibb, Katherine S; McDiarmid, Melissa A; Gaspari, Anthony A
2011-01-01
The Depleted Uranium Follow-Up Program is a clinical surveillance program run by the Baltimore Veterans Affairs Medical Center since 1993 for veterans of the Gulf and Iraqi wars who were exposed to depleted uranium (DU) as a result of "friendly-fire" incidents. In 2009, 40 veterans from this cohort were screened for skin reactivity to metals by patch-testing with extended metal series and uranyl acetate (0.25%, 2.5%, and 25%). A control arm comprised 46 patients without any known occupational exposures to DU who were seen at the University of Maryland Dermatology Clinic for evaluation of allergic contact dermatitis. Excluding irritant reactions, no patch-test reactions to uranyl acetate were observed in the participants. Irritant reactions to DU were more common in the clinic cohort, likely reflective of the demographic differences between the two arms of the study. Biologic monitoring of urine uranium concentrations in the DU program participants with 24-hour urine samples showed evidence of percutaneous uranium absorption from the skin patches. We conclude that dermatitis observed in a subset of the veterans was unrelated to their military DU exposure. Our data suggest that future studies of skin testing with uranyl acetate should utilize 0.25%, the least irritating concentration.
van Os-Medendorp, Harmieke; Appelman-Noordermeer, Simone; Bruijnzeel-Koomen, Carla; de Bruin-Weller, Marjolein
2015-03-27
Little is known about the prevalence of sick leave due to atopic dermatitis (AD). The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify influencing factors. A cross-sectional study was carried out in adult patients with AD. sick leave during the two-week and one-year periods, socio-demographic characteristics, disease severity, quality of life and socio-occupational factors. Logistic regression analyses were used to determine influencing factors on sick leave over the two-week period. In total, 253 patients were included; 12% of the patients had to take sick leave in the last two weeks due to AD and 42% in the past year. A higher level of symptom interference (OR 1.26; 95% CI 1.13-1.40) or perfectionism/diligence (OR 0.90; 95% CI 0.83-0.96) may respectively increase or decrease the number of sick leave days. Sick leave in patients with AD is a common problem and symptom interference and perfectionism/diligence appeared to influence it. Novel approaches are needed to deal with symptoms at work or school to reduce the amount of sick leave due to AD.
Potential immunotoxic effects of trichloroethylene-induced IV allergic reaction in renal impairment
Yu, Jun-Feng; Feng, Yan-Yan
2017-01-01
Trichloroethylene (TCE) is known to induce allergic contact dermatitis and subsequent occupational medicamentosa-like dermatitis (OMLD) with multi-system injuries, including liver, kidney, and skin injuries. However, the mechanisms underlying immune system dysfunction that result in organ injury have not yet been clearly elucidated. In the present study, we measured the levels of secreted cytokines by effect or T cells in TCE-treated guinea pigs to better understand the contribution of allergic disorders in renal injuries. We immunized guinea pigs with trichloroethylene using the Guinea Pig Maximization Test (GPMT) and scored the inflammation on the guinea pigs’ skin. The kidney function and ultra-structural changes in the kidneys were detected using biochemical methods and electron microscopy. The deposition of cytokines was determined using immunohistochemistry. The sensitization rate was 63.16% in the TCE-sensitized groups. The electron microscopy results showed tubular epithelial cell mitochondrial swelling, vacuolar degeneration, and atrophy of the microvillus in the sensitized groups. A high degree of cytokine deposition was observed in the renal tubular proximal epithelial cells in the TCE-sensitized groups. As observed in this study, the variation in the level of immune system activation not only indicates that TCE can largely magnify the immune reaction but also suggests a potential role of immune dysfunction in renal impairment. PMID:28867961
European Surveillance System on Contact Allergies (ESSCA): polysensitization, 2009-2014.
Dittmar, Daan; Uter, Wolfgang; Bauer, Andrea; Fortina, Ana B; Bircher, Andreas J; Czarnecka-Operacz, Magdalena; Dugonik, Aleksandra; Elsner, Peter; Gallo, Rosella; Ghaffar, Sharizan A; Giménez-Arnau, Anna; Johnston, Graham A; Kręcisz, Beata; Filon, Francesca L; Rustemeyer, Thomas; Sadowska-Przytocka, Anna; Sánchez-Pérez, Javier; Schnuch, Axel; Simon, Dagmar; Spiewak, Radoslaw; Spring, Philipp; Corradin, Maria T; Valiukevičienė, Skaidra; Vok, Marko; Weisshaar, Elke; Wilkinson, Mark; Schuttelaar, Marie L
2018-06-01
Polysensitization, defined as being allergic to three or more haptens from the European baseline series, is considered to reflect increased susceptibility to developing a contact allergy, and is likely to be associated with an impaired quality of life. To evaluate the prevalences of polysensitization across Europe and to analyse factors associated with polysensitization. Patch test data collected by the European Surveillance System on Contact Allergies (ESSCA; www.essca-dc.org) in consecutively patch tested patients from January 2009 to December 2014, comprising 11 countries and 57 departments, were retrospectively analysed. A total of 86 416 patients were available for analysis, showing a standardized prevalence of polysensitization of 7.02%, ranging from 12.7% (Austria) to 4.6% (Italy). Allergen pairs with the strongest association are reported for the total population, for South Europe, and for North/Central Europe. Overall, polysensitized patients showed a higher percentage of extreme (+++) positive patch test reactions than oligosensitized patients. Female sex, occupational dermatitis and age > 40 years were risk factors for polysensitization. The varying prevalences of polysensitization across Europe most likely reflect differences in patient characteristics and referral patterns between departments. Known risk factors for polysensitization are confirmed in a European dermatitis population. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Risk factors associated with sensitization to hydroxyisohexyl 3-cyclohexene carboxaldehyde.
Uter, Wolfgang; Geier, Johannes; Schnuch, Axel; Gefeller, Olaf
2013-08-01
Hydroxyisohexyl 3-cyclohexene carboxaldehyde (HICC) is a synthetic fragrance chemical and an important contact allergen, at least in Europe. Despite this importance, little is known about risk factors associated with this allergen. To examine factors from the history and clinical presentation of patch tested patients associated with HICC sensitization. Contact allergy surveillance data of 95 637 patients collected by the Information Network of Departments of Dermatology (IVDK, www.ivkd.org) in 2002-2011 were analysed. Point and interval estimates of the relative risk were derived from multifactorial logistic regression modelling. The overall prevalence of HICC sensitization was 2.24%. The strongest risk factors were polysensitization and dermatitis of the axillae, followed by dermatitis at other sites. No consistent and significant time trend was observed in this analysis. As compared with the youngest patients, the odds of HICC sensitization increased approximately three-fold in the 52-67-year age group, and strongly declined with further increasing age. The risk pattern with regard to age and affected anatomical site differed from that observed with other fragrance screening allergens. Cosmetic exposure, as broadly defined here, was a stronger and more prevalent individual risk factor than occupational exposure. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
North American contact dermatitis group patch test results: 2011-2012.
Warshaw, Erin M; Maibach, Howard I; Taylor, James S; Sasseville, Denis; DeKoven, Joel G; Zirwas, Matthew J; Fransway, Anthony F; Mathias, C G Toby; Zug, Kathryn A; DeLeo, Vincent A; Fowler, Joseph F; Marks, James G; Pratt, Melanie D; Storrs, Frances J; Belsito, Donald V
2015-01-01
Patch testing is an important diagnostic tool for assessment of allergic contact dermatitis (ACD). This study documents the North American Contact Dermatitis Group (NACDG) patch-testing results from January 1, 2011, to December 31, 2012. At 12 centers in North America, patients were tested in a standardized manner with a series of 70 allergens. Data were manually verified and entered into a central database. Descriptive frequencies were calculated, and trends analyzed using χ statistics. Four thousand two hundred thirty-eight patients were tested; of these, 2705 patients (63.8%) had at least 1 positive reaction, and 2029 (48.0%) were ultimately determined to have a primary diagnosis of ACD. Four hundred eight patients (9.6%) had occupationally related skin disease. There were 7532 positive allergic reactions. As compared with previous reporting periods (2009-2010 and 2000-2010), positive reaction rates statistically increased for 6 allergens: methylchloroisothiazolinone/methylisothiazolinone (5.0%; risk ratios [RRs]: 2.01 [1.60-2.52], 1.87 [1.61-2.18]), lanolin alcohol (4.6%; RRs 1.83 [1.45-2.30], 2.10 [1.79-2.47]), cinnamic aldehyde (3.9%; 1.69 [1.32-2.15], 1.53 [1.28-1.82]), glutaral (1.5%; 1.67 [1.13-2.48], 1.31 [1.00-1.71]), paraben mix (1.4%; 1.77 [1.16-2.69], 1.44 [1.09-1.92]), and fragrance mix I (12.1%; RRs 1.42 [1.25-1.61], 1.24 [1.14-1.36]). Compared with the previous decade, positivity rates for all formaldehyde-releasing preservatives significantly decreased (formaldehyde 6.6%; RR, 0.82 [0.73, 0.93]; quaternium-15 6.4% RR 0.75 [0.66, 0.85]; diazolidinyl urea 2.1%; RR, 0.67 [0.54, 0.84]; imidazolidinyl urea 1.6%, 0.60 [0.47, 0.77]; bronopol 1.6%; RR, 0.60 [0.46, 0.77]; DMDM hydantoin 1.6%; RR, 0.59 [0.54, 0.84]). Approximately a quarter of patients had at least 1 relevant allergic reaction to a non-NACDG allergen. In addition, approximately one-fourth to one-third of reactions detected by NACDG allergens would have been hypothetically missed by T.R.U.E. TEST (SmartPractice Denmark, Hillerød, Denmark). These data document the beginning of the epidemic of sensitivity to methylisothiazolinones in North America, which has been well documented in Europe. Patch testing with allergens beyond a standard screening tray is necessary for complete evaluation of occupational and nonoccupational ACD.
Cressey, Brienne D; Belum, Viswanath R; Scheinman, Pamela; Silvestri, Dianne; McEntee, Nancy; Livingston, Vashti; Lacouture, Mario E; Zippin, Jonathan H
2017-01-01
Peristomal dermatitis is a common complication for the >700 000 patients in the United States with an ostomy. The role of stoma skin care products in peristomal dermatitis is poorly understood. To evaluate stoma skin care products as a cause of peristomal dermatitis. A retrospective chart review of patients with peristomal dermatitis at four academic hospitals from January 2010 to March 2014 was performed. Patient demographics, clinical information and use test and patch test results were documented. Eighteen patients identified as having peristomal dermatitis were tested. Twelve of these had peristomal contact dermatitis. We identified numerous stoma skin care products as triggers of irritant and/or allergic contact dermatitis. The most common stoma skin care product used and/or involved in dermatitis was Cavilon™ No Sting Barrier Film. Our data support a paradigm shift whereby healthcare workers treating patients with peristomal dermatitis, which is currently considered to be a reaction mainly to bodily fluids, must consider those products used to protect the skin as potential triggers for this disease. Therefore, patients with peristomal dermatitis should be tested with their stoma skin care agents to determine the need for removal or change of these products. Additionally, full ingredient labelling by manufacturers would help identify new allergens and irritants. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Complete prevention of radiation-induced dermatitis using topical adrenergic vasoconstrictors.
Fahl, William E
2016-12-01
Radiation dermatitis is a commonly occurring, painful, side effect of cancer radiotherapy that causes some patients to withdraw from the radiotherapy course. Our goal was to test and optimize topical application of an adrenergic vasoconstrictor to rat skin in a preclinical test to prevent radiation-induced dermatitis. A radiation dermatitis assay was developed in which 17.2 Gy to a 1.5 × 3.0 cm rectangle on the clipped dorsal back of rats yielded Grade 3 radiation dermatitis over the irradiated area 13 days later. Single, topical applications of each of three adrenergic vasoconstrictors, epinephrine, norepinephrine, or phenylephrine, in various vehicle formulations, doses, and application schedules, were tested to determine their efficacy in preventing radiation dermatitis. Each of the three adrenergic agonists conferred 100 % prevention of radiation dermatitis in linear, dose-dependent manners and their EC 50 potencies in preventing radiation dermatitis correlated well with their individual K d association constants for binding to mammalian α-adrenergic receptors. Topical vasoconstrictor application as little as 3-12 min before irradiation gave 80-100 % prevention, respectively, of radiation dermatitis. There was a strong correlation between the extent (0-100 %) of skin blanch present in skin immediately before irradiation and prevention of radiation dermatitis scored 13 days after irradiation. The data presented here demonstrate that topical application of adrenergic vasoconstrictors to rat skin before a large, 17.2 Gy, radiation insult confers 100 % protection against radiation dermatitis and support ongoing clinical trials and commercial development of a vasoconstrictor-based product to prevent radiotherapy-induced dermatitis.
London-born black Caribbean children are at increased risk of atopic dermatitis.
Williams, H C; Pembroke, A C; Forsdyke, H; Boodoo, G; Hay, R J; Burney, P G
1995-02-01
Previous reports suggest that atopic dermatitis is more common in black Caribbean children born in the United Kingdom than in white children. It is unclear whether these differences are caused by selection bias or variations in the use of the word "eczema" in the groups studied. Our objective was to explore ethnic group differences in the prevalence of atopic dermatitis in London schoolchildren. A cross-sectional prevalence survey of 693 junior school children in three schools was performed. Atopic dermatitis was defined in three ways: (1) by a dermatologist, (2) by visible flexural dermatitis as recorded by an independent observer, and (3) by a history of flexural dermatitis according to the child's parents. The prevalence of atopic dermatitis according to examination by a dermatologist was 16.3% in black Caribbean children and 8.7% in white children. This increased risk was present for different methods of defining of a atopic dermatitis and persisted after adjustment for potential confounders. London-born black Caribbean children appear to be at an increased risk of having atopic dermatitis.
Ehrlich, Emily; Bunn, Terry; Kanotra, Sarojini; Fussman, Chris; Rosenman, Kenneth D.
2016-01-01
Background The US employer-based surveillance system for work-related health conditions underestimates the prevalence of work-related dermatitis. Objective The authors sought to utilize information from workers to improve the accuracy of prevalence estimates for work-related dermatitis. Methods Three state health departments included questions in the 2011 Behavioral Risk Factor Surveillance System survey designed to ascertain the prevalence of dermatitis in the working population, as well as healthcare experiences, personal perceptions of work-relatedness, and job changes associated with dermatitis. Results The percentage of working respondents who reported receiving a clinician’s opinion that their dermatitis was work-related was between 3.8% and 10.2%. When patients’ perceptions were considered, the work-related dermatitis prevalence estimate increased to between 12.9% and 17.6%. Conclusions Including patients’ perceptions of work-relatedness produced a larger prevalence estimate for work-related dermatitis than the previously published estimate of 5.6%, which included only those cases of dermatitis attributed to work by healthcare professionals. PMID:24619601
Milia after allergic contact dermatitis from poison ivy: two cases.
Berk, David R; Hurt, Mark A; Reese, Lester T; Wagner, Laura; Bayliss, Susan J
2010-01-01
Milia have rarely been reported as a complication of severe allergic contact dermatitis. To our knowledge, milia have not previously been associated with poison ivy dermatitis. We present two cases of milia after allergic contact dermatitis to poison ivy.
Battlefield Acquired Immunogenicity to Metals Affects Orthopedic Implant Outcome
2013-10-01
WJ. Nickel, cobalt and chromium in consumer products: a role in allergic contact dermatitis ? Contact Dermatitis 1993;28:15-25. (13) Cramers M...of 14 (14) Fisher AA. Allergic dermatitis presumably due to metallic foreign bodies containing nickel or cobalt. Current Contact News 1977;19...metals, and a case of allergic contact dermatitis from stainless steel. Contact Dermatitis 1994;31:299-303. (29) Haudrechy P, Foussereau J, Mantout B
A Rare Case of Oestrogen Dermatitis.
Bourgeault, Emilie; Bujold, Janie; Doucet, Marie-Eve
Oestrogen dermatitis is a rare disorder characterised by cyclical eruptions in association with a woman's menstrual cycle. A 43-year-old woman with an 8-year history of cyclical inguinal dermatitis, with a negative patch test, was tested with intradermal progesterone and oestrogen. Intradermal testing was positive for oestrogen only. In a female patient with cyclical dermatitis, it is important to consider oestrogen or progesterone dermatitis in the differential diagnosis.
Seborrheic dermatitis: an update.
Bukvić Mokos, Zrinka; Kralj, Martina; Basta-Juzbašić, Aleksandra; Lakoš Jukić, Ines
2012-01-01
Seborrheic dermatitis is a chronic relapsing inflammatory skin disorder clinically characterized by scaling and poorly defined erythematous patches. The prevalence of adult seborrheic dermatitis is estimated at 5%. Although the exact cause of seborrheic dermatitis has yet to be understood, Malassezia yeasts, hormones (androgens), sebum levels and immune response are known to play important roles in its development. Additional factors including drugs, winter temperatures and stress may exacerbate seborrheic dermatitis. A variety of treatment modalities are available, including antifungal agents, topical low-potency steroids and calcineurin inhibitors (immunomodulators). This review summarizes current knowledge on the etiopathogenesis and therapy of adult seborrheic dermatitis.
Brans, Richard; Kolomanski, Katarzyna; Mentzel, Franziska; Vollmer, Ulrike; Kaup, Olaf; John, Swen Malte
2016-10-01
To evaluate the prevalence of colonisation with methicillin-resistant Staphylococcus aureus (MRSA), associated factors and the effectiveness of decolonisation procedures among nurses with occupational skin diseases (OSD). In a retrospective cohort study, the medical records of 319 nurses from Germany who were screened consecutively for MRSA when participating in a tertiary individual prevention programme (TIP) for severe OSD between July 2009 and December 2014 were evaluated. 90.3% of nurses with severe OSD suffered from hand eczema. 43 were colonised with MRSA on admission (13.5%), mainly in the nose (n=35, 81.4%). However, the hands were affected in more than half of the MRSA carriers (n=24, 55.8%). Risk factors for MRSA colonisation were atopic skin diathesis (OR 2.01, 95% CI 1.03 to 3.92, p=0.049) and presence of atopic dermatitis on other body parts than the hands (OR 4.33, 95% CI 2.23 to 8.43, p<0.001). Hand eczema was significantly more severe in MRSA carriers than in non-carriers (OR 1.23, 95% CI 1.10 to 1.37, p<0.001) and showed a higher prevalence of vesicles, erosions or fissures. MRSA eradication was successful in 67.4% after the first attempt. Nurses with OSD have a twofold to threefold higher prevalence of MRSA colonisation than what has been reported for point-prevalence screenings among healthcare workers in Germany. Atopic skin diathesis, atopic dermatitis and severe hand eczema are the main risk factors. Thus, prevention and treatment of OSD could be important elements in reduction of colonisation with MRSA among nurses and transmission to others. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
A study of morbidity pattern among iron and steel workers from an industry in central India.
Biswas, Manish J; Koparkar, Anil R; Joshi, Mohan P; Hajare, Shilpa T; Kasturwar, Nandakishor B
2014-01-01
Iron is the world's most commonly used metal and can usually be found with other elements in the form of steel. In this era of machines, it is the inevitable part in production of various materials like eyeglass frames, jet aircraft, the space shuttle, automobiles, and surgical instruments. Occupational factors make an important contribution to the global burden of disease, but the reliable data on occupational disease are much more difficult to obtain. Hence, the current study was carried out to find out the morbidity pattern among iron and steel workers. A cross-sectional study. was carried out after obtaining permission from Institutional Ethics Committee in an iron and steel factory. Worker's detailed information regarding profile was taken in pretested questionnaire format after obtaining the informed written consent and explaining the purpose of study. Workers were also interviewed regarding their years of job, job satisfaction, usage of protective devices, and history of injuries during work. Worker's detailed general and systemic examination was conducted. The overall prevalence of morbidities among the workers was 60%. It was observed that commonest morbidity in the workers was lumbago (musculoskeletal pain), that is, 33.25%which was more in Group B (49.73%) than Group A (18.78%), followed by occupational dermatitis (27%) which more common in Group A (33.33%) than Group B (19.79%). It was seen that occupation-related morbidities were more prevalent in Group A, i.e. Exposed group (P < 0.001). It was observed that occupation-related morbidities were more common in exposed group (EG) than that of nonexposed group (NEG) and the difference was found to be statistically significant (P < 0.001).
Risk factors and common contact allergens in facial allergic contact dermatitis patients.
Kasemsarn, Pranee; Iamphonrat, Thanawan; Boonchai, Waranya
2016-04-01
Facial dermatitis is commonly encountered in dermatologic practice. It is sometimes difficult to manage because its causative factors may be multiple and difficult to diagnose. This study was designed to identify the characteristics, patch test results, and final diagnoses of facial dermatitis patients who were referred to a contact dermatitis clinic and to identify factors associated with facial allergic contact dermatitis (ACD). We retrospectively reviewed case records of facial dermatitis patients who underwent patch testing at the clinic during the period from July 2006 to June 2011. Of the 891 patients patch-tested, 244 (27.4%) had facial dermatitis. Female patients were 9.1 times more predominant than male patients. The mean ± standard deviation age of patients was 37.3 ± 14.8 years. A total of 199 (81.6%) patients demonstrated at least one positive reaction to a patch test, 66.7% of which were clinically relevant. Allergic contact dermatitis was diagnosed in 45.5% of patients. Independent factors predisposing towards facial dermatitis were female sex, having a previous history of cosmetic allergy, a positive patch test reaction to hairdressing product-related allergens, and a positive allergic reaction to preservative allergens. The prevalence of facial dermatitis was 27.4%. Almost half of all patients with facial dermatitis demonstrated ACD. Factors associated with facial ACD were female gender, a history of cosmetic allergy, and positive patch test reactions to hairdressing product-related allergens and preservatives. © 2015 The International Society of Dermatology.
NASA Astrophysics Data System (ADS)
Kim, Manjae; Kim, Sewoong; Hwang, Minjoo; Kim, Jihun; Je, Minkyu; Jang, Jae Eun; Lee, Dong Hun; Hwang, Jae Youn
2017-02-01
To date, the incident rates of various skin diseases have increased due to hereditary and environmental factors including stress, irregular diet, pollution, etc. Among these skin diseases, seborrheic dermatitis and psoriasis are a chronic/relapsing dermatitis involving infection and temporary alopecia. However, they typically exhibit similar symptoms, thus resulting in difficulty in discrimination between them. To prevent their associated complications and appropriate treatments for them, it is crucial to discriminate between seborrheic dermatitis and psoriasis with high specificity and sensitivity and further continuously/quantitatively to monitor the skin lesions during their treatment at other locations besides a hospital. Thus, we here demonstrate a mobile multispectral imaging system connected to a smartphone for selfdiagnosis of seborrheic dermatitis and further discrimination between seborrheic dermatitis and psoriasis on the scalp, which is the more challenging case. Using the system developed, multispectral imaging and analysis of seborrheic dermatitis and psoriasis on the scalp was carried out. It was here found that the spectral signatures of seborrheic dermatitis and psoriasis were discernable and thus seborrheic dermatitis on the scalp could be distinguished from psoriasis by using the system. In particular, the smartphone-based multispectral imaging and analysis moreover offered better discrimination between seborrheic dermatitis and psoriasis than the RGB imaging and analysis. These results suggested that the multispectral imaging system based on a smartphone has the potential for self-diagnosis of seborrheic dermatitis with high portability and specificity.
[Type IV contact allergies in the food processing industry: an update].
Bauer, A; Schubert, S; Geier, J; Mahler, V
2018-06-01
The food sector is one of the high-risk areas for occupational irritative and allergic contact eczema. The present work provides an overview of the main allergens as well as sensitization frequencies and risk in various food industry occupations. The literature on type IV sensitization in the food sector is summarized. The relative risk of developing a work-related eczema in food processing is increased by more than 3 times. The comparison group was calculated on the basis of the proportion of documented cases in the IVDK (Informationsverbund Dermatologischer Kliniken) network per 100,000 working persons in relation to the average of the years 2005 and 2010. For this purpose, the average risk of all patients was set as reference to 1. Bakers, pastry chefs, cooks and meat and fish processors are mainly affected. In addition to irritant contact eczema, allergic contact eczema and protein contact dermatitis often occur. Leading haptens (main allergens) are rubber ingredients, but also disinfectants and compositae. Only a few contact allergens are responsible for the majority of job-relevant sensitizations in the food industry.
Allergic contact dermatitis from color film developers: clinical and histologic features.
Brancaccio, R R; Cockerell, C J; Belsito, D; Ostreicher, R
1993-05-01
We evaluated two patients with allergic contact dermatitis that resulted from exposure to color film developers. A lichenoid eruption developed in one patient, whereas an eruption more characteristic of an acute spongiotic dermatitis developed in the second patient. Histologic findings in the first case were those of a "lichenoid dermatitis" but with features distinct from classic lichen planus. The biopsy specimens from the second patient showed a subacute spongiotic process with a bandlike infiltrate suggestive of an evolving lichenoid process. Contact allergy to color developers may result in eruptions similar to lichen planus. This process appears to evolve from an acute spongiotic dermatitis in its early phase to a lichenoid dermatitis in fully developed and more chronic forms. Although the histologic features are those of a "lichenoid" dermatitis, some features, such as the presence of spongiosis, eosinophils, and a less intense inflammatory infiltrate, may enable distinction between lichenoid allergic contact dermatitis and true lichen planus. In addition, clinicopathologic correlation with patch test results should permit accurate diagnosis in most cases.
O'Neill, Jenna L; Chan, Yiong Huak; Rapp, Stephen R; Yosipovitch, Gil
2011-09-01
Differences in itch characteristics between different inflammatory dermatoses are not well described. The aim of this study was to assess differences in itch characteristics between patients with psoriasis and atopic dermatitis using a previously validated web-based questionnaire that was made available through the National Psoriasis Foundation and National Eczema Association for Science and Education websites. Participants rated frequency and intensity of itch, associated symptoms, itch descriptors, and effect of scratching. A total of 524 subjects with atopic dermatitis and 195 subjects with psoriasis completed the survey. Atopic dermatitis responders experienced more frequent and more intense itch. Associated sweating and heat sensation were also more common in atopic dermatitis. Scratching was considered pleasurable in both atopic dermatitis and psoriasis; pleasurability correlated weakly with itch intensity in atopic dermatitis. Psoriasis respondents reported higher embarrassment associated with itch. Itch sensation is experienced differently among patients with atopic dermatitis and psoriasis. Future therapeutic interventions may be developed to target these differences.
Elistratova, I V; Morozov, S G; Zakharova, I A; Tarasova, M V
2015-01-01
Aim of this work was to record the luminol-dependent spontaneous and induced chemiluminescence at the different stages of atopic dermatitis. Peripheral blood cells were obtained from adult patient with atopic dermatitis followed by the registration of luminol-dependent chemiluminescence on luminograph. Opsonized zymosan as well as yeasts Candida tropicalis have been used to induce the chemiluminescence. Spontaneous and induced chemiluminescence were slightly elevated at the mild atopic dermatitis but were decreased at the severe stage of disease. Statistically significant difference has been found between group with mild and severe atopic dermatitis, Skin contamination by yeasts Candida tropicalis causes the increased level of blood cells chemiluminescence at the first week of atopic relapse when the disease was mild. Severe stage of atopic dermatitis was coupled with statistically significant inhibition of both, spontaneous and induced chemiluminescence. Luminol-dependent chemiluminescence of peripheral blood cells from adult atopic dermatitis patients may be stimulated at the mild stage and suppressed at severe stage of atopic dermatitis.
Cohen, L M; Cohen, J L
1998-09-01
Erythema multiforme (EM) is a hypersensitivity reaction that occurs mainly after exposure to certain medications or in the setting of infection, most commonly that due to herpes simplex virus. Rare cases of EM have been reported after allergic contact dermatitis due to various substances. There has been one case in the literature of EM following Rhus contact dermatitis. We report three patients who developed EM after allergic contact dermatitis due to poison ivy. In all three patients, targetoid lesions developed primarily on the palms and soles, either after a brief course of prednisone or during its taper. Two of the patients have had more than one episode of EM after poison ivy dermatitis. Although EM has been described after allergic contact dermatitis due to a variety of antigens (nickel being the most common), there is only one report in the literature of EM following Rhus contact dermatitis. Given the prevalence of allergic contact dermatitis due to poison ivy, this may be an under-reported complication.
Grimalt, F; Romaguera, C; Vilaplana, J; Mascaro, J
1988-01-01
There are three types of hand dermatitis in housewives. The most usual are cured when housework is stopped. Another type is that of housewife contact dermatitis which appears on pre-existing endogenous lesions such as dyshidrosis or nummular eczema. The third form is housewife hand contact dermatitis which appears, or coexists with, localized endogenous lesions of the hands. The last two forms are not cured when housework is stopped. In some cases the three forms may coexist or appear one after another. It is not usual for a person suffering from typical flexural atopic dermatitis to present with one of the described three forms of hand dermatitis. Nevertheless, without having some relationship to atopic diathesis no woman could suffer from any of these three forms of dermatitis. In spite of the lack of analytical data, everyday clinical facts (one example being these different forms of housewife hand dermatitis) suggest the need to accept a subgroup of cutaneous atopic diathesis.
Contact Dermatitis in Pediatrics.
Pelletier, Janice L; Perez, Caroline; Jacob, Sharon E
2016-08-01
Contact dermatitis is an umbrella term that describes the skin's reaction to contacted noxious or allergenic substances. The two main categories of contact dermatitis are irritant type and allergic type. This review discusses the signs, symptoms, causes, and complications of contact dermatitis. It addresses the testing, treatment, and prevention of contact dermatitis. Proper management of contact dermatitis includes avoidance measures for susceptible children. Implementation of a nickel directive (regulating the use of nickel in jewelry and other products that come into contact with the skin) could further reduce exposure to the most common allergens in the pediatric population. [Pediatr Ann. 2016;45(8):e287-e292.]. Copyright 2016, SLACK Incorporated.
Toth, Anna M.; Bliss, Donna Z.; Savik, Kay; Wyman, Jean F.
2011-01-01
Perineal dermatitis is one of the main complications of incontinence and increases the cost of health care. The Minimum Data Set (MDS) contains data about factors associated with perineal dermatitis identified in a published conceptual model of perineal dermatitis. The purpose of this study was to determine the validity of MDS data related to perineal dermatitis risk factors by comparing them with data in nursing home chart records. Findings indicate that MDS items defining factors associated with perineal dermatitis were valid and supported use of the MDS in further investigation of a significant, costly, and understudied health problem of nursing home residents. PMID:18512629
Patch test reactions to metal salts in patients with different types of dermatitis.
Turčić, Petra; Marinović Kulišić, Sandra; Lipozenčić, Jasna
2013-01-01
Metal allergies can be a clinical problem, especially in atopic individuals. This study is unique and contributes with new knowledge in everyday life skin care of irritant and atopic dermatitis patients. The aim of the study was to determine the frequency of positive patch test reactions to metal contact allergens (potassium dichromate, cobalt chloride, nickel sulfate, white mercury precipitate) in patients diagnosed with allergic contact dermatitis, irritant contact dermatitis, and atopic dermatitis. Between 2007 and 2011, patch testing was performed in 2185 patients according to the International Contact Dermatitis Research Group technique. Study results showed statistically significant differences in patch test responses to 2 allergens, nickel sulfate (χ(2)=24.22; p<0.001) and cobalt chloride (χ(2)=22.72; p<0.001). Nickel sulfate was the most common allergen in allergic contact dermatitis and atopic dermatitis, while for irritant contact dermatitis the most common allergen was cobalt chloride. Among the 4 tested metal allergens, the most common and relevant was nickel sulfate (χ(2)=17.25; p<0.004), found in almost all study subjects. In conclusion, the increased awareness of allergens and their potential sources may help limit the use of these chemicals in consumer product manufacturing.
[A clinical analysis of 50 cases of medicament-like dermatitis due to trichloroethylene].
Xia, Li-hua; Huang, Han-lin; Kuang, Shou-ren; Liu, Hui-fang; Kong, Ling-zhen
2004-06-01
To investigate the clinical manifestations, complications and treatment of medicament-like dermatitis due to trichloroethylene (TCE), so as to provide basis for studying its etiology and mechanism. Fifty patients with dermatitis due to TCE from 1997 to 2000 were analysed retrospectively. The occurrence of the dermatitis was not parallel to TCE exposure levels, without significant dose-effect relationship. This disease could be caused by both inhalation and skin exposure. The latency period of TCE dermatitis ranged from 5 to 66 days, and the average was 31.5 d (Medium). The major clinical manifestations included skin lesions, fever, superficial lymph node swelling and liver dysfunction. Infection was the major complication. Glucocorticoid was effective for treatment of this disease. The clinical manifestations due to TCE exposure were similar to dermatitis medicamentosa. The major clinical types of TCE dermatitis included exfoliative dermatitis and erythema multiforme. The dermatitis is considered to be mediated by delayed-type (IV) hypersensitivity. The key factors to treat this disease successfully included the use of glucocorticoid in time with sufficient dose and full course, professional skin care, active treatment to protect the liver and to avoid infection.
T cell lymphomatoid contact dermatitis: a challenging case and review of the literature.
Knackstedt, Thomas J; Zug, Kathryn A
2015-02-01
Lymphomatoid contact dermatitis is a pseudolymphoma with clinical and histological features of allergic contact dermatitis and cutaneous T cell lymphoma. Incorrect diagnosis may lead to unnecessary testing, unnecessary treatment, or patient harm. The objective of this study is to present a case to demonstrate the diagnostic challenge and overlap between allergic contact dermatitis and cutaneous T cell lymphoma in a patient with lymphomatoid contact dermatitis caused by methylchoroisothiazolinone/methylisothiazolinone and paraben mix, and to review the existing literature in order to summarize the demographics, clinical features, allergens and treatments reported for lymphomatoid contact dermatitis. A search of major scientific databases was conducted for English-language articles reporting cases of lymphomatoid contact dermatitis or additional synonymous search headings. Nineteen articles with a total of 23 patients were analysed. Lymphomatoid contact dermatitis was more common in men, with an average age of 58.5 years. Fourteen unique allergens were identified and confirmed by patch testing. However, no single test or study was diagnostic of lymphomatoid contact dermatitis. Allergen avoidance was the most useful management tool, but selected patients required topical or systemic immunosuppression. In conclusion, without specific diagnostic features, evaluation for lymphomatoid contact dermatitis should include a thorough history and examination, patch testing, and biopsy with immunohistochemistry and clonality studies. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Simonsen, A B; Johansen, J D; Deleuran, M; Mortz, C G; Skov, L; Sommerlund, M
2018-03-01
Whether children with atopic dermatitis have an altered risk of contact allergy than children without atopic dermatitis is frequently debated and studies have been conflicting. Theoretically, the impaired skin barrier in atopic dermatitis (AD) facilitates the penetration of potential allergens and several authors have highlighted the risk of underestimating and overlooking contact allergy in children with atopic dermatitis. To determine the prevalence of contact allergy in Danish children with atopic dermatitis and explore the problem of unacknowledged allergies maintaining or aggravating the skin symptoms. In a cross-sectional study, 100 children and adolescents aged 5-17 years with a diagnosis of atopic dermatitis were patch tested with a paediatric series of 31 allergens. Thirty per cent of the children had at least one positive patch test reaction, and 17% had at least one contact allergy that was relevant to the current skin symptoms. The risk of contact allergy was significantly correlated to the severity of atopic dermatitis. Metals and components of topical skincare products were the most frequent sensitizers. Patch testing is relevant as a screening tool in the management of children with atopic dermatitis as they may have unacknowledged contact allergies contributing to or maintaining their skin symptoms. Children with atopic dermatitis seem to be at greater risk of sensitization to certain allergens including metals and components of skincare products. © 2017 European Academy of Dermatology and Venereology.
Economic Impact of Atopic Dermatitis in Korean Patients
Kim, Chulmin; Park, Kui Young; Ahn, Seohee; Kim, Dong Ha; Li, Kapsok; Kim, Do Won; Kim, Moon-Beom; Jo, Sun-Jin; Yim, Hyeon Woo
2015-01-01
Background Atopic dermatitis is a global public health concern owing to its increasing prevalence and socioeconomic burden. However, few studies have assessed the economic impact of atopic dermatitis in Korea. Objective We conducted a cost analysis of atopic dermatitis and evaluated its economic impacts on individual annual disease burden, quality of life, and changes in medical expenses with respect to changes in health related-quality of life. Methods The cost analysis of atopic dermatitis was performed by reviewing the home accounting records of 32 patients. The economic impact of the disease was evaluated by analyzing questionnaires. To handle uncertainties, we compared the results with the data released by the Health Insurance Review & Assessment Board on medical costs claimed by healthcare facilities. Results The direct cost of atopic dermatitis per patient during the 3-month study period was 541,280 Korean won (KRW), and expenditures on other atopic dermatitis-related products were 120,313 KRW. The extrapolated annual direct cost (including expenditures on other atopic dermatitis-related products) per patient was 2,646,372 KRW. The estimated annual indirect cost was 1,507,068 KRW. Thus, the annual cost of illness of atopic dermatitis (i.e., direct+indirect costs) was estimated to be 4,153,440 KRW. Conclusion The annual total social cost of atopic dermatitis on a national level is estimated to be 5.8 trillion KRW. PMID:26082587
Current knowledge on biomarkers for contact sensitization and allergic contact dermatitis.
Koppes, Sjors A; Engebretsen, Kristiane A; Agner, Tove; Angelova-Fischer, Irena; Berents, Teresa; Brandner, Johanna; Brans, Richard; Clausen, Maja-Lisa; Hummler, Edith; Jakasa, Ivone; Jurakić-Tončic, Ružica; John, Swen M; Khnykin, Denis; Molin, Sonja; Holm, Jan O; Suomela, Sari; Thierse, Hermann-Josef; Kezic, Sanja; Martin, Stefan F; Thyssen, Jacob P
2017-07-01
Contact sensitization is common and affects up to 20% of the general population. The clinical manifestation of contact sensitization is allergic contact dermatitis. This is a clinical expression that is sometimes difficult to distinguish from other types of dermatitis, for example irritant and atopic dermatitis. Several studies have examined the pathogenesis and severity of allergic contact dermatitis by measuring the absence or presence of various biomarkers. In this review, we provide a non-systematic overview of biomarkers that have been studied in allergic contact dermatitis. These include genetic variations and mutations, inflammatory mediators, alarmins, proteases, immunoproteomics, lipids, natural moisturizing factors, tight junctions, and antimicrobial peptides. We conclude that, despite the enormous amount of data, convincing specific biomarkers for allergic contact dermatitis are yet to be described. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Management of Patients with Atopic Dermatitis: The Role of Emollient Therapy
Catherine Mack Correa, M.; Nebus, Judith
2012-01-01
Atopic dermatitis is a common inflammatory skin disorder that afflicts a growing number of young children. Genetic, immune, and environmental factors interact in a complex fashion to contribute to disease expression. The compromised stratum corneum found in atopic dermatitis leads to skin barrier dysfunction, which results in aggravation of symptoms by aeroallergens, microbes, and other insults. Infants—whose immune system and epidermal barrier are still developing—display a higher frequency of atopic dermatitis. Management of patients with atopic dermatitis includes maintaining optimal skin care, avoiding allergic triggers, and routinely using emollients to maintain a hydrated stratum corneum and to improve barrier function. Flares of atopic dermatitis are often managed with courses of topical corticosteroids or calcineurin inhibitors. This paper discusses the role of emollients in the management of atopic dermatitis, with particular emphasis on infants and young children. PMID:23008699
[Contact dermatitis: an approach used by a medical officer].
Vologzhanin, D A; Bozhchenko, A A; Bala, A M
2012-01-01
The article deals with contact dermatitis issues, that are of interest not only for dermatologists and specialists in professional pathology, but as well as for general practitioners. Issues of contact dermatitis classification, pathogenic peculiarities of the disease main forms and their basic causes are discussed. Clinical manifestations of irritative and allergic contact dermatitis are described in detail, aspects of differential diagnostics analysed. A detailed consideration is given to allergic diagnostics of contact dermatitis using application test-systems with the most common contact allergens. Main principles of contact dermatitis treatment are outlined in the article. The necessity of a complex approach to this disease therapy that requires not only external therapy, but the compliance with an appropriate treatment regimen, diet as well as application of a particular system therapy is shown. Recommendations for contact dermatitis prophylaxis are given.
Boleira, Manuela; Lupi, Omar; Pires, Gisele Vianna; Dias, Gabriela; Seba, Amanda Jaccobson; Guimarães, Daniel Boleira Sieiro
2014-01-01
BACKGROUND atopic dermatitis is directly related to psychological stress, reduced quality of life and psychosomatic symptoms. The Psychosomatic Scale for Atopic Dermatitis is the only questionnaire developed specifically for assessment of psychosomatization in atopic dermatitis. OBJECTIVES the objective of this study was to cross-culturally adapt and validate a Brazilian-Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. METHODS adaptation consisted of independent translation and backtranslation by three bilingual translators, followed by a pre-test. The Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index were self-administered to 47 patients with atopic dermatitis. Disease severity was evaluated using the Eczema Area and Severity Index. Factor analysis was used to identify the dimensions of the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. Internal consistency and convergence validity were also analyzed. Reproducibility was assessed using the Kappa coefficient. RESULTS factor analysis revealed a two-dimensional structure: stress/laziness/insecurity (I) and maladjustment/social relationships (II), explaining 54.4% of total variance. All dimensions revealed excellent internal consistency. External construct validity was confirmed by positive correlations between the Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index. Test-retest reliability was excellent, with k>0.7 for all questions. CONCLUSIONS the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis demonstrated acceptable psychometric properties and can be used for the evaluation of psychosomatic symptoms in patients with atopic dermatitis and as a tool in clinical and epidemiological research. PMID:25184916
Effect of Benralizumab in Atopic Dermatitis
2018-06-22
Dermatitis, Atopic; Dermatitis; Eczema; Skin Diseases; Skin Diseases, Genetic; Genetic Diseases, Inborn; Skin Diseases, Eczematous; Hypersensitivity; Hypersensitivity, Immediate; Immune System Diseases
Grey, Katherine R; Warshaw, Erin M
Allergic contact dermatitis is an important cause of periorbital dermatitis. Topical ophthalmic agents are relevant sensitizers. Contact dermatitis to ophthalmic medications can be challenging to diagnose and manage given the numerous possible offending agents, including both active and inactive ingredients. Furthermore, a substantial body of literature reports false-negative patch test results to ophthalmic agents. Subsequently, numerous alternative testing methods have been described. This review outlines the periorbital manifestations, causative agents, and alternative testing methods of allergic contact dermatitis to ophthalmic medications.
Rosenbach, Misha; English, Joseph C
2015-07-01
The terms "palisaded neutrophilic and granulomatous dermatitis," "interstitial granulomatous dermatitis," and the subset "interstitial granulomatous drug reaction" are a source of confusion. There exists substantial overlap among the entities with few strict distinguishing features. We review the literature and highlight areas of distinction and overlap, and propose a streamlined diagnostic workup for patients presenting with this cutaneous reaction pattern. Because the systemic disease associations and requisite workup are similar, and the etiopathogenesis is poorly understood but likely similar among these entities, we propose the simplified unifying term "reactive granulomatous dermatitis" to encompass these entities. Copyright © 2015 Elsevier Inc. All rights reserved.
Skin complaints in buildings with indoor climate problems
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stenberg, B.
1989-01-01
The Sick Building Syndrome (SBS), as defined by the World Health Organization (WHO), is a combination of both common and unspecific symptoms. Few studies have been published with detailed descriptions of clinical findings. One of the few dermatological references with a close relation to sick buildings is the so-called low humidity occupational dermatoses. Since 1982, an increasing number of outpatients from building with indoor climate problems have been investigated at the Department of Dermatology in Umea, Sweden. The most common findings regarding work-related diseases have been seborrheic dermatitis, facial erythema, periorbital eczema, rosacea, urticaria, and itching folliculitis. It is suggestedmore » that physical, chemical, and psychological factors are of importance in producing these symptoms.« less
Diagnosing Allergic Contact Dermatitis Through Elimination, Perception, Detection and Deduction.
Pongpairoj, Korbkarn; Puangpet, Pailin; Thaiwat, Supitchaya; McFadden, John P
2017-10-01
Several authors have commented upon the skills of detection required in making a diagnosis of allergic contact dermatitis. Here, we emphasise the search for clues in a systematic manner. We describe four stages as part of a systematic method for diagnosing allergic contact dermatitis. Firstly, elimination (or inclusion) of non-allergic diagnoses. Secondly, perception: the pre-patch test diagnosis and the 'three scenarios' principle. Thirdly, detection: optimising the sensitivity of the patch test process. Fourthly, deduction: diagnosing allergic contact dermatitis by associating the dermatitis with the allergen exposure. We further compare and contrast the pre-patch test history and examination with the markedly different one ('microhistory' and 'microexamination') used after patch testing. The importance of knowledge of contact dermatitis literature is emphasised with a review of recent publications. Finally, we also highlight the use of contact allergy profiling as an investigative tool in the diagnosis of allergic contact dermatitis.
[Clinical symptomps, diagnosis and therapy of feline allergic dermatitis].
Favrot, C; Rostaher, A; Fischer, N
2014-07-01
Allergies are often suspected in cats and they are mainly hypersensitivity reactions against insect bites, food- or environmental allergens. Cats, with non flea induced atopic dermatitis, normally present with one oft he following reaction patterns: miliary dermatitis, eosinophilic dermatitis, selfinduced alopecia or head and neck excoriations. None of these reaction patterns is nevertheless pathognomonic for allergic dermatitis, therefore the diagnosis is based on the one hand on the exclusion of similar diseases on the other hand on the successful response on a certain therapy. Recently a study on the clinical presentation of cats with non flea induced atopic dermatitis was published. In this study certain criteria for diagnosing atopy in cats were proposed. For therapy of allergic cats cyclosporin, glucocorticoids, antihistamines, hypoallergenic diets and allergen specific immunotherapy are used. This article should provide a recent overview on the clinical symptoms, diagnosis and therapy of feline allergic dermatitis.
Lumps, Bumps, and Things that Go Itch in Your Office!
ERIC Educational Resources Information Center
McLeod, Renee P.
2004-01-01
This article presents a short dermatological case presentation involving a 9-year-old black female student who suffered from a severe case of atopic dermatitis (AD). Health history, physical findings on the subject, and differential diagnosis, such as impetigo, atopic dermatitis, contact dermatitis, scabies, and seborrheic dermatitis, are given.…
Distribution of malassezia species on the scalp in korean seborrheic dermatitis patients.
Lee, Yang Won; Byun, Hee Jin; Kim, Beom Joon; Kim, Dong Ha; Lim, Yun Young; Lee, Jin Woong; Kim, Myeung Nam; Kim, Donghak; Chun, Young-Jin; Mun, Seog Kyun; Kim, Chan Woong; Kim, Sung Eun; Hwang, Jae Sung
2011-05-01
Malassezia species play an important role in the pathogenesis of seborrheic dermatitis. In particular, M. restricta and M. globosa are considered to be the predominant organisms in seborrheic dermatitis of Western countries. However, species distribution of Malassezia in seborrheic dermatitis has not been clearly determined yet in Asia. To identify the distribution of Malassezia species on the scalp of seborrheic dermatitis patients in Korea using 26S rDNA PCR-RFLP analysis. A total of 40 seborrheic dermatitis patients and 100 normal healthy volunteers were included in this study. For the identification of Malassezia species, the scalp scales of the subjects were analyzed by 26S rDNA PCR-RFLP analysis. The most commonly identified Malassezia species were M. restricta in the seborrheic dermatitis patients, and M. globosa in the normal controls. In the seborrheic dermatitis group, M. restricta was identified in 47.5%, M. globosa in 27.5%, M. furfur in 7.5%, and M. sympodialis in 2.5% of patients. In the healthy control group, M. globosa was identified in 32.0%, M. restricta in 25.0%, M. furfur in 8.0%, M. obtusa in 6.0%, M. slooffiae in 6.0%, and M. sympodialis in 4.0% of subjects. M. restricta is considered to be the most important Malassezia species in Korean seborrheic dermatitis patients.
Results of patch testing in 10 patients with peristomal dermatitis.
Landis, Megan N; Keeling, James H; Yiannias, James A; Richardson, Donna M; Nordberg Linehan, Diane L; Davis, Mark D P
2012-09-01
Peristomal dermatitis is a common problem in patients with ostomies that is a source of considerable morbidity. Irritant contact dermatitis is most common, but allergic contact dermatitis can also occur. Because of the lack of published reports on patch testing for this indication, we undertook a retrospective study of patch testing results in patients with suspected peristomal allergic contact dermatitis. We sought to describe our patch testing experience with patients referred with peristomal dermatitis. This was a retrospective review of medical records of patients with ostomies and peristomal dermatitis who underwent patch testing in the Mayo Clinic Departments of Dermatology in Jacksonville, FL; Rochester, MN; and Scottsdale, AZ, during a 10-year period (2000-2010). Ten patients with peristomal dermatitis were referred for patch testing (6 in Minnesota, 2 in Florida, and 2 in Arizona). Patients were patch tested to the materials used in their stoma devices, to the standard series, and in some cases to supplemental series. All 10 had at least one allergic patch test reaction, most commonly to stoma paste (3 of 10 patients). Retrospective nature of study via chart review is a limitation. Patch testing is a useful tool for identification of allergens in patients with peristomal dermatitis. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
Lubbes, Stefanie; Rustemeyer, Thomas; Sillevis Smitt, Johannes H; Schuttelaar, Marie Louise; Middelkamp-Hup, Maritza A
2017-03-01
Allergic contact dermatitis is known to occur in children with and without atopic dermatitis, but more data are needed on contact sensitization profiles in these two groups. To identify frequent allergens in children with and without atopic dermatitis suspected of having allergic contact dermatitis. A retrospective analysis of children aged 0-17 years patch tested between 1996 and 2013 was performed. Of all 1012 children tested because of suspected contact dermatitis, 46% developed one or more positive reactions, the proportions for children with (n = 526) and without (n = 395) atopic dermatitis being 48% and 47%, respectively. Children with atopic dermatitis reacted more often to lanolin alcohol (30% pet., p = 0.030), Amerchol L-101 (p = 0.030), and fragrances [fragrance mix I (p = 0.048) and Myroxylon pereirae (p = 0.005)]. Allergens outside the European baseline series that frequently gave positive reactions in these groups included cocamidopropyl betaine and Amerchol L-101. Reactivity to these allergens was significantly more common in atopic dermatitis children. Sensitization prevalences in children with and without atopic dermatitis were similar, but children with atopic dermatitis reacted significantly more often to lanolin alcohol and fragrances. Testing with additional series besides the European baseline series may be necessary, as reactions to, for example, cocamidopropyl betaine and Amerchol L-101 may otherwise be missed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Imai, Takayuki; Matsuura, Kazuto; Asada, Yukinori; Sagai, Shun; Katagiri, Katsunori; Ishida, Eiichi; Saito, Daisuke; Sadayasu, Rei; Wada, Hitoshi; Saijo, Shigeru
2014-05-01
This prospective randomized Phase II study was designed to evaluate the preventive effect of an oral nutrition supplement composed of beta-hydroxy-beta-methylbutyrate, arginine and glutamine (beta-hydroxy-beta-methylbutyrate/arginine/glutamine) on radiation dermatitis in head and neck cancer patients. Forty patients with histologically proven head and neck cancer, treated with concurrent chemoradiotherapy involving cisplatin were recruited. They were randomly assigned to the beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplement treatment group (Group A) or the control group that received no supplement (Group B). The primary endpoint of this study was the percentage of patients developing ≥Grade 3 dermatitis. The secondary endpoints were the percentage of patients developing ≥Grade 2 dermatitis, and the duration of each grade of dermatitis relative to the observation period. The incidence of ≥Grade 3 dermatitis did not differ between the two groups. However, as secondary endpoints of this study, the incidence of ≥Grade 2 dermatitis was lower in Group A than B (62.6 vs. 94.4%; P < 0.05), and the duration of ≥Grade 1 dermatitis was shorter in Group A than B (44.8 vs. 56.7%; P < 0.01), as was the duration of ≥Grade 2 dermatitis (16.5 vs. 26.5%; P < 0.05). Our study indicated that beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplementation was potentially effective in the prevention of radiation dermatitis in head and neck cancer patients.
Kallini, Joseph R; Cohen, Philip R
2013-04-15
We describe a woman with perianal and periumbilical dermatitis secondary to group G Streptococcus, summarize the salient features of this condition, and review other cutaneous conditions that clinically mimic streptococcal dermatitis of the umbilicus. Periumbilical and perianal streptococcal dermatitis are conditions that commonly occur in children and usually result from beta-hemolytic group A Streptococcus. Rarely, non-group A streptococcal and staphylococcal infections have been reported in adults. A 31-year-old woman developed perianal and periumbilical group G streptococcal dermatitis. Symptoms were present for six months and were refractory to clotrimazole 1 percent and betamethasone dipropionate 0.05 percent cream. The etiology of perianal and periumbilical dermatitis is unclear, but is perhaps explained by virulence of previously asymptomatic colonized bacteria. Perianal streptococcal dermatitis is more common in children. A number of adult infections have been reported, most of which were secondary to group A beta-hemolytic Streptococcus. Men are more often affected than women. Group G Streptococcus is rarely the infective etiology of perianal streptococcal dermatitis. This condition presents as a superficial well demarcated erythematous patch on clinical examination. Diagnosis is ascertained by diagnostic swabs and serological tests: antistreptolysin O (ASO) or anti-DNase titer. Treatments include oral amoxicillin, penicillin, erythromycin, and mupirocin ointment. Our patient expands on the clinical presentation typical of streptococcal dermatitis. We describe a rare occurrence of an adult woman infected with non-group A Streptococcus. Several conditions can mimic the presentation of perianal streptococcal dermatitis. Although rare, group G Streptococcus should be considered in the setting of virulent infections usually attributed to group A species. Streptococcal dermatitis can be added to the list of conditions affecting the umbilicus.
Increased numbers of CD4+ and CD8+ T cells in lesional skin of cats with allergic dermatitis.
Roosje, P J; van Kooten, P J; Thepen, T; Bihari, I C; Rutten, V P; Koeman, J P; Willemse, T
1998-07-01
The aim of this study was to characterize T cells in the skin of cats with an allergic dermatitis histologically compatible with atopic dermatitis, since T cells play an important role in the pathogenesis of atopic dermatitis in humans. We observed a significantly greater number of T cells in lesional skin of domestic short-haired cats with allergic dermatitis (n = 10; median age 5.8 years) than in the skin of healthy control animals (n = 10; median age 5.0 years). In the skin of the healthy control animals, one or two CD4+ cells and no CD8+ cells were found. A predominant increase of CD4+ T cells and a CD4+/CD8+ ratio (mean +/- SD: 3.9 +/- 2.0) was found in the lesional skin of 10 cats with allergic dermatitis. The CD4+/CD8+ cell ratio in the skin of healthy control animals could not be determined because of the absence of CD8+ cells. The CD4+/CD8+ cell ratio in the peripheral blood of 10 cats with allergic dermatitis (mean +/- SD: 1.9 +/- 0.4) did not differ significantly from that in 10 healthy control animals (2.2 +/- 0.4). The CD4+/CD8+ cell ratio and predominance of CD4+ T cells in the lesional skin of cats with allergic dermatitis is comparable to that found in atopic dermatitis in humans. In addition, the observed increase of CD4+ T cells in the nonlesional skin of cats with allergic dermatitis compared to the skin of healthy cats is similar to what is seen in humans. Cytokines produced by T cells and antigen-specific T cells are important mediators in the inflammatory cascade resulting in atopic dermatitis in humans. This study is a first step to investigate their role in feline allergic dermatitis.
Can, Ceren; Yazıcıoğlu, Mehtap; Gürkan, Hakan; Tozkır, Hilmi; Görgülü, Adnan; Süt, Necdet Hilmi
2017-01-01
Background: Atopic dermatitis is the most common chronic inflammatory skin disease. A complex interaction of both genetic and environmental factors is thought to contribute to the disease. Aims: To evaluate whether single nucleotide polymorphisms in the TLR2 gene c.2258C>T (R753Q) (rs5743708) and TLR2 c.-148+1614T>A (A-16934T) (rs4696480) (NM_0032643) are associated with atopic dermatitis in Turkish children. Study Design: Case-control study. Methods: The study was conducted on 70 Turkish children with atopic dermatitis aged 0.5-18 years. The clinical severity of atopic dermatitis was evaluated by the severity scoring of atopic dermatitis index. Serum total IgE levels, specific IgE antibodies to inhalant and food allergens were measured in both atopic dermatitis patients and controls, skin prick tests were done on 70 children with atopic dermatitis. Genotyping for TLR2 (R753Q and A-16934T) single nucleotide polymorphisms was performed in both atopic dermatitis patients and controls. Results: Cytosine-cytosine and cytosin-thymine genotype frequencies of the TLR2 R753Q single nucleotide polymorphism in the atopic dermatitis group were determined as being 98.6% and 1.4%, cytosine allele frequency for TLR2 R753Q single nucleotide polymorphism was determined as 99.29% and the thymine allele frequency was 0.71%, thymine-thymine, thymine-adenine, and adenine-adenine genotype frequencies of the TLR2 A-16934T single nucleotide polymorphism were 24.3%, 44.3%, and 31.4%. The thymine allele frequency for the TLR2 A-16934T single nucleotide polymorphism in the atopic dermatitis group was 46.43%, and the adenine allele frequency was 53.57%, respectively. There was not statistically significant difference between the groups for all investigated polymorphisms (p>0.05). For all single nucleotide polymorphisms studied, allelic distribution was analogous among atopic dermatitis patients and controls, and no significant statistical difference was observed. No homozygous carriers of the TLR2 R753Q single nucleotide polymorphism were found in the atopic dermatitis and control groups. Conclusion: The TLR2 (R753Q and A-16934T) single nucleotide polymorphisms are not associated with atopic dermatitis in a group of Turkish patients. PMID:28443596
Can, Ceren; Yazıcıoğlu, Mehtap; Gürkan, Hakan; Tozkır, Hilmi; Görgülü, Adnan; Süt, Necdet Hilmi
2017-05-05
Atopic dermatitis is the most common chronic inflammatory skin disease. A complex interaction of both genetic and environmental factors is thought to contribute to the disease. To evaluate whether single nucleotide polymorphisms in the TLR2 gene c.2258C>T (R753Q) (rs5743708) and TLR2 c.-148+1614T>A (A-16934T) (rs4696480) (NM_0032643) are associated with atopic dermatitis in Turkish children. Case-control study. The study was conducted on 70 Turkish children with atopic dermatitis aged 0.5-18 years. The clinical severity of atopic dermatitis was evaluated by the severity scoring of atopic dermatitis index. Serum total IgE levels, specific IgE antibodies to inhalant and food allergens were measured in both atopic dermatitis patients and controls, skin prick tests were done on 70 children with atopic dermatitis. Genotyping for TLR2 (R753Q and A-16934T) single nucleotide polymorphisms was performed in both atopic dermatitis patients and controls. Cytosine-cytosine and cytosin-thymine genotype frequencies of the TLR2 R753Q single nucleotide polymorphism in the atopic dermatitis group were determined as being 98.6% and 1.4%, cytosine allele frequency for TLR2 R753Q single nucleotide polymorphism was determined as 99.29% and the thymine allele frequency was 0.71%, thymine-thymine, thymine-adenine, and adenine-adenine genotype frequencies of the TLR2 A-16934T single nucleotide polymorphism were 24.3%, 44.3%, and 31.4%. The thymine allele frequency for the TLR2 A-16934T single nucleotide polymorphism in the atopic dermatitis group was 46.43%, and the adenine allele frequency was 53.57%, respectively. There was not statistically significant difference between the groups for all investigated polymorphisms (p>0.05). For all single nucleotide polymorphisms studied, allelic distribution was analogous among atopic dermatitis patients and controls, and no significant statistical difference was observed. No homozygous carriers of the TLR2 R753Q single nucleotide polymorphism were found in the atopic dermatitis and control groups. The TLR2 (R753Q and A-16934T) single nucleotide polymorphisms are not associated with atopic dermatitis in a group of Turkish patients.
Occupational asthma prevention and management in industry--an example of a global programme.
Gannon, Paul F G; Berg, A S; Gayosso, R; Henderson, B; Sax, S E; Willems, H M J
2005-12-01
Isocyanates are widely used in the manufacture of polyurethane foams, plastics, coatings and adhesives, and are known to cause occupational asthma in a proportion of exposed workers. Substitution as a prevention strategy is not currently a feasible option. For this reason, health and safety professionals working together in an automotive coatings business created a proactive global programme to address the known potential effects of isocyanates on its workers. The goals of the programme are prevention, early detection and mitigation of effect of key endpoints, especially asthma and to a lesser degree dermatitis, in people who are occupationally exposed, or potentially exposed, to isocyanates and products containing isocyanates. The surveillance programme for isocyanates has several important components, which include assessment of exposure, pre-placement questionnaire and spirometry, training and education of employees, regularly administered periodic questionnaires, medical assessment for abnormal questionnaire responses, process for early reporting and investigation of symptomatic employees and incidents, group data review and management reporting. Although regional differences exist regarding availability of specialized services, we have successfully implemented this programme in parts of North America, Europe and Latin America, and are currently implementing elsewhere. These simple control measures are relatively inexpensive and can be applied in even small business settings. It is recommended that all employers who manufacture, handle or use isocyanate-containing products consider such a strategy.
Code of Federal Regulations, 2011 CFR
2011-04-01
... dandruff, seborrheic dermatitis, or psoriasis. 358.750 Section 358.750 Food and Drugs FOOD AND DRUG... Dermatitis, and Psoriasis § 358.750 Labeling of drug products for the control of dandruff, seborrheic dermatitis, or psoriasis. (a) Statement of identity. The labeling of the product contains the established...
Code of Federal Regulations, 2010 CFR
2010-04-01
... dandruff, seborrheic dermatitis, or psoriasis. 358.750 Section 358.750 Food and Drugs FOOD AND DRUG... Dermatitis, and Psoriasis § 358.750 Labeling of drug products for the control of dandruff, seborrheic dermatitis, or psoriasis. (a) Statement of identity. The labeling of the product contains the established...
Sickafoose, L; Hosgood, G; Snook, T; Westermeyer, R; Merchant, S
2010-01-01
This double-blinded noninferiority clinical trial evaluated the use of oral fluconazole for the treatment of Malassezia dermatitis in dogs by comparing it with use of an accepted therapeutic agent, ketoconazole. Dogs presenting with Malassezia dermatitis were treated with either fluconazole or ketoconazole in addition to cephalexin for concurrent bacterial dermatitis. Statistically significant improvements in cytologic yeast count, clinical signs associated with Malassezia dermatitis, and pruritus were seen with both antifungal treatments. There was no statistical difference between the treatments with regard to the magnitude of reduction in these parameters. These results suggest that fluconazole is at least as effective as ketoconazole for the treatment of dogs with Malassezia dermatitis.
... this page: //medlineplus.gov/ency/article/001480.htm Dermatitis herpetiformis To use the sharing features on this page, please enable JavaScript. Dermatitis herpetiformis (DH) is a very itchy rash consisting ...
Dermatitis, contact on the cheek (image)
... skin inflammation (dermatitis) on the cheek caused by contact with a substance that produced an allergic reaction (allergen). Contact dermatitis causes redness, itching, and small blisters (vesicles).
Raposo, Inês; Lobo, Inês; Amaro, Cristina; Lobo, Maria de Lurdes; Melo, Helena; Parente, Joana; Pereira, Teresa; Rocha, Joana; Cunha, Ana P; Baptista, Armando; Serrano, Pedro; Correia, Teresa; Travassos, Ana R; Dias, Margarida; Pereira, Fátima; Gonçalo, Margarida
2017-12-01
The increasing use of long-lasting nail aesthetic products has led to a growing number of cases of allergic contact dermatitis (ACD) caused by (meth)acrylates in recent years. To provide information on ACD caused by (meth)acrylates related to nail cosmetic products. We retrospectively reviewed files of patients with ACD caused by (meth)acrylates related to nail cosmetic products, who were patch tested between January 2011 and December 2015 in 13 departments of dermatology in Portugal. Two-hundred and thirty cases of ACD caused by (meth)acrylates (55 technicians, 56 consumers, and 119 with mixed exposure) had been documented, mostly as chronic hand eczema (93%). The most common sensitizers were: 2-hydroxyethyl methacrylate (HEMA), which was positive in 90% of the tested patients, 2-hydroxypropyl methacrylate (HPMA), which was positive in 64.1%, and ethyleneglycol dimethacrylate, which was positive in 54.5%. HEMA and HPMA were the most frequent positive allergens. HEMA, which identified 90% of cases, can be considered to be a good screening allergen. The high number of cases of ACD caused by (meth)acrylates in nail cosmetic products certainly warrants better preventive measures at the occupational level, and specific regulation in the field of consumer safety. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Measured moisture in buildings and adverse health effects: A review.
Mendell, M J; Macher, J M; Kumagai, K
2018-04-23
It has not yet been possible to quantify dose-related health risks attributable to indoor dampness or mold (D/M), to support setting specific health-related limits for D/M. An overlooked target for assessing D/M is moisture in building materials, the critical factor allowing microbial growth. A search for studies of quantified building moisture and occupant health effects identified 3 eligible studies. Two studies assessed associations between measured wall moisture content and respiratory health in the UK. Both reported dose-related increases in asthma exacerbation with higher measured moisture, with 1 study reporting an adjusted odds ratio of 7.0 for night-time asthma symptoms with higher bedroom moisture. The third study assessed relationships between infrared camera-determined wall moisture and atopic dermatitis in South Korea, reporting an adjusted odds ratio of 14.5 for water-damaged homes and moderate or severe atopic dermatitis. Measuring building moisture has, despite extremely limited available findings, potential promise for detecting unhealthy D/M in homes and merits more research attention. Further research to validate these findings should include measured "water activity," which directly assesses moisture availability for microbial growth. Ultimately, evidence-based, health-related thresholds for building moisture, across specific materials and measurement devices, could better guide assessment and remediation of D/M in buildings. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
van Os-Medendorp, Harmieke; Appelman-Noordermeer, Simone; Bruijnzeel-Koomen, Carla; de Bruin-Weller, Marjolein
2015-01-01
Background: Little is known about the prevalence of sick leave due to atopic dermatitis (AD). The current literature on factors influencing sick leave is mostly derived from other chronic inflammatory diseases. This study aimed to determine the prevalence of sick leave due to AD and to identify influencing factors. Methods: A cross-sectional study was carried out in adult patients with AD. Outcome measures: sick leave during the two-week and one-year periods, socio-demographic characteristics, disease severity, quality of life and socio-occupational factors. Logistic regression analyses were used to determine influencing factors on sick leave over the two-week period. Results: In total, 253 patients were included; 12% of the patients had to take sick leave in the last two weeks due to AD and 42% in the past year. A higher level of symptom interference (OR 1.26; 95% CI 1.13–1.40) or perfectionism/diligence (OR 0.90; 95% CI 0.83–0.96) may respectively increase or decrease the number of sick leave days. Conclusion: Sick leave in patients with AD is a common problem and symptom interference and perfectionism/diligence appeared to influence it. Novel approaches are needed to deal with symptoms at work or school to reduce the amount of sick leave due to AD. PMID:26239345
Early-life risk factors for occurrence of atopic dermatitis during the first year.
Sugiyama, Mikio; Arakawa, Hirokazu; Ozawa, Kiyoshi; Mizuno, Takahisa; Mochizuki, Hiroyuki; Tokuyama, Kenichi; Morikawa, Akihiro
2007-03-01
In a prospective birth cohort study, we sought to identify perinatal predictors of the occurrence of atopic dermatitis in the first year of life. Associations of family history, infection during pregnancy, cord blood cytokine concentrations, and skin function parameters with atopic dermatitis were analyzed. Stratum corneum hydration was measured with an impedance meter until 5 days after delivery and again at 1 month. Complete data were obtained for 213 infants, including 27 diagnosed by a physician as having atopic dermatitis during their first year and 26 diagnosed as having infantile eczema during their first month. The risk of atopic dermatitis during the first year of life was related to maternal atopic dermatitis, lower concentrations of macrophage inflammatory protein-1beta in cord blood, and greater skin moisture in the surface and stratum corneum of the forehead and cheek at 1 month of age but not to viral or bacterial infection during pregnancy or breastfeeding. Paternal hay fever was associated negatively with the development of atopic dermatitis. High concentrations of interleukin-5, interleukin-17, and macrophage chemotactic protein-1 and only surface moisture in the cheek were associated with greater risk of infantile eczema in the first month. The association of atopic dermatitis in infancy with reduced neonatal macrophage inflammatory protein-1beta levels suggests a link with immature immune responses at birth. Stratum corneum barrier disruption in atopic dermatitis may involve impairment of cutaneous adaptation to extrauterine life. The majority of risk factors had different effects on infant eczema and atopic dermatitis, indicating different causes.
Foolad, N; Armstrong, A W
2014-06-01
The purpose of this review was to identify whether supplementation with prebiotics and/or probiotics help prevent the development or reduce the severity of atopic dermatitis in children less than three years of age. Since 1997, immunostimulatory supplements, such as prebiotics and probiotics, have been investigated. Various supplementations include probiotics (single strain or mix), probiotics with formula, probiotics mix with prebiotics, and prebiotics. In this narrative review, we examined 13 key articles on prebiotics and/or probiotics, and their effects on infant atopic dermatitis. Among the selected studies, a total of 3,023 participants received supplements or placebo. Eight out of the 13 (61.5%) studies reported a significant effect on the prevention of atopic dermatitis after supplementation with probiotics and/or prebiotics. Five out of the 13 (38.5%) studies indicated significant reduction in the severity of atopic dermatitis after supplementation. Based on the available studies, supplementation with certain probiotics (Lactobacillus rhamnosus GG) appears to be an effective approach for the prevention and reduction in severity of atopic dermatitis. A mix of specific probiotic strains prevented atopic dermatitis among infants. Based on studies with prebiotics, there was a long-term reduction in the incidence of atopic dermatitis. Supplementation with prebiotics and probiotics appears useful for the reduction in the severity of atopic dermatitis. Additional interventional studies exploring prebiotics and probiotics are imperative before recommendations can be made.
Hair dye dermatitis and p-phenylenediamine contact sensitivity: A preliminary report
Gupta, Mrinal; Mahajan, Vikram K.; Mehta, Karaninder S.; Chauhan, Pushpinder S.
2015-01-01
Background: The contact allergic reactions from p-phenylenediamine (PPD) in hair dyes vary from mild contact dermatitis to severe life- threatening events (angioedema, bronchospasm, asthma, renal impairment). Objectives: To study the clinical patterns and PPD contact sensitivity in patients with hair-dye dermatitis. Materials and Methods: Eighty (M:F 47:33) consecutive patients aged between 18 and 74 years suspected to have contact allergy from hair dye were studied by patch testing with Indian Standard Series including p-phenylenediamine (PPD, 1.0% pet). Results: 54 Fifty-four (M:F 21:33) patients showed positive patch tests from PPD. Eight of these patients also showed positive patch test reaction from fragrance mix, thiuram mix, paraben mix, or colophony. Fifty-seven (71%) patients affected were aged older than 40 years. The duration of dermatitis varied from < 1 month to > 1 year with exacerbation following hair coloring. Forty-nine patients had dermatitis of scalp and/or scalp margins and 23 patients had face and neck dermatitis. Periorbital dermatitis, chronic actinic dermatitis, and erythema multiforme-like lesions were seen in 4, 2, and 1 patients, respectively. Conclusions: Hair dyes and PPD constitute a significant cause of contact dermatitis. There is an urgent need for creating consumer awareness regarding hair-dyes contact sensitivity and the significance of performing sensitivity testing prior to actual use. PMID:26225326
Distribution of Malassezia Species on the Scalp in Korean Seborrheic Dermatitis Patients
Lee, Yang Won; Byun, Hee Jin; Kim, Dong Ha; Lim, Yun Young; Lee, Jin Woong; Kim, Myeung Nam; Kim, Donghak; Chun, Young-Jin; Mun, Seog Kyun; Kim, Chan Woong; Kim, Sung Eun; Hwang, Jae Sung
2011-01-01
Background Malassezia species play an important role in the pathogenesis of seborrheic dermatitis. In particular, M. restricta and M. globosa are considered to be the predominant organisms in seborrheic dermatitis of Western countries. However, species distribution of Malassezia in seborrheic dermatitis has not been clearly determined yet in Asia. Objective To identify the distribution of Malassezia species on the scalp of seborrheic dermatitis patients in Korea using 26S rDNA PCR-RFLP analysis. Methods A total of 40 seborrheic dermatitis patients and 100 normal healthy volunteers were included in this study. For the identification of Malassezia species, the scalp scales of the subjects were analyzed by 26S rDNA PCR-RFLP analysis. Results The most commonly identified Malassezia species were M. restricta in the seborrheic dermatitis patients, and M. globosa in the normal controls. In the seborrheic dermatitis group, M. restricta was identified in 47.5%, M. globosa in 27.5%, M. furfur in 7.5%, and M. sympodialis in 2.5% of patients. In the healthy control group, M. globosa was identified in 32.0%, M. restricta in 25.0%, M. furfur in 8.0%, M. obtusa in 6.0%, M. slooffiae in 6.0%, and M. sympodialis in 4.0% of subjects. Conclusion M. restricta is considered to be the most important Malassezia species in Korean seborrheic dermatitis patients. PMID:21747613
Min Lee, Charles Kyung; Li, Shufeng; Tran, Duy Cong; Zhu, Gefei Alex; Kim, Jinah; Kwong, Bernice Y; Chang, Anne Lynn S
2018-05-29
Cutaneous adverse events are common with Programmed Death (PD)-1/ PD-Ligand (L)1 inhibitors. However, the nature of the specific cutaneous adverse event of dermatitis has not been investigated across various PD-1/PD-L1 inhibitors. Oncologic outcomes potentially associated with dermatitis are not well characterized. (s): To assess the nature of dermatitis after PD-1/PD-L1 inhibitor exposure and oncologic outcomes associated with dermatitis. Retrospective, matched, case-control study conducted at a single academic center. The most common histologic patterns were lichenoid dermatitis (50%) and spongiotic dermatitis (40%). Overall tumor response rate was 65.0% for cases and 17.0% for controls (p=0.0007), odds ratio: 7.3 (95% CI 2.3-23.1). Progression Free Survival (PFS) and Overall Survival (OS) times were significantly longer for cases than controls by Kaplan-Meier analysis (p<0.0001 and 0.0203, respectively). Retrospective design and relatively small sample size precluded matching on all cancer types. Lichenoid and spongiotic dermatitis associated with PD-1/PD-L1 inhibitors could be a sign of robust immune response and improved oncologic outcomes. The predictive value of PD-1/PD-L1 related dermatitis on cancer outcomes awaits investigation through prospective multicenter studies for specific cancer types. Copyright © 2018. Published by Elsevier Inc.
This picture shows a skin inflammation (dermatitis) caused by contact with a material that causes an allergic reaction in this person. Contact dermatitis is a relatively common condition, and can be caused ...
Jacob, Sharon E; Hamann, Dathan; Goldenberg, Alina; Connelly, Elizabeth A
2015-01-01
Pediatric systemic allergic contact dermatitis to nickel has previously been reported in association with cocoa. We present four clinical cases of hypersensitivity temporally associated with chocolate consumption at Easter. Clinicians should be aware of the potential for foods high in nickel to provoke patients with known nickel sensitivity and systemic dermatitis. © 2014 Wiley Periodicals, Inc.
Magembe, Anna J; Davis, Mark D P; Richardson, Donna M
2009-01-01
Patch testing rarely is confounded by localized dermatitis induced in the area being tested (usually the back). Its occurrence renders the interpretation of patch tests impossible. To review our experience of the circumstances in which this phenomenon occurs during patch testing. We retrospectively reviewed patients with this phenomenon who underwent patch testing from January 1, 2002, through June 30, 2006. Of the 3,569 patients tested, 12 (0.34% [9 men and 3 women]) had development of this phenomenon. All patients previously had recent widespread dermatitis that was suppressed temporarily with topical corticosteroids and wet dressings at the time of patch testing. The period between control of the dermatitis and the initiation of patch testing was less than 1 week for all patients. Three patients (25%) had recently discontinued therapy with systemic corticosteroids (less than 1 week earlier). In patients with irritable skin either immediately after widespread dermatitis is controlled or after the cessation of systemic corticosteroid treatment, a flare of dermatitis induced by patch testing may render patch tests unreadable and therefore uninterpretable. To avoid this confounding occurrence, a waiting period between control of widespread dermatitis and initiation of patch testing is advised.
Effect of environmental tobacco smoke on atopic dermatitis among children in Korea.
Yi, Okhee; Kwon, Ho-Jang; Kim, Ho; Ha, Mina; Hong, Soo-Jong; Hong, Yun-Chul; Leem, Jong-Han; Sakong, Joon; Lee, Chul Gab; Kim, Su-Young; Kang, Dongmug
2012-02-01
The prevalence of atopic dermatitis is increasing in many countries. Several factors are known to be associated with childhood atopic dermatitis. Environmental tobacco smoke (ETS) is one of the most common indoor pollutants, and children are more vulnerable to ETS exposure than adults are. In this study, the possible association of ETS with atopic dermatitis was evaluated in 7030 individuals aged 6-13 years who participated in the Children's Health and Environment Research study. In addition, predictive factors, such as the allergic history of the parents, children's immunoglobulin E levels and children's history of rhinitis and its association with dermatitis, were assessed. After adjustment for possible confounding variables, atopic dermatitis was found to be highly correlated with ETS, especially among children whose mothers had smoked during pregnancy and/or in the first year after birth (OR=2.06, 95% CI: 1.01-4.22). In conclusion, our results show that childhood exposure to ETS is a major risk factor for atopic dermatitis. Copyright © 2012 Elsevier Inc. All rights reserved.
Stressors in Atopic Dermatitis.
Barilla, Steven; Felix, Kayla; Jorizzo, Joseph L
2017-01-01
As with other inflammatory skin disorders, atopic dermatitis has a tendency to cause stress and also be exacerbated by it. Patients with atopic dermatitis have several disease-associated stressors, some of which include physical discomfort due to itching and altered appearance due to flare-ups. These stressors have been shown to effect patients psychosocially by altering sleep patterns, decreasing self-esteem and interfering with interpersonal relationships. In combination with its direct effect on patients, atopic dermatitis also causes stress for parents and caregivers. Studies suggest that atopic dermatitis is strongly correlated with co-sleeping habits, which can negatively impact the health and mood of parents or caregivers. It has also been reported to interfere with the formation of a strong mother-child relationship. In order to optimize treatment for patients with atopic dermatitis, it is important to note the impact that it has on quality of life. By implementing patient counseling, sleep-targeted therapies, and the use of quality of life (QoL) indices, atopic dermatitis patients and caregivers have the potential to experience greater satisfaction with treatment.
Influences of Environmental Chemicals on Atopic Dermatitis.
Kim, Kwangmi
2015-06-01
Atopic dermatitis is a chronic inflammatory skin condition including severe pruritus, xerosis, visible eczematous skin lesions that mainly begin early in life. Atopic dermatitis exerts a profound impact on the quality of life of patients and their families. The estimated lifetime prevalence of atopic dermatitis has increased 2~3 fold during over the past 30 years, especially in urban areas in industrialized countries, emphasizing the importance of life-style and environment in the pathogenesis of atopic diseases. While the interplay of individual genetic predisposition and environmental factors contribute to the development of atopic dermatitis, the recent increase in the prevalence of atopic dermatitis might be attributed to increased exposure to various environmental factors rather than alterations in human genome. In recent decades, there has been an increasing exposure to chemicals from a variety of sources. In this study, the effects of various environmental chemicals we face in everyday life - air pollutants, contact allergens and skin irritants, ingredients in cosmetics and personal care products, and food additives - on the prevalence and severity of atopic dermatitis are reviewed.
The Association Between Bathing Habits and Severity of Atopic Dermatitis in Children.
Koutroulis, Ioannis; Pyle, Tia; Kopylov, David; Little, Anthony; Gaughan, John; Kratimenos, Panagiotis
2016-02-01
Atopic dermatitis is an inflammatory skin disease that frequently affects children. The current recommendations on management using lifestyle modification are highly variable, leading to confusion and uncertainty among patients. To determine current bathing behaviors and the subsequent impact on disease severity. This was an observational cross-sectional study conducted at an urban pediatric emergency department. Parents were asked to fill out a questionnaire concerning the patient's bathing habits. The results were correlated with the atopic dermatitis severity determined by the SCORAD (SCORing Atopic Dermatitis) tool. No difference between variables was found to be significant for bathing frequency, time spent bathing, or use of moisturizers. Multivariate analysis showed that atopic dermatitis severity increased with age greater than 2 years (P = .0004) and with greater bathing duration (P = .001). Atopic dermatitis severity may be associated with a longer duration of bathing. The frequency of bathing does not appear to affect atopic dermatitis severity. © The Author(s) 2015.
Identification and treatment of poison ivy dermatitis.
Briant, D; Brouder, G
1983-01-01
Poison ivy dermatitis is an acute self-limiting problem of two or three weeks' duration that can cause significant discomfort. Poison ivy, poison oak and poison sumac cause more cases of allergic contact dermatitis than all the other contact allergens combined. Treatment of poison ivy dermatitis depends on the severity of the reaction. The nurse practitioner can manage the majority of poison ivy cases. However, if there is systemic involvement, a physician consultation is necessary. The patient can best be assisted by assessing the severity of the dermatitis, prescribing an appropriate supportive therapy and teaching preventive measures.
Ciclopirox 1% shampoo for the treatment of seborrheic dermatitis.
Gupta, Aditya K; Nicol, Karyn A
2006-01-01
Seborrheic dermatitis is a chronic superficial fungal infection of the skin, particularly affecting sites rich in sebaceous glands. Although the precise etiology of seborrheic dermatitis is uncertain, yeasts of the genus Malassezia are known to play a causative role. Ciclopirox is a broad-spectrum, hydroxypyridone-derived, synthetic antifungal agent, which also has anti-inflammatory properties. Ciclopirox is effective both in vitro and in vivo against Malassezia yeasts, making it a valuable option for the treatment of seborrheic dermatitis. Varying frequencies and concentrations of ciclopirox shampoo have been shown to be effective and safe in the treatment of seborrheic dermatitis of the scalp.
... is called dermatitis, meaning inflammation of the skin. Contact dermatitis is caused by things your skin touches, such ... sumac, as well as for other types of contact dermatitis. Hydrocortisone cream (1%) is available without a prescription ...
Exploration into the Genetics of Food Allergy
2013-10-01
pathogenesis of allergic contact dermatitis ,1 atopic dermatitis (AD),2 allergic drug reactions,3 immediate hypersensitivity reactions (eg, ana...of basophils. Basophils have been shown to contribute to many human disease states, including allergic diseases ( contact dermatitis , AD...MC Jr. Basophilic leukocytes in allergic contact dermatitis . J Exp Med 1972;135:235-54. 2. Ito Y, Satoh T, Takayama K, Miyagishi C, Walls AF, Yokozeki
Contact dermatitis to training toilet seat (potty seat dermatitis).
Dorfman, Claire O; Barros, Mark A; Zaenglein, Andrea L
2018-05-29
Allergic contact dermatitis from various components of toilet seats has been well described. We report a case of a young boy presenting with an atypical pattern of dermatitis who was found to be allergic to his training toilet seat. This case highlights the importance of recognizing this diagnosis and the role of potty seats as the causative factor. © 2018 Wiley Periodicals, Inc.
A review of agricultural pesticide incidents in man in England and Wales, 1952-71
Hearn, C. E. D.
1973-01-01
Hearn, C. E. D. (1973).British Journal of Industrial Medicine,30, 253-258. A review of agricultural pesticide incidents in man in England and Wales, 1952-71. An analysis was carried out of the poisoning incidents attributed to pesticides in England and Wales investigated by the Safety Inspectorate of the Pesticides Branch of the Ministry of Agriculture, Fisheries, and Food from 1952 to 1971. All poisoning incidents attributed to pesticides which are reported to the Safety Inspectorate are recorded and separated into reported and confirmed incidents. The confirmed incidents are classified into fatal and non-fatal. The non-fatal incidents are subdivided into four categories, systemic poisoning, eye injuries, dermatitis, and chemical burns. There were nine fatal cases of poisoning due to pesticides between 1952 and 1971, of which only three were occupational in origin. The remaining six were non-occupational but were investigated by the Safety Inspectorate only because the incident happened to arise on, or in connection with, a farm. The details of all the cases are recorded. There were 222 non-fatal confirmed incidents during the period, affecting a total of 296 persons. There has been an increased frequency of incidents since 1966 largely attributable to more complete and comprehensive recording by the Safety Inspectorate. Out of a total of 250 recorded pesticide effects, 121 (48·5%) were systemic poisoning, 57 (22·8%) were eye injuries, 54 (21·6%) were dermatitis, and 18 (7·1%) were chemical burns. Of the 121 incidents of non-fatal systemic poisoning, usually of a mild character, 34 were due to organophosphates, 26 to a single incident involving chloropicrin, 15 to arsenites, eight to dinitro compounds, three to nicotine, two to fungicides, one to cyanide, and one to an organomercury compound. Thirty-one incidents were not classified because the symptoms were non-specific in character and the worker had been exposed to a large number of different chemicals. In some instances the relationship of the symptoms to previous exposure to pesticides was extremely uncertain. Eye injuries and dermatitis were attributable to a wide variety of different chemicals and in the majority of instances were mild. Sulphuric acid, used for potato haulm destruction, was the commonest recorded cause of chemical burns. The main problems in the use of pesticides in England and Wales today are (1) the illicit decanting of concentrate from the manufacturer's labelled containers, (2) the hoarding of incompletely used containers, (3) the disposal of empty containers, and (4) the importation of pesticides in inadequately labelled containers. These defined practical problems of safety in application and accident control are perhaps of greater importance than the long-term theoretical toxicological effects of pesticides which may be attracting too much attention today. PMID:4737427
Molecular aspects of allergens in atopic dermatitis
Campana, Raffaela; Dzoro, Sheron; Mittermann, Irene; Fedenko, Elena; Elisyutina, Olga; Khaitov, Musa; Karaulov, Alexander; Valenta, Rudolf
2017-01-01
Purpose of review Molecular allergology uses pure, mainly recombinant and structurally defined allergen molecules and allergen-derived epitopes to study mechanisms of IgE-associated allergy, to diagnose, and even predict the development of allergic manifestations and to treat and prevent IgE-associated allergies. Atopic dermatitis, a chronic inflammatory skin disease is almost always associated with IgE sensitization to allergens. However, also non-IgE-mediated pathomechanisms seem to be operative in atopic dermatitis and it is often difficult to identify the disease-causing allergens. Here we review recent work showing the usefulness of molecular allergology to study mechanisms of atopic dermatitis, for diagnosis and eventually for treatment and prevention of atopic dermatitis. Recent findings IgE sensitization to airborne, food-derived, microbial allergens, and autoallergens has been found to be associated with atopic dermatitis. Using defined allergen molecules and non-IgE-reactive allergen derivatives, evidence could be provided for the existence of IgE- and non-IgE-mediated mechanisms of inflammation in atopic dermatitis. Furthermore, effects of epicutaneous allergen administration on systemic allergen-specific immune responses have been studied. Multi-allergen tests containing micro-arrayed allergen molecules have been shown to be useful for the identification of culprit allergens in atopic dermatitis and may improve the management of atopic dermatitis by allergen-specific immunotherapy, allergen avoidance, and IgE-targeting therapies in a personalized medicine approach. Summary Molecular allergology allows for dissection of the pathomechanisms of atopic dermatitis, provides new forms of allergy diagnosis for identification of disease-causing allergens, and opens the door to new forms of management by allergen-specific and T cells-targeting or IgE-targeting interventions in a personalized medicine approach. PMID:28622169
Roduit, Caroline; Wohlgensinger, Johanna; Frei, Remo; Bitter, Sondhja; Bieli, Christian; Loeliger, Susanne; Büchele, Gisela; Riedler, Josef; Dalphin, Jean-Charles; Remes, Sami; Roponen, Marjut; Pekkanen, Juha; Kabesch, Michael; Schaub, Bianca; von Mutius, Erika; Braun-Fahrländer, Charlotte; Lauener, Roger
2011-01-01
Cross-sectional studies have suggested that prenatal farm exposures might protect against allergic disease and increase the expression of receptors of the innate immune system. However, epidemiologic evidence supporting the association with atopic dermatitis remains inconsistent. To study the association between prenatal farm-related exposures and atopic dermatitis in a prospective study. We further analyzed the association between the expression of innate immune genes at birth and atopic dermatitis. A total of 1063 children who participated in a birth cohort study, Protection against Allergy-Study in Rural Environments, were included in this study. Doctor diagnosis of atopic dermatitis was reported by the parents from 1 to 2 years of age by questionnaire. Gene expression of Toll-like receptors (TLRs) and CD14 was assessed in cord blood leukocytes by quantitative PCR. Maternal contact with farm animals and cats during pregnancy had a significantly protective effect on atopic dermatitis in the first 2 years of life. The risk of atopic dermatitis was reduced by more than half among children with mothers having contact with 3 or more farm animal species during pregnancy compared with children with mothers without contact (adjusted odds ratio, 0.43; 95% CI, 0.19-0.97). Elevated expression of TLR5 and TLR9 in cord blood was associated with decreased doctor diagnosis of atopic dermatitis. A significant interaction between polymorphism in TLR2 and prenatal cat exposure was observed in atopic dermatitis. Maternal contact with farm animals and cats during pregnancy has a protective effect on the development of atopic dermatitis in early life, which is associated with a lower expression of innate immune receptors at birth. Copyright © 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
... You may need additional treatment. What is contact dermatitis? Contact dermatitis is caused by irritation of the skin by ... Lichen simplex chronicus may be a result of contact dermatitis or other skin disorder that has been present ...
Hurwitz, R M; Rivera, H P; Guin, J D
1984-08-01
A black spot in the epidermis over a blister of poison ivy dermatitis is an uncommon finding. Four patients with the phenomenon are described. Histologic and histochemical studies were made on biopsy material and the blackish deposit on the skin surface was compared with black deposits in and on leaves of the species of poison ivy. This examination revealed a yellow, amorphous substance on the stratum corneum of the lesions and a similar substance in and on leaves of the poison ivy plant, Toxicodendron radicans ssp. negundo. Associated with the pigmentary deposits there were distinct changes of acute irritant contact dermatitis superimposed upon allergic contact dermatitis. Our findings support the view that the black material is the oleoresin of the plant, and that this substance behaves both as an irritant and an allergen.
A prospective study on canine atopic dermatitis and food-induced allergic dermatitis in Switzerland.
Picco, F; Zini, E; Nett, C; Naegeli, C; Bigler, B; Rüfenacht, S; Roosje, P; Gutzwiller, M E Ricklin; Wilhelm, S; Pfister, J; Meng, E; Favrot, C
2008-06-01
Canine atopic dermatitis sensu stricto and food-induced allergic dermatitis are common canine skin conditions, which are often considered clinically undistinguishable. Several attempts have been made to describe populations of atopic dogs and determine breed predisposition but the results were often biased by the use of hospital populations as control group. The present study aims to describe a population of Swiss atopic and food-allergic dogs and to compare it with a data set representing more than 85% of all Swiss dogs. The study, which was carried out during 1 year in several practices and teaching hospital in Switzerland, describes a group of 259 allergic dogs, determines breed predisposition for atopic dermatitis and food-induced allergic dermatitis, compares the clinical signs and features of both conditions, and outlines the clinical picture of five frequently affected breeds.
Bradley, Charles W; Morris, Daniel O; Rankin, Shelley C; Cain, Christine L; Misic, Ana M; Houser, Timothy; Mauldin, Elizabeth A; Grice, Elizabeth A
2016-06-01
Host-microbe interactions may play a fundamental role in the pathogenesis of atopic dermatitis, a chronic relapsing inflammatory skin disorder characterized by universal colonization with Staphylococcus species. To examine the relationship between epidermal barrier function and the cutaneous microbiota in atopic dermatitis, this study used a spontaneous model of canine atopic dermatitis. In a cohort of 14 dogs with canine atopic dermatitis, the skin microbiota were longitudinally evaluated with parallel assessment of skin barrier function at disease flare, during antimicrobial therapy, and post-therapy. Sequencing of the bacterial 16S ribosomal RNA gene showed decreased bacterial diversity and increased proportions of Staphylococcus (S. pseudintermedius in particular) and Corynebacterium species compared with a cohort of healthy control dogs (n = 16). Treatment restored bacterial diversity with decreased proportions of Staphylococcus species, concurrent with decreased canine atopic dermatitis severity. Skin barrier function, as measured by corneometry, pH, and transepidermal water loss also normalized with treatment. Bacterial diversity correlated with transepidermal water loss and pH level but not with corneometry results. These findings provide insights into the relationship between the cutaneous microbiome and skin barrier function in atopic dermatitis, show the impact of antimicrobial therapy on the skin microbiome, and highlight the utility of canine atopic dermatitis as a spontaneous nonrodent model of atopic dermatitis. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Čelakovská, Jarmila; Bukač, Josef
2014-01-01
Background: A few reports demonstrate the comorbidity of food allergy and allergic march in adult patients. Aims and Objectives: To evaluate, if there is some relation in atopic dermatitis patients at the age 14 years and older who suffer from food allergy to common food allergens to other allergic diseases and parameters as bronchial asthma, allergic rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis. Materials and Methods: Complete dermatological and allergological examination was performed; these parameters were examined: food allergy (to wheat flour, cow milk, egg, peanuts and soy), the occurrence of bronchial asthma, allergic rhinitis, duration of atopic dermatitis, family history and onset of atopic dermatitis. The statistical evaluation of the relations among individual parameters monitored was performed. Results: Food allergy was altogether confirmed in 65 patients (29%) and these patients suffer significantly more often from bronchial asthma and allergic rhinitis. Persistent atopic dermatitis lesions and positive data in family history about atopy are recorded significantly more often in patients with confirmed food allergy to examined foods as well. On the other hand, the onset of atopic dermatitis under 5 year of age is not recorded significantly more often in patients suffering from allergy to examined foods. Conclusion: Atopic dermatitis patients suffering from food allergy suffer significantly more often from allergic rhinitis, bronchial asthma, persistent eczematous lesions and have positive data about atopy in their family history. PMID:25284847
Cho, Byoung Ok; Che, Denis Nchang; Yin, Hong Hua; Shin, Jae Young; Jang, Seon Il
2017-05-01
Atopic dermatitis, a chronic relapsing and pruritic inflammation of the skin also thought to be involved in, or caused by immune system destruction is an upsetting health problem due to its continuously increasing incidence especially in developed countries. Mast cell infiltration in atopic dermatitis skin lesions and its IgE-mediated activation releases various cytokines and chemokines that have been implicated in the pathogenesis of atopic dermatitis. This study was aimed at investigating synergistic anti-inflammatory, anti-pruritic and anti-atopic dermatitis effects of Diospyros lotus leaf extract (DLE) and Muscat bailey A grapefruit stem extract (GFSE) in atopic dermatitis-like induced skin lesions in mice. Combinations of DLE and GFSE inhibited TNF-α and IL-6 production more than DLE or GFSE in PMA plus calcium ionophore A23187-activated HMC-1 cells. DLE and GFSE synergistically inhibited compound 48/80-induced dermal infiltration of mast cells and reduced scratching behavior than DLE or GFSE. Furthermore, DLE and GFSE synergistically showed a stronger ameliorative effect in skin lesions by reducing clinical scores; dermal infiltration of mast cells; ear and dorsal skin thickness; serum IgE and IL-4 production in atopic dermatitis-like mice. Collectively, these results suggest that DLE and GFSE synergistically exhibit anti-atopic dermatitis effects in atopic dermatitis-like skin lesions in mice. Copyright © 2017. Published by Elsevier Masson SAS.
Health-related quality of life in adult dermatitis patients stratified by filaggrin genotype.
Heede, Nina G; Thyssen, Jacob P; Thuesen, Betina H; Linneberg, Allan; Szecsi, Pal B; Stender, Steen; Johansen, Jeanne D
2017-03-01
Information concerning health-related quality of life (HRQoL) and comorbidities of adult dermatitis patients stratified by loss-of-function mutations in the filaggrin gene (FLG) is limited. To investigate HRQoL, skin symptoms and comorbidities in adult FLG mutation carriers. This cross-sectional study included patients diagnosed with atopic dermatitis and/or hand eczema (n = 520). Patients completed questionnaires about dermatitis, skin symptoms, HRQoL, and comorbidities, including actinic keratosis, and atopic and mental disorders. FLG mutations (R501X, 2282del4, and R2447X) were identified in 16.9% of patients, and were significantly associated not only with atopic dermatitis, but also independently with skin fissures on the fingers and heels, and self-reported actinic keratosis. Although FLG mutations were significantly associated with reduced HRQoL, as measured by use of the Dermatology Life Quality Index (DLQI), no association with self-reported anxiety or depression was identified. Notably, the highest median DLQI score, reflecting greater impairment, was reported by patients with both FLG mutations and atopic dermatitis. Overall, 19.7% of patients with both atopic dermatitis and FLG mutations reported a 'large or extremely large' impact on their lives; this represents twice the prevalence seen in patients with atopic dermatitis and wild-type FLG (9.6%). Patients with both atopic dermatitis and common FLG mutations are more frequently affected by reduced HRQoL. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Battlefield Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome
2014-10-01
consumer products: a role in allergic contact dermatitis ? Contact Dermatitis 1993;28:15-25. (13) Cramers M, Lucht U. Metal sensitivity in patients... dermatitis presumably due to metallic foreign bodies containing nickel or cobalt. Current Contact News 1977;19:285-95. (15) Benson MK, Goodwin PG...Sipilainen-Malm T, Estlander T, Zitting A, Jolanki R, Tarvainen K. Nickel release from metals, and a case of allergic contact dermatitis from
Development of Non-Hormonal Steroids for the Treatment of Duchenne Muscular Dystrophy
2013-02-01
rat models of irritant contact dermatitis and allergic contact dermatitis showed that this compound exerted potent anti- inflammatory activity...conditions such as arthriti dermatitis , asthma, muscular dystrophy, and auto-immune disor ders.20–22 However, glucocorticoids have many off-target effect...commonly pre- scribed drugs due to their potent anti-inflammatory properties, and remain standard of care in many conditions such as arthritis, dermatitis
Wound-Related Allergic/Irritant Contact Dermatitis.
Alavi, Afsaneh; Sibbald, R Gary; Ladizinski, Barry; Saraiya, Ami; Lee, Kachiu C; Skotnicki-Grant, Sandy; Maibach, Howard
2016-06-01
To provide information from a literature review about the prevention, recognition, and treatment for contact dermatitis. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify signs and symptoms of and diagnostic measures for contact dermatitis.2. Identify causes and risks for contact dermatitis.3. Select appropriate treatment for contact dermatitis and its prevention. Contact dermatitis to wound care products is a common, often neglected problem. A review was conducted to identify articles relevant to contact dermatitis.A PubMed English-language literature review was conducted for appropriate articles published between January 2000 and December 2015.Contact dermatitis is both irritant (80% of cases) or allergic (20% of cases). Frequent use of potential contact allergens and impaired barrier function of the skin can lead to rising sensitization in patients with chronic wounds. Common known allergens to avoid in wound care patients include fragrances, colophony, lanolin, and topical antibiotics.Clinicians should be cognizant of the allergens in wound care products and the potential for sensitization. All medical devices, including wound dressings, adhesives, and bandages, should be labeled with their complete ingredients, and manufacturers should be encouraged to remove common allergens from wound care products, including topical creams, ointments, and dressings.
Evaluation and Management of Patch Test-Negative Patients With Generalized Dermatitis.
Spiker, Alison; Mowad, Christen M
Patients with generalized dermatitis are common in dermatology practices. Allergic contact dermatitis is often suspected, and patients frequently undergo patch testing. When the patch testing result is negative, further evaluation and management of these patients are challenging. The purpose of this study was to survey members of the American Contact Dermatitis Society regarding the evaluation and management of patch test-negative patients with generalized dermatitis. Generalized dermatitis was the most common term identified for patch test-negative patients with diffuse dermatitis. After having negative expanded patch testing results, most physicians proceeded with additional testing including skin biopsy, complete blood cell count with differential, and liver and renal function tests. The most commonly used systemic treatment is prednisone, followed by methotrexate. Narrow-band ultraviolet B (UVB) is the most commonly used light source. Antihistamines are frequently prescribed. Food allergy is not felt to be causative. This cohort of patients experiences significant impairment in quality of life, stress on personal relationships, and time off work. The management of patch test-negative patients with generalized dermatitis is challenging. This study provides insight into management of these complex patients. It also demonstrates practice gaps in the management of these patients, indicating a need for further studies to direct the evaluation and management of this patient population.
Oh, Jae-Won; Pyun, Bok-Yang; Choung, Ji-Tae; Ahn, Kang-mo; Kim, Chul-Hong; Song, Sang-Wook; Son, Jin-Ah; Lee, Soo-young
2004-01-01
Little is known about the prevalence of atopic dermatitis and food allergy outside North America and Europe. We evaluated the prevalence of atopic dermatitis and food allergy with the comparison of prevalence between 1995 and 2000 in Korea and evaluated the correlation of prevalence between atopic dermatitis and food allergy. A cross-sectional questionnaire survey was conducted on random samples of schoolchildren 6 to 14 yr at two time points, 1995 and 2000 throughout Korea. The last twelve months prevalence of atopic dermatitis in Korean school-aged children was increased from 1995 to 2000. The twelve-month prevalence of atopic dermatitis and food allergy were higher in Seoul than in any other provincial cities in 1995, but the prevalence of both diseases in Seoul and Provincial Centers became to be similar in 2000. The rate responded to food allergy of children with atopic dermatitis (9.5%) was lower than that of the western countries (60%). And our data demonstrated paternal and maternal allergy history is very significantly correlated to developing atopic dermatitis in their offspring. The further objective evaluations are required to confirm these outcomes because the environmental and risk factors may be different among the countries according to their living cultures. PMID:15483350
Atopic Dermatitis and Comorbidities: Added Value of Comprehensive Dermatoepidemiology.
Nijsten, Tamar
2017-05-01
Atopic dermatitis is common and in its severe form is devastating. This chronic inflammatory dermatosis is part of the atopic syndrome, which includes asthma, food allergies, and hay fever and is known to be associated with mental health disorders. In line with psoriasis, several recent observational studies using national survey and linkage data have suggested a link between atopic dermatitis and cardiovascular disease. The atopic dermatitis field can benefit from the past experiences in psoriasis research and should not follow the same path, but, rather, aim for a more comprehensive approach from the beginning. A recent German consortium studying links between atopic dermatitis and cardiovascular disease first screened a large claims database, followed by analyses of more deeply phenotyped (birth) cohorts with longitudinal data. In addition, genetic and metabolic analyses assessing the predisposition of patients with atopic dermatitis for cardiovascular disease were performed. Overall, the association between atopic dermatitis and cardiovascular disease was at most modest, but in more refined cohorts the cardiovascular risk profile and genetic architecture was comparable. A more integrated approach could create clarity about the clinical relevance of cardiovascular disease in individuals with atopic dermatitis sooner, avoid speculation that affects patient care, and save scientific resources. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
[Shiitake dermatitis: flagellate dermatitis after eating mushrooms].
Haas, N; Vogt, R; Sterry, W
2001-02-01
The name of flagellate dermatitis originates from self-flagellating medieval people. This dermatitis is not rare as a drug eruption following bleomycin therapy. An identical skin eruption caused by the mushroom shiitake Lentinus edodes is more common but reported mostly from Japan. We saw a 67-year-old patient who presented with the typical linear scratch marks after a dinner in a Chinese restaurant. The basic mechanism is a toxic epidermal damage. Since it is not clear why the dermatitis does not occur frequently since Shiitake is the second most popular mushroom in the world, we discuss possible cofactors that may trigger the toxic reaction.
Caustic ulcers caused by cement aqua: report of a case.
Machovcova, Alena
2010-01-01
Chromium is widely used in various industries including construction sector. Skin contact with cement has been associated with allergic or irritant contact dermatitis. Contact dermatitis is one of the most frequently reported health problems among construction workers. Irritant contact dermatitis from cement ranges from cement burns to cumulative irritant contact dermatitis. Cement burns are rarely reported and are considered a severe form of acute irritant contact dermatitis. They are associated with amateur user working in a short ready-mix time-frame with poor protective measures. They usually result in significant morbidity and initially are associated with minimal discomfort. We report a typical case.
Latex Allergy: A Prevention Guide
... most common reaction to latex products is irritant contact dermatitis – the development of dry, itchy, irritated areas on ... exposure to the powders added to them. Irritant contact dermatitis is not a true allergy. Allergic contact dermatitis ( ...
Scratching the Surface on Skin Allergies
... cool compress or wearing loose/light clothing. Contact Dermatitis Contact dermatitis is often more painful than itchy. It is ... commonly neomycin, an ingredient in antibiotic creams. Allergic contact dermatitis reactions can happen 24 to 48 hours after ...
Scalp Psoriasis vs. Seborrheic Dermatitis: What's the Difference?
... dermatitis of the scalp? Answers from Lawrence E. Gibson, M.D. Your doctor can usually tell whether ... bring psoriasis under better control. With Lawrence E. Gibson, M.D. Sasseville D. Seborrheic dermatitis in adolescents ...
Tsuduki, Tsuyoshi; Kuriyama, Keiko; Nakagawa, Kiyotaka; Miyazawa, Teruo
2013-01-01
In this study, we examined whether tocotrienol (T3) reduces allergic dermatitis in mice and suppresses degranulation of mast cells. First, allergic dermatitis was examined in the atopic dermatitis model NC/Nga mouse. Allergic dermatitis was induced using picryl chloride in mice with and without administration of T3 (1 mg/day/mouse). Increases in scratching behavior, dermal thickening, and the serum histamine level were greatly reduced in mice treated with T3, indicating that T3 reduces allergic dermatitis in vivo. Next, the effect of T3 on degranulation of mast cells was examined, since these cells release bioactive substances such as histamine. T3 significantly suppressed degranulation of mast cells and significantly reduced histamine release. The effect of T3 on protein kinase C (PKC) activity was also measured, since suppression of this activity may be associated with the mechanism underlying the antidegranulation effect of T3. T3 significantly suppressed PKC activity. Therefore, we conclude that T3 suppresses degranulation of mast cells and reduces allergic dermatitis in mice through reduction of PKC activity.
Just, Helle L; Deleuran, Mette; Vestergaard, Christian; Deleuran, Bent; Thestrup-Pedersen, Kristian
2008-01-01
We used T-cell receptor excision circles (TREC) to evaluate thymic function in adult patients with atopic dermatitis and psoriasis. We observed that men, but not women, with atopic dermatitis had a significantly faster decline in TREC content with increasing age compared with healthy men. In contrast, both men and women with psoriasis had significantly reduced TREC levels, which were, on average, only 30% of that of healthy persons. In atopic dermatitis the levels of TREC declined with increasing levels of IgE, disease intensity and extent of eczema. Furthermore, patients with atopic dermatitis showed signs of altered thymus function, as they had a significantly greater variation in TREC content measured over time than healthy controls, especially within the CD8+ T-cell subpopulation. Because both atopic dermatitis and psoriasis patients have an increased number of T-cells, this indicates that atopic dermatitis patients can have compensatory emissions of thymic emigrants, whereas psoriatic patients do not, thus supporting different thymic function in these two diseases.
Influences of Environmental Chemicals on Atopic Dermatitis
2015-01-01
Atopic dermatitis is a chronic inflammatory skin condition including severe pruritus, xerosis, visible eczematous skin lesions that mainly begin early in life. Atopic dermatitis exerts a profound impact on the quality of life of patients and their families. The estimated lifetime prevalence of atopic dermatitis has increased 2~3 fold during over the past 30 years, especially in urban areas in industrialized countries, emphasizing the importance of life-style and environment in the pathogenesis of atopic diseases. While the interplay of individual genetic predisposition and environmental factors contribute to the development of atopic dermatitis, the recent increase in the prevalence of atopic dermatitis might be attributed to increased exposure to various environmental factors rather than alterations in human genome. In recent decades, there has been an increasing exposure to chemicals from a variety of sources. In this study, the effects of various environmental chemicals we face in everyday life - air pollutants, contact allergens and skin irritants, ingredients in cosmetics and personal care products, and food additives - on the prevalence and severity of atopic dermatitis are reviewed. PMID:26191377
Contact dermatitis in students practicing sports: incidence of rubber sensitisation.
Ventura, M T; Dagnello, M; Matino, M G; Di Corato, R; Giuliano, G; Tursi, A
2001-04-01
Over the last few years, changes in cutaneous homoeostasis resulting from sports activities have been reported. In particular, alterations in sweating mechanisms, the hydrolipid barrier, and surface bacterial flora, together with exposure to atmospheric conditions and the need to use medicaments, detergents, and other topical substances, predispose subjects to allergic contact dermatitis. To evaluate the incidence of allergic contact dermatitis in a group of young people practising sports activities. Patch tests were performed to confirm the diagnosis of irritant or allergic dermatitis; in addition, the radioallergoabsorbent test (RAST) to latex was evaluated in the group studied. Allergic contact dermatitis caused by thiourams (23.3%) and mercaptobenzothiazole (20.9%) was prevalent. Other haptens, such as benzocaine and nickel, which are contained in clothing, equipment, topical medicaments, and creams used for massage, were also allergenic. In two cases, RAST positivity to latex was registered. -The results suggest that close contact with sports equipment may increase the incidence of allergic contact dermatitis. Students practising certain sports may have "professional" allergic contact dermatitis to additives used in the production of rubber.
Influences on use of hand moisturizers in nurses.
Burke, K M; Wright, A J; Parsons, V; Madan, I
2018-05-07
Nurses are at high risk of hand dermatitis. Regular hand moisturizing can prevent dermatitis, but nurses' use of hand moisturizers is suboptimal. To establish (i) what beliefs about hand dermatitis and hand moisturizer use are associated with hand moisturizer use by nurses at home and at work and (ii) if hand moisturizer use behaviours in nurses are associated with the prevalence of hand dermatitis. We used a questionnaire to investigate nurses' knowledge, beliefs and behaviours regarding hand dermatitis and use of hand moisturizers. The response rate was 55/65 (85%). Forty-two (76%) participants agreed that applying hand moisturizers reduced the risk of dermatitis, and 53 (96%) agreed that dermatitis increased the risk of skin carrying pathogenic organisms. Frequent moisturizer application was associated with beliefs that it was part of the nurse's role to apply hand creams, a belief that they had had training in the use of moisturizers and believing that patients approved of them moisturizing their hands. Hand moisturizer use by nurses can be improved by enhancing their beliefs that it is part of their professional role to apply hand cream regularly.
A new development in PTSD and the law: the case of Fairfax County v. Mottram.
Lindahl, Mary W
2004-12-01
The decision of the Virginia Supreme Court in Fairfax County Fire & Rescue Department v. Mottram (2002) has important implications for Workers' Compensation claims for posttraumatic stress disorder, particularly those involving emergency services personnel. A firefighter/paramedic who developed chronic, disabling PTSD after responding to a fatal fire was denied benefits because he had previously reported symptoms of the disorder, whereas the statute recognized a single traumatic incident only. The court held that PTSD resulting from multiple traumatic stressors may be considered a compensable occupational disease analogous to dermatitis developed by a flower shop employee with chronic exposure to irritating stimuli. The decision, which constitutes legal recognition of work-related cumulative PTSD in rescue workers, provides benefits for treatment and encourages earlier treatment of traumatic stress in this group.
NASA Astrophysics Data System (ADS)
Ivanova, Irina; Golovina, Elena; Kulakov, Kirill; Sorokin, Andrey
2018-03-01
In the production of building structures for high-rise buildings, the dangerous and harmful factors of foundry production include high concentrations of dust and harmful gases released at various stages of the process. Disperse and elemental compositions of dust determine the hygienic state of the working area of the foundry. According to experts, the presence of dust of less than 10 microns in size in the air increases the danger of getting occupational diseases, such as pneumoconiosis (silicosis), bronchitis, dermatitis, conjunctivitis. The determination of the granulometric composition of the powder sample provided was carried out by the laser diffraction method realized on a laser particle analyzer Fritsch NanoTec «ANALISETTE 22».
... while it's healing. Allergic contact dermatitis is a rash caused by contact with an allergen (say: AL-ur-jun). An ... when you'll be going outside. For allergic dermatitis or irritant contact dermatitis, try to avoid that substance. If you ...
2013-07-11
4.91 Cellulitis 44 12 0.72 6 0.36 15 0.90 3 0.18 1 0.06 7 0.42 2.53 Contact dermatitis 49 14 0.84 4 0.24 25 1.50 6 0.36 – 0.00 – 0.00 3.34 Dermatitis ...3.50 6 2.20 7 2.10 15 2.70 45 3.70 184 3.20 Contact dermatitis 0 0.00 0 0.00 7 0.50 0 0.00 0 0.00 0 0.00 9 2.70 15 2.70 59 4.80 90 1.60 Dermatitis 56...0.54 42 1.61 13 0.50 10 0.38 12 0.46 103 3.95 Contact dermatitis 0 0.00 1 0.04 15 0.58 2 0.08 6 0.23 5 0.19 29 1.11 Dermatitis , unspec. 51 1.96 27 1.04
Current Quality-of-Life Tools Available for Use in Contact Dermatitis.
Swietlik, Jacquelyn; Reeder, Margo
2016-01-01
Contact dermatitis is a common dermatologic condition that can cause significant impairment in patients' overall quality of life (QoL). This impact is separate and potentially more clinically relevant than one's disease "severity" in contact dermatitis and should be consistently addressed by dermatologists. Despite this, QoL tools specific to contact dermatitis are lacking, and there is little consistency in the literature regarding the tool used to evaluate clinical response to therapies. Measurements currently available to evaluate disease-related QoL in contact dermatitis fit into 1 of the following 3 general types: generic health-related QoL measures, dermatology-related QoL measures, or specific dermatologic disease-related QoL measures. This article reviews the strengths and weaknesses of existing QoL tools used in contact dermatitis including: Short Form Survey 36, Dermatology Life Quality Index, Skindex-29, Skindex-16, Dermatology-Specific Quality of Life, and Fragrance Quality of Life Index.
The Role of Malassezia spp. in Atopic Dermatitis
Glatz, Martin; Bosshard, Philipp P.; Hoetzenecker, Wolfram; Schmid-Grendelmeier, Peter
2015-01-01
Malassezia spp. is a genus of lipophilic yeasts and comprises the most common fungi on healthy human skin. Despite its role as a commensal on healthy human skin, Malassezia spp. is attributed a pathogenic role in atopic dermatitis. The mechanisms by which Malassezia spp. may contribute to the pathogenesis of atopic dermatitis are not fully understood. Here, we review the latest findings on the pathogenetic role of Malassezia spp. in atopic dermatitis (AD). For example, Malassezia spp. produces a variety of immunogenic proteins that elicit the production of specific IgE antibodies and may induce the release of pro-inflammatory cytokines. In addition, Malassezia spp. induces auto-reactive T cells that cross-react between fungal proteins and their human counterparts. These mechanisms contribute to skin inflammation in atopic dermatitis and therefore influence the course of this disorder. Finally, we discuss the possible benefit of an anti-Malassezia spp. treatment in patients with atopic dermatitis. PMID:26239555
Dysbiosis and Staphylococcus aureus colonization drives inflammation in atopic dermatitis
Kobayashi, Tetsuro; Glatz, Martin; Horiuchi, Keisuke; Kawasaki, Hiroshi; Akiyama, Haruhiko; Kaplan, Daniel H.; Kong, Heidi H.; Amagai, Masayuki; Nagao, Keisuke
2015-01-01
Summary Staphylococcus aureus skin colonization is universal in atopic dermatitis and common in cancer patients treated with epidermal growth factor receptor inhibitors. However, the causal relationship of dysbiosis and eczema has yet to be clarified. Herein, we demonstrate that Adam17fl/flSox9-Cre mice, generated to model ADAM17-deficiency in human, developed eczematous dermatitis with naturally occurring dysbiosis, similar to that observed in atopic dermatitis. Corynebacterium mastitidis, S. aureus, and Corynebacterium bovis sequentially emerged during the onset of eczematous dermatitis, and antibiotic specific for these bacterial species almost completely reversed dysbiosis and eliminated skin inflammation. Whereas S. aureus prominently drove eczema formation, C. bovis induced robust T helper 2 cell responses. Langerhans cells were required for eliciting immune responses against S. aureus inoculation. These results characterize differential contributions of dysbiotic flora during eczema formation, and highlight the microbiota-host immunity axis as a possible target for future therapeutics in eczematous dermatitis. PMID:25902485
Kern, Malan; Shiver, Mallory B; Addis, Kristen M; Gardner, Jerad M
2017-09-01
Palisaded neutrophilic and granulomatous dermatitis and interstitial granulomatous dermatitis are uncommon granulomatous dermatoses that often arise in association with rheumatoid arthritis. These 2 entities have overlapping features and may exist on a spectrum. We report an intriguing case of a 53-year-old man with advanced rheumatoid arthritis who presented with a large indurated painful truncal plaque with a palpable cord in addition to a papulonodular eruption on his dorsal hands. Furthermore, our patient had a recurrence in a near-identical mirror-image pattern on the contralateral trunk. The constellation of clinical and histopathological findings in our patient further suggests that palisaded neutrophilic and granulomatous dermatitis and interstitial granulomatous dermatitis exist as overlapping disease entities on a continuum. In addition, we propose that recurrence of skin findings may be indicative of the severity of the underlying systemic disease process.
Chen, Jennifer K; Jacob, Sharon E; Nedorost, Susan T; Hanifin, Jon M; Simpson, Eric L; Boguniewicz, Mark; Watsky, Kalman L; Lugo-Somolinos, Aida; Hamann, Carsten R; Eberting, Cheryl Lee; Silverberg, Jonathan I; Thyssen, Jacob P
2016-01-01
Allergic contact dermatitis (ACD) may complicate the clinical course of atopic dermatitis (AD), and patch testing remains the criterion standard for diagnosing ACD. To date, there have been no guidelines or consensus recommendations on when and how to patch test individuals with AD. Failure to patch test when appropriate may result in overlooking an important and potentially curable complicating comorbidity. In this article, we present consensus recommendations regarding when to perform patch testing in the AD patient, best practices, and common pitfalls. Patch testing should be considered in AD patients with dermatitis that fails to improve with topical therapy; with atypical/changing distribution of dermatitis, or pattern suggestive of ACD; with therapy-resistant hand eczema in the working population; with adult- or adolescent-onset AD; and/or before initiating systemic immunosuppressants for the treatment of dermatitis. A suggested patch testing algorithm for AD patients is provided.
Treatment of Atopic Dermatitis From the Perspective of Traditional Persian Medicine
Choopani, Rasool; Mehrbani, Mehrzad; Fekri, Alireza; Mehrabani, Mitra
2015-01-01
There is a strong current trend for using complementary and alternative medications to treat atopic dermatitis. Atopic dermatitis is a common, chronic, pruritic, and inflammatory skin disease. It can have a profound, negative effect on patients’ quality of life. Mild cases of atopic dermatitis can be controlled by the application of moisturizers and topical corticosteroids. However, in severe cases, application of immunosuppressive medication is unavoidable but it can have adverse effects. In traditional Persian medicine, diseases similar to resistant atopic dermatitis are treated with whey in combination with decoction of field dodder. Both whey and field dodder have anti-inflammatory properties. Consumption of whey can also aid skin repair, mitigate pruritus, and help combat the high level of stress experienced by patients. Therefore, it is hypothesized that consumption of traditional medicinal treatment of whey with decoction of field dodder can be applied as a complementary treatment for atopic dermatitis. PMID:26260045
Hidaka, Takanori; Ogawa, Eisaku; Kobayashi, Eri H; Suzuki, Takafumi; Funayama, Ryo; Nagashima, Takeshi; Fujimura, Taku; Aiba, Setsuya; Nakayama, Keiko; Okuyama, Ryuhei; Yamamoto, Masayuki
2017-01-01
Atopic dermatitis is increasing worldwide in correlation with air pollution. Various organic components of pollutants activate the transcription factor AhR (aryl hydrocarbon receptor). Through the use of AhR-CA mice, whose keratinocytes express constitutively active AhR and that develop atopic-dermatitis-like phenotypes, we identified Artn as a keratinocyte-specific AhR target gene whose product (the neurotrophic factor artemin) was responsible for epidermal hyper-innervation that led to hypersensitivity to pruritus. The activation of AhR via air pollutants induced expression of artemin, alloknesis, epidermal hyper-innervation and inflammation. AhR activation and ARTN expression were positively correlated in the epidermis of patients with atopic dermatitis. Thus, AhR in keratinocytes senses environmental stimuli and elicits an atopic-dermatitis pathology. We propose a mechanism of air-pollution-induced atopic dermatitis via activation of AhR.
Severe facial dermatitis as a late complication of aesthetic rhinoplasty; a case report
Rajabian, Mohammad Hossain; Sodaify, Manoochehr; Aghaei, Shahin
2004-01-01
Background Contact dermatitis, as a cutaneous complication after rhinoplasty, is of early onset, limited and transient. The cause of this dermatitis is irritant or allergic. Late onset skin complications are rare and non-inflammatory. Case presentation We are reporting an unexpected, severe allergic contact dermatitis of the face, in a young female, appearing one month following aesthetic rhinoplasty. She failed to respond to ordinary treatments for dermatitis. We did standard battery – including nitrofurazone, tincture of benzoin and hydrocortisone – patch test for the patient that showed sensitivity to benzoin and corticosteroid. Conclusions In summary we report a case of a severe allergic contact dermatitis of the face, in a 21-year-old girl who underwent corrective aesthetic rhinoplasty, appearing one month following surgical operation. We were unable to find a similar report in the medical literature. PMID:15056395
Allergic contact dermatitis to fragrances: part 2.
Arribas, M P; Soro, P; Silvestre, J F
2013-01-01
Allergic contact dermatitis due to fragrances usually manifests as subacute or chronic dermatitis because fragrances are found in a wide range of products to which patients are repeatedly exposed. The typical patient is a middle-aged woman with dermatitis on her hands and face, although other sites may be affected depending on the allergen and the product in which it is found. The standard patch test series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) contains 4 fragrance markers: balsam of Peru, fragrance mix i, fragrance mix ii, and lyral. Testing with a specific fragrance series is recommended in patients with a positive result to any of these 4 markers. The use of a specific fragrance series and new legislation obliging manufacturers to specify the fragrances used in their products, will help to improve the management of allergic contact dermatitis due to fragrances. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.
Wet Work and Barrier Function.
Fartasch, Manigé
2016-01-01
Wet work defined as unprotected exposure to humid environments/water; high frequencies of hand washing procedures or prolonged glove occlusion is believed to cause irritant contact dermatitis in a variety of occupations. This review considers the recent studies on wet-work exposure and focuses on its influence on barrier function. There are different methods to study the effect of wet work on barrier function. On the one hand, occupational cohorts at risk can be monitored prospectively by skin bioengineering technology and clinical visual scoring systems; on the other hand, experimental test procedures with defined application of water, occlusion and detergents are performed in healthy volunteers. Both epidemiological studies and the results of experimental procedures are compared and discussed. A variety of epidemiological studies analyze occupational cohorts at risk. The measurement of transepidermal water loss, an indicator of the integrity of the epidermal barrier, and clinical inspection of the skin have shown that especially the frequencies of hand washing and water contact/contact to aqueous mixtures seem to be the main factors for the occurrence of barrier alterations. On the other hand, in a single cross-sectional study, prolonged glove wearing (e.g. occlusion for 6 h per shift in clean-room workers) without exposure to additional hazardous substances seemed not to affect the skin negatively. But regarding the effect of occlusion, there is experimental evidence that previously occluded skin challenged with sodium lauryl sulfate leads to an increased susceptibility to the irritant with an aggravation of the irritant reaction. These findings might have relevance for the real-life situation in so far as after occupational glove wearing, the skin is more susceptible to potential hazards to the skin even during leisure hours. © 2016 S. Karger AG, Basel.
Febriana, Sri Awalia; Jungbauer, Frank; Soebono, Hardyanto; Coenraads, Pieter-Jan
2012-07-01
Tannery workers are exposed to hazardous chemicals. Tannery work is outsourced to newly industrialized countries (NICs) where attention into occupational health hazards is limited. In this study, we investigated the skin exposure to hazardous chemicals in tannery workers and determined the prevalence of occupational skin diseases (OSDs) at tanneries in a NIC. A cross-sectional study on the observation of the working process and an inventory and risk assessment of the chemicals used. Classification of chemicals as potential sensitizers/irritants and a qualitative assessment of exposure to these chemicals. Workers were examined and interviewed using Nordic Occupational Skin Questionnaire-2002/LONG. The risk of OSDs at the investigated tanneries was mainly related to the exposure of the workers' skin to chemicals in hot and humid environmental conditions. In 472 workers, 12% reported a current OSD and 9% reported a history of OSD. In 10% of all cases, an OSD was confirmed by a dermatologist and 7.4% had an occupational contact dermatitis (OCD). We observed that personal protective equipment (PPE) used was mainly because of skin problems in the past and not as a primary protection against OSD. We observed a high frequency and prolonged exposure to many skin hazardous factors in tannery work although PPE was relatively easily available and which was generally used as a secondary preventative measure. The observed point-prevalence in this study was at the same level as that reported for other high-risk OSDs in Western countries and other tanneries in NICs. However, the observed point-prevalence in this study was lower than that reported in India and Korea. The results of our study and those of other studies at tanneries from other NICs were probably influenced by Healthy Worker Survivor Effect (HWSE).
Work-related ill-health: Republic of Ireland, Northern Ireland, Great Britain 2005-2012.
Money, A; Carder, M; Noone, P; Bourke, J; Hayes, J; Turner, S; Agius, R
2015-01-01
Data on work-related ill-health (WRIH) in the Republic of Ireland is inconsistent. To compare the incidence of WRIH in the Republic of Ireland (ROI), Northern Ireland (NI) and Great Britain (GB) reported by clinical specialists in skin and respiratory medicine and by specialist occupational physicians (OPs). Analysis of data reported to three surveillance schemes in The Health and Occupation Research (THOR) network in ROI and corresponding UK schemes. Contact dermatitis was the most frequently reported skin disease in the three areas. Asthma was the most frequently-reported respiratory disease in the ROI, while asbestos-related cases predominate in GB and NI. Mental health disorders, followed by musculoskeletal disorders were reported most frequently by OPs. Annual average incidence rates for skin disease were 2 per 100000 employed (95% confidence interval [CI] 1.9-2.8) in the ROI and 7 per 100000 for GB (95% CI 4.8-9.4). Unadjusted incidence rates for respiratory disease were 1 (95% CI 0.3-1) and 8 (95% CI 6.1-10.7) per 100000 in the ROI and GB, respectively; adjusted for reporter non-response, these figures increased to 15 (95% CI 11.3-19.6) and 32 (95% CI 28.4-35.6) per 100000 respectively. This is the first paper to include THOR data on WRIH from the ROI, NI and GB. Consistent and dedicated data collection in the ROI via the THOR schemes is viable and important in the light of a deficit of occupational ill-health data. Sustained efforts to improve participation are underway. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Parents' reported preference scores for childhood atopic dermatitis disease states
Friedman, Joëlle Y; Reed, Shelby D; Weinfurt, Kevin P; Kahler, Kristijan H; Walter, Emmanuel B; Schulman, Kevin A
2004-01-01
Background We sought to elicit preference weights from parents for health states corresponding to children with various levels of severity of atopic dermatitis. We also evaluated the hypothesis that parents with children who had been diagnosed with atopic dermatitis would assign different preferences to the health state scenarios compared with parents who did not have a child with atopic dermatitis. Methods Subjects were parents of children aged 3 months to 18 years. The sample was derived from the General Panel, Mommies Sub-Panel, and Chronic Illness Sub-Panel of Harris Interactive. Participants rated health scenarios for atopic dermatitis, asthma, and eyeglasses on a visual analog scale, imagining a child was experiencing the described state. Results A total of 3539 parents completed the survey. Twenty-nine percent had a child with a history of atopic dermatitis. Mean preference scores for atopic dermatitis were as follows: mild, 91 (95% confidence interval [CI], 90.7 to 91.5); mild/moderate, 84 (95%CI, 83.5 to 84.4); moderate, 73 (95%CI, 72.5 to 73.6); moderate/severe, 61 (95%CI, 60.6 to 61.8); severe, 49 (95% CI, 48.7 to 50.1); asthma, 58 (95%CI, 57.4 to 58.8); and eyeglasses, 87(95%CI, 86.3 to 87.4). Conclusions Parents perceive that atopic dermatitis has a negative effect on quality of life that increases with disease severity. Estimates of parents' preferences can provide physicians with insight into the value that parents place on their children's treatment and can be used to evaluate new medical therapies for atopic dermatitis. PMID:15491500
Mitchell, Amy E; Fraser, Jennifer A
2011-02-01
Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change. To develop a suite of valid and reliable research instruments to appraise parents' self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis. The Parents' Eczema Management Scale (PEMS) and the Parents' Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales' reliability and validity was conducted. A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia. Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child's symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of atopic dermatitis by the parent, involving healthcare professionals in management, and involving the child in the management of atopic dermatitis were found. Parents' self-efficacy and outcome expectations had a significant influence on self-reported task performance. Findings suggest that PEMS and POEEMS are valid and reliable instruments worthy of further psychometric evaluation. Likewise, validity and reliability of PASECI was confirmed. Copyright © 2010 Elsevier Ltd. All rights reserved.
Increasing Comorbidities Suggest that Atopic Dermatitis Is a Systemic Disorder.
Brunner, Patrick M; Silverberg, Jonathan I; Guttman-Yassky, Emma; Paller, Amy S; Kabashima, Kenji; Amagai, Masayuki; Luger, Thomas A; Deleuran, Mette; Werfel, Thomas; Eyerich, Kilian; Stingl, Georg
2017-01-01
Atopic dermatitis comorbidities extend well beyond the march to allergic conditions (food allergy, asthma, allergic rhinitis, allergic conjunctivitis, and eosinophilic esophagitis), suggesting both cutaneous and systemic immune activation. In reviewing atopic dermatitis comorbidities, Councilors of the International Eczema Council found a strong pattern of immune activation in peripheral blood and the propensity to both skin and systemic infections. Associations with cardiovascular, neuropsychiatric, and malignant diseases were increasingly reported, but confirmation of their link with atopic dermatitis requires longitudinal studies. Given the possibility of atopic dermatitis-related systemic immune activation, future investigations of new interventions should concurrently examine the impact on these comorbidities. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Chromate Dermatitis from Paint
Engel, H. O.; Calnan, C. D.
1963-01-01
Among 250 workers engaged on wet sandpapering of primer paint on car bodies 65 developed a contact dermatitis. The average latent period before dermatitis developed was 4·6 months: only 60% of the patients made a completely satisfactory recovery. The average duration of dermatitis was 5·3 months. Two thirds of the men used one of two barrier creams supplied, while one third used none. Routine patch testing showed that the majority was allergic to chromate. It was found that a primer paint contained zinc chromate, which had been introduced into the paint by the manufacturers shortly before the first cases occurred. Removal of chromate from the paint resulted in a prompt cessation of new cases of dermatitis. Images PMID:14046155
Atopic Dermatitis According to GARP: New Mechanistic Insights in Disease Pathogenesis.
Nousbeck, Janna; Irvine, Alan D
2016-12-01
In complex disease such as atopic dermatitis, the journey from identification of strong risk loci to profound functional and mechanistic insights can take several years. Here, Manz et al. have elegantly deciphered the mechanistic pathways in the well-established 11q13.5 atopic dermatitis risk locus. Their genetic and functional insights emphasize a role for T regulatory cells in atopic dermatitis pathogenesis. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Conctact dermatitis: some important topics.
Pigatto, P D
2015-11-01
Allergic contact dermatitis (ACD) is a type IV delayed hypersensitivity reaction. The gold standard for diagnosis is patch testing. The prevalence of positive patch tests in referred patients with suspected ACD ranges from 27 to 95.6%. The relationship between ACD and atopic dermatitis (AD) is complicated with conflicting reports of prevalence in the literature; however, in a patient with dermatitis not responding to traditional therapies, or with new areas of involvement, ACD should be considered as part of the work-up.
Eyelid Dermatitis Caused by Allergic Contact to Acrylates in Artificial Nails.
Moreira, Jorge; Gonçalves, Rita; Coelho, Pedro; Maio, Tiago
2017-03-13
Over the past few years, there has been an increase in cases of allergic contact dermatitis caused by acrylates, because of the growing popularity of artificial nails. Pathological reactions to artificial nails typically occur on or around the nail area. Eyelid contact dermatitis due to artificial nails is rarely seen, especially in a nonoccupational setting. The authors report the case of a 45-year-old female accountant who developed eyelid dermatitis due to artificial nails.
Digital Dermatitis in Cattle: Current Bacterial and Immunological Findings
Wilson-Welder, Jennifer H.; Alt, David P.; Nally, Jarlath E.
2015-01-01
Simple Summary Digital dermatitis causes lameness in cattle. Numerous studies have identified multiple bacteria associated with these painful lesions. Several types of a spiral shaped bacteria, Treponema species, are thought to play a role in disease development. Little is known about the immune response to bacteria involved in digital dermatitis. Local inflammatory cells can contribute to the non-healing nature of the disease. Animal models of infection are required to develop effective vaccines and treatments. Abstract Globally; digital dermatitis is a leading form of lameness observed in production dairy cattle. While the precise etiology remains to be determined; the disease is clearly associated with infection by numerous species of treponemes; in addition to other anaerobic bacteria. The goal of this review article is to provide an overview of the current literature; focusing on discussion of the polybacterial nature of the digital dermatitis disease complex and host immune response. Several phylotypes of treponemes have been identified; some of which correlate with location in the lesion and some with stages of lesion development. Local innate immune responses may contribute to the proliferative, inflammatory conditions that perpetuate digital dermatitis lesions. While serum antibody is produced to bacterial antigens in the lesions, little is known about cellular-based immunity. Studies are still required to delineate the pathogenic traits of treponemes associated with digital dermatitis; and other host factors that mediate pathology and protection of digital dermatitis lesions. PMID:26569318
Kwon, Jeoung A.; Park, Eun-Cheol; Lee, Minjee; Yoo, Ki-Bong; Park, Sohee
2013-01-01
This study investigated the relationship between level of stress in middle and high school students aged 12–18 and risk of atopic dermatitis. Data from the Sixth Korea Youth Risk Behavior Web-based Survey (KYRBWS-VI), a cross-sectional study among 74,980 students in 800 middle schools and high schools with a response rate of 97.7%, were analyzed. Ordinal logistic regression analyses were conducted to determine the relationship between stress and atopic dermatitis with severity. A total of 5,550 boys and 6,964 girls reported having been diagnosed with atopic dermatitis. Younger students were more likely to have atopic dermatitis. Interestingly, the educational level of parents was found to be associated with having atopic dermatitis and having more severe condition. In particular, girls with mothers with at least college education had a 41% higher risk of having atopic dermatitis and severe atopic condition (odds ratio (OR)) = 1.41, 95% CI, 1.22–1.63; P<0.0001) compared with those with mothers who had attended middle school at most. Similar trend was shown among both boys and girls for their father's education level. The stress level was found to be significantly associated with the risk of atopic dermatitis. Compared to boys with who reported “no stress”, boys with “very high” stress had 46% higher the risk of having more severe atopic dermatitis (OR = 1.46, 95% CI, 1.20–1.78; P<0.0001), 44% higher (OR = 1.44, 95% CI, 1.19–1.73; P<0.0001) with “high” stress, and 21% higher (OR = 1.21, 95% CI, 1.00–1.45; P = 0.05) with “moderate” stress. In contrast, we found no statistically significant relationship between stress and atopic dermatitis in girls. This study suggests that stress and parents' education level were associated with atopic dermatitis. Specifically, degree of stress is positively correlated with likelihood of being diagnosed with this condition and increasing the severity. PMID:23940513
Prospective multicenter survey on the clinical management of pediatric contact dermatitis.
Ruggiero, Giuseppe; Carnevale, Claudia; Diociaiuti, Andrea; Arcangeli, Fabio; El Hachem, May
2016-12-01
Contact dermatitis can be defined as an inflammatory process affecting the skin surface and induced by contact with chemical, physical and/or biotic agents in the environment. It causes lesions to skin, mucosae and semi-mucosae by means of allergic and irritant pathogenic mechanisms. Among the main triggers of contact dermatitis in the pediatric age are chemical or physical agents, which cause irritant contact dermatitis (ICD), and sensitizers, which cause a tissue damage through an allergic mechanism (allergic contact dermatitis [ACD]). A prospective, multicenter, observational study was carried out in 204 children affected by contact dermatitis, aged up to 14 years, and enrolled by pediatricians from 7 different Italian provinces. The diagnosis of contact dermatitis was based on the pediatrician's clinical evaluation. The data were collected through a series of simple and multiple choice questions, anonymously filled out by pediatricians. In 90% of cases (184 of 204 patients), there was complete remission of contact dermatitis, with no cases of worsening. No adverse events were observed, either. The effectiveness of the therapy was rated as "very effective" by 84.4% of the parents and 86.8% of the pediatricians. In only 10 patients a new therapy had to be prescribed. Contact dermatitis is a heterogeneous inflammatory skin disease induced by contact with different kinds of environmental agents. Cutaneous manifestations are highly variable and depend on the modality of contact, on the causative agent and on the pathogenesis. This Italian experience of a clinical approach to contact dermatitis stresses the need of daily skin care through different therapeutic strategies, based on the diagnosis, the clinical severity and the parents and children compliance. The first therapeutic measure to be implemented is prevention, through the removal of the causative agent and the use of protective devices. Indeed, preserving the skin's barrier function is an important goal and a priority of treatment algorithms.
Polysensitization and individual susceptibility to allergic contact dermatitis.
Gosnell, Amy L; Schmotzer, Brian; Nedorost, Susan T
2015-01-01
Patients with allergic contact dermatitis to 1 antigen have been shown to be at increased risk of developing delayed type hypersensitivity reactions to additional antigens. Both environmental and genetic factors likely influence the risk of sensitization. The aim of this study was to determine whether polysensitization occurs at a higher frequency than would be expected based on chance and whether polysensitization occurs more often in subsets of patients with hand involvement and atopic dermatitis. From a database of patch test results from a single practitioner, the probability of having positive reactions to 3 or more unrelated allergens was calculated under the assumption that positive reactions are independent and compared with the observed proportion having positive reactions to 3 or more unrelated allergens. The analysis was repeated excluding patients with leg involvement as a proxy for venous insufficiency dermatitis. The proportion of patients from the polysensitized and nonpolysensitized cohorts with either hand involvement or a history of atopic dermatitis was also calculated. Polysensitization occurs more often than expected based on chance. Polysensitized patients were more likely to have hand dermatitis. Atopic dermatitis was not significantly associated with polysensitization in this analysis. Polysensitized individuals may represent a phenotype with increased genetic susceptibility to sensitization.
Schalock, Peter C; Thyssen, Jacob P
2013-01-01
Metal hypersensitivity reactions to implanted devices remain a challenging and controversial topic. Diagnostic criteria and methods are not well delineated. Diagnostic criteria for hypersensitivity reactions after metallic device implantation are evaluated in this study by a multinational group of patch testers using Thyssen's previously published criteria. A total of 119 dermatologists at the 2012 European Contact Dermatitis Society and 2013 American Contact Dermatitis Society meetings answered a survey regarding their opinions on topics relating to metal hypersensitivity. Four major and 5 minor diagnostic criteria emerged. Approximately 80% of respondents found the following criteria useful (major criteria): chronic dermatitis beginning weeks to months after metallic implantation, eruption overlying the metal implant, positive patch test to a metal component of the implant, and complete clearing after removal of the potentially allergenic implant. Minor criteria (<61% of respondents) were as follows: systemic allergic dermatitis reaction, therapy-resistant dermatitis, morphology consistent with dermatitis, histology consistent with allergic contact dermatitis, and a positive in vitro test to metals (eg, lymphocyte transformation test). In the challenging situation such as a symptomatic or failing orthopedic device, applying these 4 major criteria and the 5 supportive minor criteria may be useful for guiding decision making.
Advances in understanding and managing atopic dermatitis
Barton, Michael; Sidbury, Robert
2015-01-01
Atopic dermatitis is a chronic, pruritic skin disease characterized by an improperly functioning skin barrier and immune dysregulation. We review proposed atopic dermatitis pathomechanisms, emphasizing how these impact current perspectives on natural history, role of allergic sensitization, and future therapeutic targets. PMID:26918129
Crystal deodorant dermatitis: irritant dermatitis to alum-containing deodorant.
Gallego, H; Lewis, E J; Crutchfield, C E
1999-07-01
Two patients developed an irritant dermatitis of the axillae shortly after using an over-the-counter "natural deodorant crystal" product containing alum. We discuss this previously unreported, untoward reaction to alum, an ancient agent with newfound popularity as an alternative health product.
Pustular irritant contact dermatitis caused by dexpanthenol in a child.
Gulec, Ali Ihsan; Albayrak, Hulya; Uslu, Esma; Başkan, Elife; Aliagaoglu, Cihangir
2015-03-01
Pustular irritant contact dermatitis is rare and unusual clinic form of contact dermatitis. Dexpanthenol is the stable alcoholic analogue of pantothenic acid. It is widely used in cosmetics and topical medical products for several purposes. We present the case of 8-year-old girl with pustules over erythematous and eczematous areas on the face and neck. To the best of our knowledge, this is the first case reported that is diagnosed as pustular irritant contact dermatitis caused by dexpanthenol.
2013-04-24
established to minimize the potential of dermal irritation and dermatitis (6). Chromium exposure can lead to allergic contact dermatitis , irritant... dermatitis with skin contact . (5; 15; 25; 33; 47). Nickel is potentially the most common contact allergen among the general population. Some studies...thresholds - a review focusing on occluded nickel exposure. Contact Dermatitis 52:57-64 21. Fogh CL, Andersson KG. 2000. Modelling of skin exposure
[Atopic dermatitis in children: general principles of management].
Takeuchi, Yusuke Leo; Christen-Zaech, Stéphanie
2013-04-03
Atopic dermatitis is the most frequent dermatosis in childhood. Numerous studies underscored the central role of skin barrier alterations in the pathogenesis of the inflammatory skin lesions. The management of atopic dermatitis has to be multidimensional. It combines among others some daily local care and a sporadic topical anti-inflammatory treatment during the acute flare-ups. The objective of this article is to summarize, in light of the recent European guidelines, the general principles of management of atopic dermatitis, for the general practitioner.
Eyelid Dermatitis Caused by Allergic Contact to Acrylates in Artificial Nails
Moreira, Jorge; Gonçalves, Rita; Coelho, Pedro; Maio, Tiago
2017-01-01
Over the past few years, there has been an increase in cases of allergic contact dermatitis caused by acrylates, because of the growing popularity of artificial nails. Pathological reactions to artificial nails typically occur on or around the nail area. Eyelid contact dermatitis due to artificial nails is rarely seen, especially in a nonoccupational setting. The authors report the case of a 45-year-old female accountant who developed eyelid dermatitis due to artificial nails. PMID:28603598
Park, Shin Yong; Gupta, Dipika; Kim, Chang H.; Dziarski, Roman
2011-01-01
Skin protects the body from the environment and is an important component of the innate and adaptive immune systems. Atopic dermatitis and contact dermatitis are among the most frequent inflammatory skin diseases and are both determined by multigenic predisposition, environmental factors, and aberrant immune response. Peptidoglycan Recognition Proteins (Pglyrps) are expressed in the skin and we report here that they modulate sensitivity to experimentally-induced atopic dermatitis and contact dermatitis. Pglyrp3 −/− and Pglyrp4 −/− mice (but not Pglyrp2 −/− mice) develop more severe oxazolone-induced atopic dermatitis than wild type (WT) mice. The common mechanism underlying this increased sensitivity of Pglyrp3 −/− and Pglyrp4 −/− mice to atopic dermatitis is reduced recruitment of Treg cells to the skin and enhanced production and activation Th17 cells in Pglyrp3 −/− and Pglyrp4 −/− mice, which results in more severe inflammation and keratinocyte proliferation. This mechanism is supported by decreased inflammation in Pglyrp3 −/− mice following in vivo induction of Treg cells by vitamin D or after neutralization of IL-17. By contrast, Pglyrp1 −/− mice develop less severe oxazolone-induced atopic dermatitis and also oxazolone-induced contact dermatitis than WT mice. Thus, Pglyrp3 and Pglyrp4 limit over-activation of Th17 cells by promoting accumulation of Treg cells at the site of chronic inflammation, which protects the skin from exaggerated inflammatory response to cell activators and allergens, whereas Pglyrp1 has an opposite pro-inflammatory effect in the skin. PMID:21949809
Noneczematous Contact Dermatitis
Foti, Caterina; Vestita, Michelangelo; Angelini, Gianni
2013-01-01
Irritant or allergic contact dermatitis usually presents as an eczematous process, clinically characterized by erythematoedematovesicous lesions with intense itching in the acute phase. Such manifestations become erythematous-scaly as the condition progresses to the subacute phase and papular-hyperkeratotic in the chronic phase. Not infrequently, however, contact dermatitis presents with noneczematous features. The reasons underlying this clinical polymorphism lie in the different noxae and contact modalities, as well as in the individual susceptibility and the various targeted cutaneous structures. The most represented forms of non-eczematous contact dermatitis include the erythema multiforme-like, the purpuric, the lichenoid, and the pigmented kinds. These clinical entities must obviously be discerned from the corresponding “pure” dermatitis, which are not associated with contact with exogenous agents. PMID:24109520
Protein contact dermatitis: allergens, pathogenesis, and management.
Levin, Cheryl; Warshaw, Erin
2008-01-01
Protein contact dermatitis is an allergic skin reaction induced principally by proteins of either animal or plant origin. The clinical presentation is that of a chronic dermatitis, and it is often difficult to differentiate between allergic contact dermatitis and other eczematous dermatoses. One distinguishing clinical feature is that acute flares of pruritus, urticaria, edema, or vesiculation are noted minutes after contact with the causative substances. Additionally, the patch-test result is typically negative, and the scratch- or prick-test result is positive. The pathogenesis of protein contact dermatitis is unclear but may involve a type I (immunoglobulin E [IgE], immediate) hypersensitivity reaction, type IV (cell-mediated delayed) hypersensitivity reaction, and/or a delayed reaction due to IgE-bearing Langerhans' cells. Management involves avoidance of the allergen.
Dysbiosis and Staphylococcus aureus Colonization Drives Inflammation in Atopic Dermatitis.
Kobayashi, Tetsuro; Glatz, Martin; Horiuchi, Keisuke; Kawasaki, Hiroshi; Akiyama, Haruhiko; Kaplan, Daniel H; Kong, Heidi H; Amagai, Masayuki; Nagao, Keisuke
2015-04-21
Staphylococcus aureus skin colonization is universal in atopic dermatitis and common in cancer patients treated with epidermal growth factor receptor inhibitors. However, the causal relationship of dysbiosis and eczema has yet to be clarified. Herein, we demonstrate that Adam17(fl/fl)Sox9-(Cre) mice, generated to model ADAM17-deficiency in human, developed eczematous dermatitis with naturally occurring dysbiosis, similar to that observed in atopic dermatitis. Corynebacterium mastitidis, S. aureus, and Corynebacterium bovis sequentially emerged during the onset of eczematous dermatitis, and antibiotics specific for these bacterial species almost completely reversed dysbiosis and eliminated skin inflammation. Whereas S. aureus prominently drove eczema formation, C. bovis induced robust T helper 2 cell responses. Langerhans cells were required for eliciting immune responses against S. aureus inoculation. These results characterize differential contributions of dysbiotic flora during eczema formation, and highlight the microbiota-host immunity axis as a possible target for future therapeutics in eczematous dermatitis. Copyright © 2015 Elsevier Inc. All rights reserved.
Dermatitis herpetiformis--a skin manifestation of a generalized disturbance in immunity.
Davies, M G; Marks, R; Nuki, G
1978-04-01
Detailed investigations on 42 patients with dermatitis herpetiformis (DH) are presented, emphasis being placed on the presence of other disorders having a prominent immunopathogenic basis. These patients and 42 age and sex matched controls were submitted to an extensive clinical and investigative search for the presence of disorders with an immunological basis including the atopic disorders. The findings provided further evidence supporting the association of dermatitis herpetiformis with thyroid disease and pernicious anaemia. A statistically increased incidence of Raynaud's phenomenon and atopy was found in the patients with dermatitis herpetiformis compared to the control group. In addition, of the patients with dermatitis herpetiformis, two had rheumatoid arthritis, two had ulcerative colitis, one had systemic lupus erythematosus and four had splenomegaly. The possible basis for these associations is discussed and it is suggested that dermatitis herpetiformis may be part of a wider spectrum of disease. Genetic linkage and the formation of immune complexes following exposure to a dietary antigen may both be responsible for the disorders associated with DH.
Treudler, R; Richter, G; Geier, J; Schnuch, A; Orfanos, C E; Tebbe, B
2000-02-01
Contact allergy to oil of turpentine was reported to have become rare. However, the evaluation of standardized data of 45,005 patients tested 1992-1997 in 30 Dermatological Centers associated with the German-Austrian Information Network of Departments of Dermatology (IVDK) showed an increase in positive patch test reactions to turpentine from 0.5% during the years 1992-1995, up to 1.7% in 1996 and 3.1% in 1997. In particular, 17,347 patients tested in 1996-1997 were evaluated in detail by comparing 431 individuals with positive patch test reactions with the rest of the group found negative to turpentine. Using the so-called MOAHLFA index, the following characteristics were shown. Turpentine allergy (a) was found to be significantly less frequent in men and in patients with occupational dermatitis, (b) showed no difference in its association with atopic dermatitis, (c) patients with turpentine allergy had significantly less symptoms of the hands, more symptoms of the legs or in the face and (d) were significantly more often aged over 60 years. Also, patients sensitized to turpentine had increased rates of additional sensitizations. The definite reason for the increase in turpentine sensitization in the population tested here is not clear. Therefore, a detailed exposure analysis is necessary; the new increase in turpentine allergies may be due to popular topical remedies or household chemicals.
Aerts, Olivier; Meert, Hans; Romaen, Elien; Leysen, Julie; Matthieu, Lucretia; Apers, Sandra; Lambert, Julien; Goossens, An
2016-11-01
Octylisothiazolinone (OIT) is used as an antifungal agent by the leather industry. To show sensitization to OIT from leather, and to highlight the potential implications when cross-reactivity between OIT and methylisothiazolinone (MI) is studied. Two patients with allergic contact dermatitis caused by a leather belt and shoes, respectively, were patch tested with methylchloroisothiazolinone (MCI)/MI, MI, MCI, OIT, and benzisothiazolinone (BIT). High-performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect isothiazolinone derivatives in leather goods. Additionally, files of OIT-sensitized patients, observed at the KU Leuven department during the period 1990-2015, were retrospectively analysed. Both patients had been primarily sensitized to OIT, but the diagnosis in one of them could be achieved only when a higher patch test concentration of OIT (1000 ppm pet.) was used. HPLC-UV confirmed the presence of OIT in their leather goods. Non-relevant sensitization to MI was noted in both cases. Four additional cases of OIT sensitization from leather could be retrieved from the KU Leuven database. Non-occupational sensitization to OIT from leather may occur. Patch test concentrations of >250 ppm pet. may be necessary for diagnosis, and to show cross-reactivity with MI. Safer use limits for OIT in the leather industry may be needed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Almutawa, Fahad
2017-01-01
Introduction Contact with nickel-releasing coins as a cause of hand dermatitis has been debated. Aim Studying a hand dermatitis risk from handling Kuwaiti cupronickel coins among nickel-allergic and nickel non-allergic subjects. Material and methods One hundred hand dermatitis patients (group I: nickel-allergic) and 100 matched patients (group II: nickel non-allergic) were selected from over 500 hand dermatitis cases seen between September 2014 and September 2015. Nickel released from Kuwaiti cupronickel coins immersed in a standardized artificial sweat solution was measured at 1, 24, 48, 144 and 168 h at room temperature. Subjects in both groups were exposed to nickel releasing coins. The process was repeated after 3 months using nickel coated coins as controls. Results Nickel released from 20, 50 and 100 fils Kuwaiti cupronickel coins at 1 week was 28.64, 32.76, 35.76 μg/cm2/week, respectively. Ninety-one patients (29 males, 62 females) in group I and 87 patients (38 males, 49 females) in group II completed the study. 47.3% in group I vs. 13.8% in group II developed dermatitis on exposure to nickel releasing coins. Nickel coated coins resulted in dermatitis in 8.8% of group I vs. 5.7% in group II. Conclusions Nickel is released significantly from cupronickel Kuwaiti coins. Handling of coins caused dermatitis more often in patients with nickel-allergy compared to nickel non-allergic patients. PMID:28951705
Ahmadloo, Niloofar; Kadkhodaei, Behnam; Omidvari, Shapour; Mosalaei, Ahmad; Ansari, Mansour; Nasrollahi, Hamid; Hamedi, Sayed Hasan; Mohammadianpanah, Mohammad
2017-01-01
Purpose: Radiotherapy induced dermatitis is a common and sometimes serious side effect. We conducted a randomized study to understand whether the adjunctive use of aloe vera gel might reduce the prevalence and/or severity of radiotherapy induced dermatitis. Methods: One hundred patients with newly diagnosed breast cancer were randomized to receive aloe vera gel or nothing during adjuvant radiotherapy consisting of conventional external beam radiation using 6 MV mega voltage linear accelerator photons. The radiation portals were composed of breast fields in all patients and supraclavicular and posterior axillary fields in node positive cases. The total dose was 50 Gy with a daily fraction of 2 Gy, five fractions per week. Results: Dermatitis was first found among patients of both groups after week 2. In the aloe vera and control groups, 2/8 patients and 5/12 patients had dermatitis grade 1 after weeks 2 (P value = 0.240) and 3 (P value = 0.317). After the 4th week, the numbers were 18 and, 23 fordermatitis grade 1 and only 1 for grade 3 dermatitis (P value = 0.328). After the 5th week, 31, 12 and 2 patients in the aloe vera group and 36, 6 and 5 of the controls had grades 1, 2 and 3 dermatitis, respectively (P value = 0.488). Conclusion: Aloe vera exerted no positive effect on prevalence orseverity of radiation dermatitis in this study. PMID:28547955
Ahmadloo, Niloofar; Kadkhodaei, Behnam; Omidvari, Shapour; Mosalaei, Ahmad; Ansari, Mansour; Nasrollahi, Hamid; Hamedi, Sayed Hasan; Mohammadianpanah, Mohammad
2017-04-01
Purpose: Radiotherapy induced dermatitis is a common and sometimes serious side effect. We conducted a randomized study to understand whether the adjunctive use of aloe vera gel might reduce the prevalence and/or severity of radiotherapy induced dermatitis. Methods: One hundred patients with newly diagnosed breast cancer were randomized to receive aloe vera gel or nothing during adjuvant radiotherapy consisting of conventional external beam radiation using 6 MV mega voltage linear accelerator photons. The radiation portals were composed of breast fields in all patients and supraclavicular and posterior axillary fields in node positive cases. The total dose was 50 Gy with a daily fraction of 2 Gy, five fractions per week. Results: Dermatitis was first found among patients of both groups after week 2. In the aloe vera and control groups, 2/8 patients and 5/12 patients had dermatitis grade 1 after weeks 2 (P value = 0.240) and 3 (P value = 0.317). After the 4th week, the numbers were 18 and, 23 fordermatitis grade 1 and only 1 for grade 3 dermatitis (P value = 0.328). After the 5th week, 31, 12 and 2 patients in the aloe vera group and 36, 6 and 5 of the controls had grades 1, 2 and 3 dermatitis, respectively (P value = 0.488). Conclusion: Aloe vera exerted no positive effect on prevalence orseverity of radiation dermatitis in this study. Creative Commons Attribution License
Borrego, Leopoldo; Hernández, Noelia; Hernández, Zaida; Peñate, Yeray
2016-05-01
Povidone-iodine solution is an antiseptic that is used worldwide as surgical paint and is considered to have a low irritant potential. Post-surgical severe irritant dermatitis has been described after the misuse of this antiseptic in the surgical setting. Between January 2011 and June 2013, 27 consecutive patients with post-surgical contact dermatitis localized outside of the surgical incision area were evaluated. Thirteen patients were also available for patch testing. All patients developed dermatitis the day after the surgical procedure. Povidone-iodine solution was the only liquid in contact with the skin of our patients. Most typical lesions were distributed in a double lumbar parallel pattern, but they were also found in a random pattern or in areas where a protective pad or an occlusive medical device was glued to the skin. The patch test results with povidone-iodine were negative. Povidone-iodine-induced post-surgical dermatitis may be a severe complication after prolonged surgical procedures. As stated in the literature and based on the observation that povidone-iodine-induced contact irritant dermatitis occurred in areas of pooling or occlusion, we speculate that povidone-iodine together with occlusion were the causes of the dermatitis epidemic that occurred in our surgical setting. Povidone-iodine dermatitis is a problem that is easily preventable through the implementation of minimal routine changes to adequately dry the solution in contact with the skin. © 2015 The International Society of Dermatology.
Atopic dermatitis and concomitant disease patterns in children up to two years of age.
Böhme, Maria; Lannerö, Eva; Wickman, Magnus; Nordvall, S Lennart; Wahlgren, Carl-Fredrik
2002-01-01
There are few prospective studies of atopic dermatitis and co-existing diseases such as respiratory infections in children up to 2 years of age. Using annual questionnaires, we studied the cumulative incidence of atopic dermatitis and concomitant symptoms indicating other atopic diseases and respiratory infections in 0-2-year-old children in a prospective birth cohort of 4089 children. We found associations between atopic dermatitis and asthma (ratio of proportion 1.45, 95% CI 1.16-1.80), allergic rhinoconjunctivitis (RP 2.25, CI 1.77-2.85), adverse reactions to foods (RP 3.20, CI 2.83-3.62), urticaria (RP 2.04, CI 1.80-2.31), acute otitis media (RP 1.13, CI 1.05-1.21), more than one pneumonia during the first and/or second year of life (RP 2.17, CI 1.14-4.15), and use of antibiotics at least twice yearly (RP 1.29, CI 1.07-1.56). The association between atopic dermatitis and respiratory infections persisted after stratification for asthma. There was a higher proportion of atopic disease manifestations, but not respiratory infections, in children with onset of atopic dermatitis during the first year of life than during the second. The study shows that during the first 2 years of life there is a significant association not only between atopic dermatitis and other atopic disease manifestations, but also between atopic dermatitis and respiratory infections manifested in an increased rate of acute otitis media, pneumonia and use of antibiotics.
77 FR 11536 - Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM...
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-27
... Categorization of Chemicals Causing Allergic Contact Dermatitis: Availability of Federal Agency Responses AGENCY... lymph node assay (LLNA) for potency categorization of chemicals causing allergic contact dermatitis (ACD... Local Lymph Node Assay for Potency Categorization of Chemicals Causing Allergic Contact Dermatitis in...
Experimental transmission of bovine digital dermatitis to sheep: development of an infection model.
USDA-ARS?s Scientific Manuscript database
Digital dermatitis is an infectious cause of lameness primarily affecting cattle, but also described in sheep, goats, and North American wild elk. Digital dermatitis is a polybacterial infection, comprised predominantly by several Treponema species, and other anaerobic bacteria. While the exact etio...
Schram, Sarah E; Willey, Andrea; Lee, Peter K; Bohjanen, Kimberly A; Warshaw, Erin M
2008-01-01
In black-spot poison ivy dermatitis, a black lacquerlike substance forms on the skin when poison ivy resin is exposed to air. Although the Toxicodendron group of plants is estimated to be the most common cause of allergic contact dermatitis in the United States, black-spot poison ivy dermatitis is relatively rare.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-10-13
... Eye Injuries and Chemically Induced Allergic Contact Dermatitis (ACD) AGENCY: National Institute of... Potential for Chemically Induced Allergic Contact Dermatitis,'' are planned for January 19 and 20, 2011... for Chemically Induced Allergic Contact Dermatitis'' will be held on January 20, 2011. Sessions for...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-29
... Nonradioactive Versions of the Murine Local Lymph Node Assay for Assessing Allergic Contact Dermatitis Hazard... nonradioactive versions of the Local Lymph Node Assay (LLNA) for assessing allergic contact dermatitis (ACD... Nonradioactive Alternative Test Method to Assess the Allergic Contact Dermatitis Potential of Chemicals and...
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-10
... Contact Dermatitis Potential of Chemicals and Products: Notice of Availability AGENCY: National Institute... contact dermatitis (ACD), are now available. ICCVAM recommended an updated LLNA test method protocol, a... Fewer Animals to Assess the Allergic Contact Dermatitis Potential of Chemicals and Products (NIH...
Grades of Severity and the Validation of an Atopic Dermatitis Assessment Measure (ADAM).
ERIC Educational Resources Information Center
Charman, Denise P.; Varigos, George A.
1999-01-01
Studied the validity of the Atopic Dermatitis Assessment Measure (D. Charman and others, 1999) with 171 pediatric patients in Australia using partial credit analyses to produce clinically relevant "word pictures" of grades of severity for atopic dermatitis. Discusses implications for measurement in medicine. (SLD)
Flagellate dermatitis after consumption of Shiitake mushrooms
Kreft, Burkhard; Marsch, Wolfgang Ch.
2014-01-01
Flagellate dermatitis occurs in patients who have eaten Shiitake mushrooms. We are reporting on a 55-year-old man, who developed whiplash-striped, severely itching efflorescences on the trunk 3 days after eating Lentinula edodes. Flagellate dermatitis is also known as a cutaneous side effect of bleomycin therapy. PMID:25097492
Allergic contact dermatitis to cosmetics.
Park, Michelle E; Zippin, Jonathan H
2014-01-01
Allergic contact dermatitis caused by cosmetic products is an increasing concern given the continual creation and introduction of new cosmetics to the public. This article presents an overview of how to evaluate a patient for patch testing, including common areas for cosmetic-induced dermatitis, common cosmetic allergens, and proper management. Published by Elsevier Inc.
Shiitake Mushroom Dermatitis: A Review.
Stephany, Mathew Paul; Chung, Stella; Handler, Marc Zachary; Handler, Nancy Stefanie; Handler, Glenn A; Schwartz, Robert A
2016-10-01
Shiitake mushroom dermatitis is a cutaneous reaction caused by the consumption of raw or undercooked shiitake mushrooms. Symptoms include linear erythematous eruptions with papules, papulovesicles or plaques, and severe pruritus. It is likely caused by lentinan, a heat-inactivated beta-glucan polysaccharide. Cases were initially reported in Japan but have now been documented in other Asian countries, North America, South America, and Europe, as this mushroom is now cultivated and consumed worldwide. Shiitake mushroom dermatitis may result from mushroom ingestion or from handling, which can result in an allergic contact dermatitis.
[Inpatient rehabilitation of chronic dermatoses illustrated by atopic dermatitis].
Nürnberg, W
2005-07-01
Atopic dermatitis is defined as a chronically relapsing skin disease resulting from complex interactions between genetic and environmental factors. It usually occurs during early childhood and shows typical clinical manifestations, depending on the patient's age. In cases of chronic atopic dermatitis, negative effects on professional and social activities and participation have to be expected. To counteract or overcome these threatening impairments in the different facets of life, prescribing inpatient rehabilitative measures should be considered early. Dermatological rehabilitation according to guidelines guarantees an interdisciplinary and multimodal treatment of atopic dermatitis.
Gittler, Julia K.; Krueger, James G.; Guttman-Yassky, Emma
2014-01-01
Atopic dermatitis (AD), as well as irritant contact dermatitis (ICD) and allergic contact dermatitis (ACD), are common skin diseases. These diseases are characterized by skin inflammation mediated by activated innate immunity or acquired immune mechanisms. Although AD, ICD, and ACD can be encountered in pure forms by allergists and dermatologists, patients with AD often present with increased frequency of ICD and ACD. Although a disturbed barrier alone could potentiate immune reactivity in patients with AD through increased antigen penetration, additional immune mechanisms might explain the increased susceptibility of atopic patients to ICD and ACD. This review discusses cellular pathways associated with increased skin inflammation in all 3 conditions and presents mechanisms that might contribute to the increased rate of ICD and ACD in patients with AD. PMID:22939651
Gallate Contact Dermatitis: Product Update and Systematic Review.
Holcomb, Zachary E; Van Noord, Megan G; Atwater, Amber Reck
Allergic contact dermatitis related to cosmetic use can result from allergens not routinely evaluated by standard patch test protocols. Propyl, octyl, and dodecyl gallates are commonly used antioxidant preservatives with reports of associated allergic contact dermatitis in the literature. The objectives of this review were to investigate the role of gallates in allergic contact dermatitis and to explore products containing these preservatives. A systematic review of the literature through April 2016 was performed to explore cases of reported gallate allergy. Food and cosmetic product databases were searched for products containing gallates. Seventy-four cases of gallate contact allergy have been reported. In addition, a variety of commercially available cosmetic products and foods contain gallate chemicals. Propyl gallate is the most commonly reported gallate contact allergen and often causes facial and/or hand dermatitis.
Surgery-Related Contact Dermatitis: A Review of Potential Irritants and Allergens.
Cook, Kevin A; Kelso, John M
Surgical procedures utilize an increasing number of medical products including antiseptics, anesthetics, gloves, suture materials, tissue adhesives, topical antibiotics, and bandages. Many of these products have irritant potential. Allergic contact dermatitis has also been reported. This review covers preoperative, operative, and postoperative exposures that may result in contact dermatitis. Testing with standard patch panels such as T.R.U.E. Test and the North American Contact Dermatitis Group 65 allergen series does not evaluate for all relevant contactants. A thorough understanding of potential exposures is vital to effectively evaluate a patient with surgery-related contact dermatitis. A systematic approach is needed to ensure that standard patch panels and supplementary patches adequately address each encountered contactant. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
2011-01-01
Seborrheic dermatitis is a common chronic-recurrent inflammatory disorder that most commonly affects adults; however, a more transient infantile form also occurs. The definitive cause of seborrheic dermatitis is unknown. However, proliferation of Malassezia species has been described as a contributing factor. The adult form of seborrheic dermatitis affects up to approximately five percent of the general population. The disorder commonly affects the scalp, face, and periauricular region, with the central chest, axillae, and genital region also involved in some cases. Pruritus is not always present and is relatively common, especially with scalp disease. A variety of treatments are available including topical corticosteroids, topical antifungal agents, topical calcineurin inhibitors, and more recently, a nonsteroidal “device ”cream. This article reviews the practical topical management of seborrheic dermatitis in the United States, focusing on the adult population. PMID:21607192
Cytopathology of parasitic dermatitis in dogs.
Sood, N K; Mekkib, Berhanu; Singla, L D; Gupta, K
2012-04-01
Out of 44 cases of dermatitis in dogs, 11 cases of parasitic origin were analyzed by cytopathology. Histopathologic examination of punch biopsies was also done for correlation with cytologic findings. Sarcoptic dermatitis was recorded in six cases, wherein, besides sarcoptic mites, neutrophils, macrophages, and plasma cells and keratinizing epithelial cells were also seen. Hematology revealed a relative neutrophilia and mild eosinophilia. Four cases of severe and generalized demodicosis complicated with bacteria and/or Malassezia sp. infection were also recorded. Histopathologically numerous Demodex sp. mites in varying stage of maturation were found damaging the hair follicles along with associated pathological changes and foreign body granulomas in one case. In addition, flea allergy dermatitis was also observed in one dog. In nutshell, cytology was found to be unequivocally effective in diagnosing parasitic dermatitis.
Overgaard, Line E K; Bonefeld, Charlotte M; Frederiksen, Hanne; Main, Katharina M; Thyssen, Jacob P
2016-06-01
Phthalate diesters are widely used as emollients in plastic and cosmetics as well as in food packaging and perfumes, potentially leading to prolonged and repeated dermal, oral and airborne exposure. We here review published articles that have evaluated the putative role of phthalate diesters in the pathogenesis of atopic dermatitis and discuss possible pathogenic pathways. A literature search resulted in 563 articles in Embase and 263 articles in Pubmed. After identification of relevant articles based on screening of titles, abstracts and reference lists, a total of 39 articles were selected and included. While no clear association has been shown between systemic phthalate levels and atopic dermatitis in human studies, animal data suggests that phthalates may worsen dermatitis and in vitro data suggests that interleukin-4 could be upregulated. Moreover, both loss-of-function mutations in the filaggrin gene and atopic dermatitis have been associated with elevated systemic phthalate levels. There is a need for prospective studies to clarify the possible pathogenic role of phthalate diesters in atopic dermatitis and the associated health risk, especially with the general trend towards barrier restoration with emollients in infants at risk of developing atopic dermatitis. In summary, we conclude that the results from published studies are controversial and inconclusive.
Epidermal multinucleated keratinocytes: a histopathologic clue to dermatitis artefacta.
Gutierrez, Daniel; Schowalter, Michael K; Piliang, Melissa P; Fernandez, Anthony P
2016-10-01
Dermatitis artefacta is a psycho-cutaneous disorder characterized by self-inflicted cutaneous injuries, often in association with an underlying psychiatric disorder or as a response to external stressors. Cutaneous lesions suggestive of dermatitis artefacta are dependent on the means of injury and thus may be morphologically variable, but typically have geometric shapes, spare hard-to-reach anatomic areas, and are present in variable stages of evolution at any specific time. Although a dermatologist may be suspicious of dermatitis artefacta in a given patient, making a definitive diagnosis is extremely challenging. Patients often clinically evade questioning and deny creating skin lesions, and histopathologic evaluation of lesional biopsies usually reveals non-specific epidermal and dermal changes and inflammation. Thus, identification of clues that lend support to a diagnosis of dermatitis artefacta would be welcomed by both clinicians and pathologists. Here we present a case of dermatitis artefacta with a unique, yet previously reported, histopathological finding of multinucleated keratinocytes within the epidermis. Although probably uncommon and dependent on the etiology of cutaneous injury, we believe this finding is important for dermatopathologists to be aware of as a potential diagnostic clue when evaluating biopsies in patients suspected to have dermatitis artefacta. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Agulló-Pérez, Alfredo-Daniel; Hervella-Garcés, Marcos; Oscoz-Jaime, Saioa; Azcona-Rodríguez, Maialen; Larrea-García, Mónica; Yanguas-Bayona, Juan-Ignacio
Perianal complaints are often consulted in dermatology clinics, and in many cases, a conclusive diagnosis is not easily made. The aim of this study was to study and identify the epidemiological, clinical, and contact allergy features of patients with perianal dermatitis who attended at a contact dermatitis unit in a tertiary hospital in Spain. Adult patients with long-lasting (>4 weeks) perianal dermatitis were recruited during the past 10 years for investigation and follow-up. Every patient underwent a diagnostic workup consisting of dermatological exploration and patch tests with the standard and specific series, as well as the patients' own products. General surgical exploration was also performed in some patients. One hundred twenty-four patients were included. The MOAHLFA index was as follows: 43.5, 0, 4.8, 11.3, 1.6, 8.1, and 75. The main final diagnoses were allergic contact dermatitis (32.3%), psoriasis (24.2%), irritant contact dermatitis (17.7%), and lichen simplex (neurodermatitis) (10%). Eighty-one patients (66.1%) showed 1 or more positive reactions, and in 52 patients (43%), positive reactions relevant to the present disease were found. Contact allergy in patients with long-lasting perianal complaints is frequent. It is mandatory for these patients to be referred to a dermatologist for an adequate evaluation and patch testing. Methylchloroisothiazolinone/methylisothiazolinone seems as the most common allergen implicated in perianal contact dermatitis.
O'Boyle, Niamh M; Delaine, Tamara; Luthman, Kristina; Natsch, Andreas; Karlberg, Ann-Therese
2012-11-19
Diglycidyl ethers of bisphenol A (DGEBA) and bisphenol F (DGEBF) are widely used as components in epoxy resin thermosetting products. They are known to cause occupational and nonoccupational allergic contact dermatitis. The aim of this study is to investigate analogues of DGEBF with regard to contact allergy and cytotoxicity. A comprehensive knowledge of the structural features that contribute to the allergenic and cytotoxic effects of DGEBF will guide the development of future novel epoxy resin systems with reduced health hazards for those coming into contact with them. It was found that the allergenic effects of DGEBF were dependent on its terminal epoxide groups. In contrast, it was found that the cytotoxicity in monolayer cell culture was dependent not only on the presence of epoxide groups but also on other structural features.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Pinnix, Chelsea; Perkins, George H.; Strom, Eric A.
2012-07-15
Purpose: To determine the efficacy of an emulsion containing hyaluronic acid to reduce the development of {>=}Grade 2 radiation dermatitis after adjuvant breast radiation compared with best supportive care. Methods and Materials: Women with breast cancer who had undergone lumpectomy and were to receive whole-breast radiotherapy to 50 Gy with a 10- to 16-Gy surgical bed boost were enrolled in a prospective randomized trial to compare the effectiveness of a hyaluronic acid-based gel (RadiaPlex) and a petrolatum-based gel (Aquaphor) for preventing the development of dermatitis. Each patient was randomly assigned to use hyaluronic acid gel on the medial half ormore » the lateral half of the irradiated breast and to use the control gel on the other half. Dermatitis was graded weekly according to the Common Terminology Criteria v3.0 by the treating physician, who was blinded as to which gel was used on which area of the breast. The primary endpoint was development of {>=}Grade 2 dermatitis. Results: The study closed early on the basis of a recommendation from the Data and Safety Monitoring Board after 74 of the planned 92 patients were enrolled. Breast skin treated with the hyaluronic acid gel developed a significantly higher rate of {>=}Grade 2 dermatitis than did skin treated with petrolatum gel: 61.5% (40/65) vs. 47.7% (31/65) (p = 0.027). Only 1ne patient developed Grade 3 dermatitis using either gel. A higher proportion of patients had worse dermatitis in the breast segment treated with hyaluronic acid gel than in that treated with petrolatum gel at the end of radiotherapy (42% vs. 14%, p = 0.003). Conclusion: We found no benefit from the use of a topical hyaluronic acid-based gel for reducing the development of {>=}Grade 2 dermatitis after adjuvant radiotherapy for breast cancer. Additional studies are needed to determine the efficacy of hyaluronic acid-based gel in controlling radiation dermatitis symptoms after they develop.« less
Pinnix, Chelsea; Perkins, George H; Strom, Eric A; Tereffe, Welela; Woodward, Wendy; Oh, Julia L; Arriaga, Lisa; Munsell, Mark F; Kelly, Patrick; Hoffman, Karen E; Smith, Benjamin D; Buchholz, Thomas A; Yu, T Kuan
2012-07-15
To determine the efficacy of an emulsion containing hyaluronic acid to reduce the development of ≥ Grade 2 radiation dermatitis after adjuvant breast radiation compared with best supportive care. Women with breast cancer who had undergone lumpectomy and were to receive whole-breast radiotherapy to 50 Gy with a 10- to 16-Gy surgical bed boost were enrolled in a prospective randomized trial to compare the effectiveness of a hyaluronic acid-based gel (RadiaPlex) and a petrolatum-based gel (Aquaphor) for preventing the development of dermatitis. Each patient was randomly assigned to use hyaluronic acid gel on the medial half or the lateral half of the irradiated breast and to use the control gel on the other half. Dermatitis was graded weekly according to the Common Terminology Criteria v3.0 by the treating physician, who was blinded as to which gel was used on which area of the breast. The primary endpoint was development of ≥ Grade 2 dermatitis. The study closed early on the basis of a recommendation from the Data and Safety Monitoring Board after 74 of the planned 92 patients were enrolled. Breast skin treated with the hyaluronic acid gel developed a significantly higher rate of ≥ Grade 2 dermatitis than did skin treated with petrolatum gel: 61.5% (40/65) vs. 47.7% (31/65) (p = 0.027). Only one patient developed Grade 3 dermatitis using either gel. A higher proportion of patients had worse dermatitis in the breast segment treated with hyaluronic acid gel than in that treated with petrolatum gel at the end of radiotherapy (42% vs. 14%, p = 0.003). We found no benefit from the use of a topical hyaluronic acid-based gel for reducing the development of ≥ Grade 2 dermatitis after adjuvant radiotherapy for breast cancer. Additional studies are needed to determine the efficacy of hyaluronic acid-based gel in controlling radiation dermatitis symptoms after they develop. Copyright © 2012 Elsevier Inc. All rights reserved.
Pinnix, Chelsea; Perkins, George H.; Strom, Eric A.; Tereffe, Welela; Woodward, Wendy; Oh, Julia L.; Arriaga, Lisa; Munsell, Mark F.; Kelly, Patrick; Hoffman, Karen E.; Smith, Benjamin D.; Buchholz, Thomas A.; Yu, T. Kuan
2014-01-01
Purpose To determine the efficacy of an emulsion containing hyaluronic acid to reduce the development of ≥ grade 2 radiation dermatitis after adjuvant breast radiation (RT) compared with best supportive care. Materials and Methods Women with breast cancer who had undergone lumpectomy and were to receive whole-breast RT to 50 Gy with a 10- to 16-Gy surgical bed boost were enrolled in a prospective randomized trial to compare the effectiveness of a hyaluronic acid-based gel (RadiaPlex) and a petrolatum-based gel (Aquaphor) for preventing the development of dermatitis. Each patient was randomly assigned to use hyaluronic acid gel, on the medial half or the lateral half of the irradiated breast, and the control gel to the other half. Dermatitis was graded weekly according to the Common Terminology Criteria v3.0 by the treating physician, who was blinded as to which gel was used on which area of the breast. The primary endpoint was development of ≥grade 2 dermatitis. Results The study closed early based on a recommendation from the Data and Safety Monitoring Board after 74 of the planned 92 patients were enrolled. Breast skin treated with the hyaluronic acid gel developed significantly higher rate of ≥grade 2 dermatitis than did skin treated with petrolatum gel (61.5% [40/65] vs. 47.7% [31/65], P = 0.027). Only one patient developed grade 3 dermatitis using either gel. A higher proportion of patients had worse dermatitis in the breast segment treated with hyaluronic acid gel than petrolatum gel at the end of RT (42% vs. 14%, P = 0.003). Conclusion We found no benefit from use of a topical hyaluronic acid-based gel for reducing the development of grade ≥2 dermatitis after adjuvant RT for breast cancer. Additional studies are needed to determine the efficacy of hyaluronic acid-based gel in controlling radiation dermatitis symptoms after they develop. PMID:22172912
Choi, Won Jun; Ko, Joo Yeon; Kim, Jin Wou; Lee, Kwang Hoon; Park, Chun Wook; Kim, Kyu Han; Kim, Myeung Nam; Lee, Ai Young; Cho, Sang Hyun; Park, Young Lip; Choi, Jee Ho; Seo, Seong Jun; Lee, Yang Won; Roh, Joo Young; Park, Young Min; Kim, Dong Jae; Ro, Young Suck
2012-09-01
The aims of this study were to evaluate the prevalence, severity and risk factors for atopic dermatitis in Korean pre-school children as determined by dermatological examination vs questionnaire survey. A total of 6,453 pre-school children from 59 kindergartens and 14 day-care centres were evaluated. Parents responded to an International Study of Asthma and Allergies in Childhood (ISAAC)-based questionnaire containing questions concerning 23 risk factors, as well as the prevalence, and severity of atopic dermatitis. Fourteen dermatologists then examined the participants according to the Korean diagnostic criteria for atopic dermatitis, and the Eczema Area and Severity Index (EASI) score. Atopic dermatitis prevalence determined by dermatological examination was lower than the questionnaire-based prevalence (9.2% vs 19.1%). Most patients (96.2%) had mild atopic dermatitis according to the EASI score (mean ± SD 3.91 ± 4.73; median 1.5; range 0.2-38.0). However, 17.4% had sleep disturbance, and 56.7% had not obtained complete remission of their rash over the previous 12 months. Among the 12 risk factors, "changing the patient's house to a newly built house during the first year of life" had significant odds ratio. In conclusion, the prevalence of atopic dermatitis in Korea in the ISAAC-based survey conducted by paediatricians was similar to that in several European countries, and lower than the 2006 Korean figure (28.9%). In addition, the prevalence of atopic dermatitis was lower when assessed by dermatological examination than by questionnaire.
Kim, Seong Hee; Lee, Jae Ho; Ly, Sun Yung
2016-12-01
Atopic dermatitis is one of the most common pediatric chronic inflammatory skin diseases, and certain food allergens and nutrients are closely related to the development and severity of atopic dermatitis. While avoidance of the causative foods is considered the mainstay of treatment, unverified excessive restriction might induce unnecessary limitations in the food intake, consequently leading to nutritional deficiencies and poor growth. This study aimed to identify the characteristics and nutrient intake status in children with atopic dermatitis and to investigate the effects of individualized nutrition intervention. We retrospectively reviewed electronic medical records of 77 pediatric patients with atopic dermatitis who received 4 months of individualized nutrition intervention combined with an elimination diet. The patient characteristics, nutrient intake status, and clinical status were examined before and after the intervention. Before the intervention, 5 children had a weight for height z-score below -2.0, and 48.1% had experienced food restriction; these children showed a significantly higher SCORing of Atopic Dermatitis index than those without experiences, with the number of restricted foods before the intervention positively correlating with the disease severity. The intakes of n-6 and n-3 fatty acids, calcium, folate, and vitamin D were lower than the recommended nutrient intakes for Koreans. After the intervention, the weight for height z-score of 35 children was significantly increased and their SCORing of Atopic Dermatitis index was significantly reduced (p<0.05). Individualized nutrition intervention appears useful for alleviating the severity of atopic dermatitis and improving the growth status by improving the nutrient intake.
Marsella, Rosanna; Ahrens, Kim; Sanford, Rachel
2018-02-01
IL-31 is a cytokine that is believed to play an important role in atopic dermatitis (AD). IL-31 levels positively correlate with disease severity in children with AD. Currently, there is no study that has investigated such a correlation in atopic dogs. The purpose of this study was to evaluate the correlation between IL-31 serum levels and severity of dermatitis. It was hypothesized that a positive correlation exists between severity of AD and circulating levels of IL-31. Sixteen atopic beagles experimentally sensitized to house dust mites. Atopic beagles were exposed to dust mites epicutaneously twice weekly for four weeks. Severity of dermatitis was scored by the Canine Atopic Dermatitis and Extent Severity Index, 3 rd iteration (CADESI-03) on days 0 and 28. Blood samples were taken on days 0 and 28 to measure serum IL-31 using a commercially available ELISA. Correlation between CADESI-03 scores and serum IL-31 levels was not detected on day 0 (Pearson, r = -0.2609, P = 0.3291). After flare-up of dermatitis was induced with allergen exposure, a significant positive correlation was detected between serum IL-31 and CADESI-03 on Day 28 (r = 0.6738, P = 0.004). Positive correlation was detected in active disease between severity of dermatitis and circulating levels of IL-31. Additional studies are needed to investigate this correlation in other breeds of dogs and to test whether circulating levels of IL-31 may predict clinical response to biological agents aimed at IL-31. © 2017 ESVD and ACVD.
Shafiei, Alireza; Moin, Mostafa; Pourpak, Zahra; Gharagozlou, Mohammad; Aghamohammadi, Asghar; Aghamohamadi, Asghar; Sajedi, Vahid; soheili, Habib; Sotoodeh, Soheila; Movahedi, Masoud
2011-03-01
Despite preliminary evidence, the role of probiotic and synbiotic in treatment of the atopic dermatitis has shown varying results. We aimed to evaluate whether synbiotic supplementation decrease severity of atopic dermatitis (AD) in childhood. In a randomized double blind-placebo controlled trial, we evaluated the synbiotic supplementation efficiency on the treatment of atopic dermatitis. Infants aged 1-36 months with moderate to severe atopic dermatitis were randomized (n=41) and received either synbiotic (probiotic plus prebiotic) (n=20) or placebo (n=21) daily as a powder for two months. Emollient (Eucerin) and topical corticosteroid (Hydrocortisone) were permitted. Children were scored for severity of atopic dermatitis (SCORAD). Also allergen Skin Prick Tests (SPT), IgE blood level and eosinophil count were measured at first visit. Patients' SCORAD were reevaluated at the end of intervention. We followed 36 out of 41 subjects for two months (drop out rate = 9%). In the whole group, the mean Total SCORAD (at base line 40.93) decreased by 56% (p=0.00). The mean Objective SCORAD (at base line 31.29) decreased by 53% (p=0.00). There was no significant difference in the mean decrease of total SCORAD between placebo (22.3) and synbiotic groups (24.2). There was also no difference between two intervention groups in the mean decrease of total SCORAD regarding to different demographic, clinical and para clinical subgroups. This study could not confirm synbiotic as an effective treatment for childhood atopic dermatitis and further studies are needed. These findings challenge the role of synbiotics in the treatment of childhood atopic dermatitis.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-01-13
... Nonradioactive Versions of the Murine Local Lymph Node Assay (LLNA) for Assessing Allergic Contact Dermatitis... Assay: BrdU-ELISA, A Nonradioactive Alternative Test Method to Assess the Allergic Contact Dermatitis... Lymph Node Assay: DA, A Nonradioactive Alternative Test Method to Assess the Allergic Contact Dermatitis...
78 FR 42006 - Oral Dosage Form New Animal Drugs; Nicarbazin; Oclacitinib; Zilpaterol
Federal Register 2010, 2011, 2012, 2013, 2014
2013-07-15
..., where applicable. DATES: This rule is effective July 15, 2013. FOR FURTHER INFORMATION CONTACT: George K... associated with allergic dermatitis and control of atopic dermatitis in dogs at least 12 months of age. 200... maintenance therapy. (2) Indications for use. For control of pruritus associated with allergic dermatitis and...
Federal Register 2010, 2011, 2012, 2013, 2014
2011-07-28
... Contact Dermatitis in Humans AGENCY: Division of the National Toxicology Program (DNTP), National... categorizing the potency of substances with the potential to cause allergic contact dermatitis (ACD) as strong... Contact Dermatitis in Humans (NIH Publication No. 11-7709), describes ICCVAM's recommendations for using...
Bensignor, Emmanuel
2010-10-01
Canine atopic dermatitis is an inflammatory skin disease characterized by typical clinical signs and affecting up to 10 % of dogs aged from 1 to 3 years. The diagnosis is mainly clinical and the treatment is complex. This canine form may offer a good model of human atopic dermatitis, as the two diseases show many pathogenetic, clinical and therapeutic similarities.
Larsen, W G
1985-01-01
The most common reaction to fragrance materials seen by practicing dermatologists is allergic contact dermatitis. Photodermatitis is occasionally seen, as is contact urticaria, irritation, and depigmentation. Fragrances are the leading cause of allergic contact dermatitis due to cosmetics. The fragrance mixture can cause false-positive reactions; therefore, it is more desirable to test with a separate series of fragrance materials.
Contact Dermatitis to Personal Sporting Equipment in Youth.
Marzario, Barbara; Burrows, Dianne; Skotnicki, Sandy
2016-07-01
Contact dermatitis to personal sporting equipment in youth is poorly studied. To review the results of patch testing 6 youth to their sporting equipment in a dermatology general private practice from 2006 to 2011. A retrospective analysis of 6 youth aged 11 to 14 who were evaluated for chronic and persistent dermatitis occurring in relation to sports equipment was conducted. All patients were subjected to epicutaneous (patch) testing, which included some or all of the following: North American Contact Dermatitis Group (NACGD) series, textile series, rubber series, corticosteroid series, and raw material from the patients' own personal equipment. All cases had 1 or more positive patch test reactions to an allergen within the aforementioned series, and 3 subjects tested positive to their personal equipment in raw form. Allergic contact dermatitis, not irritant, was deemed the relevant cause of chronic dermatitis in 4 of the 6 patients due to positive reactions to epicutaneous tests and/or personal equipment. The utility of testing to patients' own sporting equipment was shown to be of additional value and should be considered when patch testing for contact allergy to sporting equipment. © The Author(s) 2015.
Nezafati, Kaveh A; Carroll, Bryan; Storrs, Frances J; Cruz, Ponciano D
2013-01-01
The American Contact Dermatitis Society (ACDS) is the principal organization representing the subspecialty of contact dermatitis in the United States. The aim of this study was to characterize ACDS members with respect to demographic characteristics, patch-test practices, and sentiments regarding the Society and its journal Dermatitis. We conducted cross-sectional postal and online surveys of ACDS members. More than a third of ACDS members responded to the survey, 92% of whom practice dermatology, and most of whom are community practitioners. Responders manage patients with allergic and irritant dermatitis at a similar frequency. On average, they patch test 4 patients per week using 66 allergens per patient, which often include customized trays. Almost half of these practitioners learned patch testing from their residency programs. Most of the responders read and value the Society journal, value the Contact Allergen Management Program database, and attend society meetings. The ACDS is comprised overwhelmingly of dermatologists who are primarily community-based, young relative to the start of their practices, and use the Society's resources for continuing education.
Fiberglass dermatitis: report of two cases.
Wang, B J; Lee, J Y; Wang, R C
1993-08-01
Fiberglass is widely used for insulation and as a reinforcement filling material. Handling fiberglass products may induce contact dermatitis. We report on the first two cases of fiberglass dermatitis reported in Taiwan. The first patient suffered from a severe pruritic eruption two hours after repairing a roof with wave-form ceiling boards. Erythematous maculopapules were present on both hands and finger webs. The second patient was a quality controller of printed circuit boards (PRCBs). She presented with erythematous maculopapules on the face and excoriated papules and lichenified plaques on the trunk and forearms, which had been present for two years. Scrapings of the skin lesions from both patients showed fiberglass spicules of 7.5 to 8 microns in diameter. Similar fibers were detected in scrapings from the wave-form ceiling board and PRCB. Histopathology of the second case revealed spongiotic psoriasiform dermatitis. Patch tests in case 2 with the plastics and glues series, epoxy resin and scrapings from the PRCBs were all negative. Fiberglass dermatitis may be easily misdiagnosed. Clinically, it may resemble scabies, eczematous dermatitis, folliculitis, petechiae and urticaria. A high index of suspicion is essential for a correct diagnosis.
Douwes, Jeroen; Slater, Tania; Shanthakumar, Mathangi; McLean, Dave; Firestone, Ridvan Tua; Judd, Lissa; Pearce, Neil
2017-04-01
This study assessed the risk of dermatitis, urticaria and loss of skin barrier function in 425 cleaners and 281 reference workers (retail workers and bus drivers). Symptoms, atopy and skin barrier function were assessed by questionnaire, skin prick tests, and measurement of transepidermal water loss. Cleaners had an increased risk of current (past 3 months) hand/arm dermatitis (14.8% vs. 10.0%; OR = 1.9, p < 0.05) and urticaria (11% vs. 5.3%; OR = 2.4, p < 0.05) and were more likely to have dermatitis as adults (17.6% vs. 11.4%; OR = 1.8, p < 0.05). The risk of atopy was not increased, but associations with symptoms were more pronounced in atopics. Transepidermal water loss was significantly higher in cleaners. Wet-work was a significant risk factor for dermatitis and hand washing and drying significantly reduced the risk of urticaria. In conclusion, cleaners have an increased risk of hand/arm dermatitis, urticaria and loss of skin barrier function.
Apgar Score Is Related to Development of Atopic Dermatitis: Cotwin Control Study
Naeser, Vibeke; Kahr, Niklas; Stensballe, Lone Graff; Kyvik, Kirsten Ohm; Skytthe, Axel; Backer, Vibeke
2013-01-01
Aim. To study the impact of birth characteristics on the risk of atopic dermatitis in a twin population. Methods. In a population-based questionnaire study of 10,809 twins, 3–9 years of age, from the Danish Twin Registry, we identified 907 twin pairs discordant for parent-reported atopic dermatitis. We cross-linked with data from the Danish National Birth Registry and performed cotwin control analysis in order to test the impact of birth characteristics on the risk of atopic dermatitis. Results. Apgar score, OR (per unit) = 1.23 (1.06–1.44), P = 0.008, and female sex, OR = 1.31 (1.06–1.61), P = 0.012, were risk factors for atopic dermatitis in cotwin control analysis, whereas birth anthropometric factors were not significantly related to disease development. Risk estimates in monozygotic and dizygotic twins were not significantly different for the identified risk factors. Conclusions. In this population-based cotwin control study, high Apgar score was a risk factor for atopic dermatitis. This novel finding must be confirmed in subsequent studies. PMID:24222775
Allergic contact dermatitis from allyl isothiocyanate in a Danish cohort of 259 selected patients.
Lerbaek, Anne; Rastogi, Suresh Chandra; Menné, Torkil
2004-08-01
Allyl isothiocyanate is present in many plants. Allergic contact dermatitis from allyl isothiocyanate is well known but infrequently reported. The aim of this study was to investigate the prevalence of contact allergy to allyl isothiocyanate in patients with suspected contact dermatitis from vegetables and food. 259 such patients were tested at the Department of Dermatology, Gentofte Hospital, Denmark, from 1994 to 2003. Only 2 patients (0.8%) had a positive reaction (+) to allyl isothiocyanate and 43 patients (16.6%) had a ?+ reaction. One of the patients with a positive reaction provided samples of margarine, salad cream, oil and mayonnaise. These were analysed with high-performance liquid chromatography, and a moderate concentration of allyl isothiocyanate (2.5 ppm) was detected in the sample of margarine. This patient was a professional sandwich maker presenting with fingertip dermatitis mimicking 'tulip fingers' or allergic contact dermatitis from garlic and onions. In conclusion, allergic contact dermatitis from allyl isothiocyanate occurs in only a limited number of cases, despite frequent exposure. The large number of ?+ reactions raises the question as to whether the recommended patch test concentration is too low.
Sheu, Mary; Simpson, Eric L; Law, Sandra V; Storrs, Frances J
2006-08-01
Botanical ingredients used in personal care products are a significant and underreported cause of allergic contact dermatitis. To evaluate allergic contact dermatitis from a widely-used botanical deodorant. We conducted patch testing in four patients who were using the botanical deodorant and were referred to the contact dermatitis clinic; three patients had axillary dermatitis and one had dermatitis of the external ear. All four patients had positive patch test reactions to lichen acid mix and D-usnic acid. Of the three patients who were patch tested to the botanical deodorant, all had positive reactions. We did not test to the specific lichen used in the natural deodorant but rather used our own lichen acid mix and d-usnic acid in addition to testing to the actual product. One of the patients declined to be tested with the natural deodorant, but did test positive to the lichen acid mix and d-usnic acid. Personal care products such as deodorants may represent a new route of exposure to lichen extract, a known allergen.
Soltanipoor, Maryam; Kezic, Sanja; Sluiter, Judith K; Rustemeyer, Thomas
2017-02-28
Health care workers (HCW) are at high risk for developing occupational hand dermatitis (HD) due to frequent exposure to 'wet work'. Amongst HCWs, nurses are at highest risk, with an estimated point prevalence of HD ranging between 12 and 30%. The burden of disease is high with chronicity, sick leave, risk of unemployment and impaired quality of life. Despite evidence from the medical literature on the risk factors and the importance of skin care in the prevention of HD, in practice, compliance to skin care protocols are below 30%. New preventive strategies are obviously needed. This is a cluster randomized controlled trial, focusing on nurses performing wet work. In total, 20 wards are recruited to include 504 participating nurses in the study at baseline. The wards will be randomized to an intervention or a control group and followed up for 18 months. The intervention consists of the facilitation of creams being available at the wards combined with the continuous electronic monitoring of their consumption with regular feedback on skin care performance in teams of HCWs. Both the intervention and the control group receive basic education on skin protection (as 'care as usual'). Every 6 months, participants of both groups will fill in the questionnaires regarding exposure to wet work and skin protective behavior. Furthermore, skin condition will be assessed and samples of the stratum corneum collected. The effect of the intervention will be measured by comparing the change in Hand Eczema Severity Index (HECSI score) from baseline to 12 months. The Natural Moisturizing Factor (NMF) levels, measured in the stratum corneum as an early biomarker of skin barrier damage, and the total consumption of creams per ward will be assessed as a secondary outcome. This trial will assess the clinical effectiveness of an intervention program to prevent hand dermatitis among health care workers TRIAL REGISTRATION: Netherlands Trial Register (NTR), identification number NTR5564 . Registered on 2 November 2015.
Teixeira, Vera; Coutinho, Inês; Gonçalo, Margarida
2014-01-01
Metals are a common cause of allergic contact dermatitis. After the introduction of the EU Nickel Directive (1994/27/CE; 2004/96/EC) and, more recently, the Cement Directive (2003/53/EC) there has been a significant decrease in sensitization to metals mainly in the Nordic countries. The applicability of these directives and their impact in the Portuguese population is unknown. A retrospective study (1992-2011) was carried out in our patch test clinic to assess the temporal trend of metal sensitization (nickel [Ni], cobalt [Co] and chromium [Cr]) along the last 20 years, particularly considering age, sex and its relation with occupational activity. Out of 5 250 consecutively patch-tested patients, 1 626 (31%) were reactive to at least one metal (26.5% to Ni; 10.0% to Co and 7.9% to Cr). Women had a higher prevalence of sensitization to Ni (34.4% vs 8.9%) whereas men were more reactive to Cr (11.5% vs 5.0%). Nickel sensitization did not decrease significantly over the years, although in recent years among women sensitized to nickel the percentage of younger patients (16-30 years-old) is significantly lower (p < 0.001). Chromium sensitization significantly decreased, particularly in men (r = -0.535), and mainly in the construction workers (r = -0.639). Chromium reactivity associated with the shoe dermatitis has remained stable. We emphasize the higher and stable percentage of nickel sensitized individuals suggesting, so far, a low impact from the EU Ni directive, although a decreasing percentage in the the younger group among Ni sensitized women may suggest a beneficial effect is becoming evident is this age group. On the contrary, the impact of the directive regarding the modification of Cr in cement seems to be effective. There is now a need to regulate chromium content in leather products, namely in shoes. The regulation of interventional measures related either to the manufacture and trade of adornments or professional use will better protect the population of allergy to metals.
Paederus dermatitis featuring chronic contact dermatitis.
Stanimirović, Andrija; Skerlev, Mihael; Culav-Košćak, Ivana; Kovačević, Maja
2013-01-01
Paederus dermatitis is a distinct variant of acute irritant contact dermatitis caused by mucocutaneous contact with the specific toxin of an insect belonging to the genus Paederus. It is characterized by the sudden onset of erythema and vesiculobullous lesions on exposed skin, with special predilection for the periorbital region. Paederus species have been mostly identified in Africa, Asia, Australia, and Central/South America. We report a 51-year-old woman who experienced 4 recurrences of periorbital erythema and edema in the previous year. No consistent etiology could be established at the beginning. Only after taking a detailed medical history was it discovered that 1 year before our examination, the patient had traveled to Kenya, where she had experienced contact with the insect. This fact led us to the diagnosis of Paederus dermatitis. After appropriate treatment, a complete regression was observed over a 3-week period.
Antioxidant Therapies for Ulcerative Dermatitis: A Potential Model for Skin Picking Disorder
George, Nneka M.; Whitaker, Julia; Vieira, Giovana; Geronimo, Jerome T.; Bellinger, Dwight A.; Fletcher, Craig A.; Garner, Joseph P.
2015-01-01
Skin Picking Disorder affects 4% of the general population, with serious quality of life impacts, and potentially life threatening complications. Standard psychoactive medications do not help most patients. Similarly, Mouse Ulcerative Dermatitis (skin lesions caused by excessive abnormal grooming behavior) is very common in widely used inbred strains of mice, and represents a serious animal welfare issue and cause of mortality. Treatment options for Ulcerative Dermatitis are largely palliative and ineffective. We have proposed mouse Ulcerative Dermatitis as a model for human Skin Picking Disorder based on similar epidemiology, behavior, and its comorbidity and mechanistic overlap with hair pulling (trichotillomania). We predicted that mouse Ulcerative Dermatitis would be treated by N-Acetylcysteine, as this compound is highly effective in treating both Skin Picking Disorder and Trichotillomania. Furthermore, we hypothesized that N-Acetylcysteine’s mode of action is as a precursor to the production of the endogenous antioxidant glutathione in the brain, and therefore intranasal glutathione would also treat Ulcerative Dermatitis. Accordingly, we show in a heterogenous prospective trial, the significant reduction in Ulcerative Dermatitis lesion severity in mice receiving either N-acetylcysteine (oral administration) or glutathione (intranasal). The majority of mice treated with N-acetylcysteine improved slowly throughout the course of the study. Roughly half of the mice treated with glutathione showed complete resolution of lesion within 2-4 weeks, while the remainder did not respond. These findings are the first to show that the use of N-acetylcysteine and Glutathione can be curative for mouse Ulcerative Dermatitis. These findings lend additional support for mouse Ulcerative Dermatitis as a model of Skin Picking Disorder and also support oxidative stress and glutathione synthesis as the mechanism of action for these compounds. As N-Acetylcysteine is poorly tolerated by many patients, intranasal glutathione warrants further study as potential therapy in Skin Picking, trichotillomania and other body-focused repetitive behavior disorders. PMID:26167859
Liu, X; Tan, L; Yu, I T S; Zhang, Z; Wong, C C-Y; Guo, C; Ho, K F; Lau, A P S; Yeoh, E K; Lee, A; Lao, X Q
2018-04-01
Household cleaning products are widely used by the public, but limited data have been obtained on whether their use induces allergic dermatitis in children. This study investigated the association between exposure to household cleaning products and allergic dermatitis in primary-school children. A prospective cohort study of Hong Kong primary-school children was conducted between 2012 and 2014. A baseline survey was administered to 1812 students who did not have allergic dermatitis. Information on respiratory symptoms, exposure to household chemical cleaning products and other topics was collected using a self-administered questionnaire. A cumulative chemical burden (CCB) score was calculated for each student by summing the duration of exposure to 14 chemical cleaning products. Principal component analysis was used to identify patterns in the use of these cleaning products. Logistic regression was performed to calculate relative risk (RR) with 95% confidence intervals (CIs) after adjusting for potential confounders. Eighty-nine (4.9%) of the students surveyed had dermatitis during the follow-up. However, exposure to individual chemical cleaning products was not found to be associated with the children's allergic dermatitis (all P > 0.05). In contrast to those in the lowest tertile, neither CCB scores in the middle tertile (RR: 1.16, 95% CI: 0.67 to 2.00) nor those in the highest tertile (RR: 1.24, 95% CI: 0.73 to 2.14) were significantly associated with the risk of allergic dermatitis. The adjusted RR for every 5-unit increment in CCB score was 1.01 (95% CI: 0.98 to 1.03). Four patterns of cleaning-product use were derived, but none were found to be associated with the risk of dermatitis (all P > 0.05). The use of household chemical cleaning products is not associated with the risk of dermatitis in primary-school children. © 2017 European Academy of Dermatology and Venereology.
Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention
Simpson, Eric L.; Chalmers, Joanne R.; Hanifin, Jon M.; Thomas, Kim S.; Cork, Michael J.; McLean, W.H. Irwin; Brown, Sara J.; Chen, Zunqiu; Chen, Yiyi; Williams, Hywel C.
2014-01-01
Background Atopic dermatitis (atopic eczema) is a chronic inflammatory skin disease that has reached epidemic proportions in children worldwide and is increasing in prevalence. Because of the significant socioeconomic effect of atopic dermatitis and its effect on the quality of life of children and families, there have been decades of research focused on disease prevention, with limited success. Recent advances in cutaneous biology suggest skin barrier defects might be key initiators of atopic dermatitis and possibly allergic sensitization. Objective Our objective was to test whether skin barrier enhancement from birth represents a feasible strategy for reducing the incidence of atopic dermatitis in high-risk neonates. Methods We performed a randomized controlled trial in the United States and United Kingdom of 124 neonates at high risk for atopic dermatitis. Parents in the intervention arm were instructed to apply full-body emollient therapy at least once per day starting within 3 weeks of birth. Parents in the control arm were asked to use no emollients. The primary feasibility outcome was the percentage of families willing to be randomized. The primary clinical outcome was the cumulative incidence of atopic dermatitis at 6 months, as assessed by a trained investigator. Results Forty-two percent of eligible families agreed to be randomized into the trial. All participating families in the intervention arm found the intervention acceptable. A statistically significant protective effect was found with the use of daily emollient on the cumulative incidence of atopic dermatitis with a relative risk reduction of 50% (relative risk, 0.50; 95% CI, 0.28-0.9; P = .017). There were no emollient-related adverse events and no differences in adverse events between groups. Conclusion The results of this trial demonstrate that emollient therapy from birth represents a feasible, safe, and effective approach for atopic dermatitis prevention. If confirmed in larger trials, emollient therapy from birth would be a simple and low-cost intervention that could reduce the global burden of allergic diseases. PMID:25282563
Antioxidant Therapies for Ulcerative Dermatitis: A Potential Model for Skin Picking Disorder.
George, Nneka M; Whitaker, Julia; Vieira, Giovana; Geronimo, Jerome T; Bellinger, Dwight A; Fletcher, Craig A; Garner, Joseph P
2015-01-01
Skin Picking Disorder affects 4% of the general population, with serious quality of life impacts, and potentially life threatening complications. Standard psychoactive medications do not help most patients. Similarly, Mouse Ulcerative Dermatitis (skin lesions caused by excessive abnormal grooming behavior) is very common in widely used inbred strains of mice, and represents a serious animal welfare issue and cause of mortality. Treatment options for Ulcerative Dermatitis are largely palliative and ineffective. We have proposed mouse Ulcerative Dermatitis as a model for human Skin Picking Disorder based on similar epidemiology, behavior, and its comorbidity and mechanistic overlap with hair pulling (trichotillomania). We predicted that mouse Ulcerative Dermatitis would be treated by N-Acetylcysteine, as this compound is highly effective in treating both Skin Picking Disorder and Trichotillomania. Furthermore, we hypothesized that N-Acetylcysteine's mode of action is as a precursor to the production of the endogenous antioxidant glutathione in the brain, and therefore intranasal glutathione would also treat Ulcerative Dermatitis. Accordingly, we show in a heterogenous prospective trial, the significant reduction in Ulcerative Dermatitis lesion severity in mice receiving either N-acetylcysteine (oral administration) or glutathione (intranasal). The majority of mice treated with N-acetylcysteine improved slowly throughout the course of the study. Roughly half of the mice treated with glutathione showed complete resolution of lesion within 2-4 weeks, while the remainder did not respond. These findings are the first to show that the use of N-acetylcysteine and Glutathione can be curative for mouse Ulcerative Dermatitis. These findings lend additional support for mouse Ulcerative Dermatitis as a model of Skin Picking Disorder and also support oxidative stress and glutathione synthesis as the mechanism of action for these compounds. As N-Acetylcysteine is poorly tolerated by many patients, intranasal glutathione warrants further study as potential therapy in Skin Picking, trichotillomania and other body-focused repetitive behavior disorders.
Kosheleva, I V; Bitkina, O A; Klivitskaya, N A; Shadyzheva, L I
This article was designed to discuss the therapeutic potential of various non-pharmacological and physiotherapeutic methods for the treatment and rehabilitation of the patients presenting with atopic dermatitis (AD) during the inter-recurrence period of the disease. The particular emphasis is placed on the physical agents most frequently used for the purpose with special reference to the combined therapy of atopic dermatitis in the adults and children and to their rehabilitation in the inter-exacerbation periods. In addition, the data on the prospects for the use of various medications intended for tissue- and organotherapy of the patients suffering from atopic dermatitis are presented. The main traditional approaches to the management of the patients with atopic dermatitis under conditions of the spa and health resort facilities are considered based on the original experience of the authors including the application of various modes of ozone therapy regarded as a physiotherapeutic procedure for the treatment of atopic dermatitis in the children and adult patients, their rehabilitation, and the prevention of exacerbations of the pathological process based on the external and/or systemic application of the ozone-oxygen gaseous mixture. The selected modalities of ozone therapy used to treat various clinical forms and stages of the atopic dermatitis differing in severity are described in detail. The data on the influence of ozone therapy on a variety of pathogenetic factors of atopic dermatitis are presented as obtained by the investigations into dynamics of the characteristics of immunity, microcirculation, and the levels of free radical metabolites. The results of the study give evidence of the high effectiveness of ozone therapy as a method of physiotherapeutic treatment both in the capacity of a component of combined therapy during the acute phase of atopic dermatitis and as the means of secondary (post-exposure) prophylaxis of the exacerbations and relapses of this condition based at the medical and preventive treatment facilities of various specialization.
Thomsen, Peter T
2015-04-01
Digital dermatitis is a major problem in modern dairy production because of decreased animal welfare and financial losses. Individual cow treatments are often seen as too time consuming by farmers, and walk-through hoof baths have therefore been used extensively to control digital dermatitis. For decades, copper sulfate hoof baths have been used to treat and prevent digital dermatitis. Copper sulfate has been referred to as the industry gold standard when it comes to hoof-bath chemicals. In several scientific studies testing the efficacy of other hoof-care products, copper sulfate has been used as a positive control, thereby indicating that copper sulfate has a known positive effect. However, this may not be the case. A dilemma may exist between (1) copper sulfate generally being perceived as being effective against digital dermatitis and (2) a possible lack of well-documented scientific evidence of this effect. The objective of this study was to evaluate the existing scientific literature to determine whether the efficacy of copper sulfate used in hoof baths against digital dermatitis has in fact been demonstrated scientifically. A systematic literature search identified 7 peer-reviewed journal articles describing the efficacy of copper sulfate in hoof baths as treatment or prevention of bovine digital dermatitis. Only 2 of the 7 studies compared copper sulfate to a negative control; most studies were relatively small, and often no clear positive effect of copper sulfate was demonstrated. In conclusion, the frequent claim that copper sulfate is widely reported to be effective is supported by little scientific evidence. Well-designed clinical trials evaluating the effect of copper sulfate against digital dermatitis compared with a negative control are needed. Until such studies have been made, the efficacy of copper sulfate in hoof baths against digital dermatitis remains largely unproven. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Atopic and Contact Dermatitis of the Vulva.
Pichardo-Geisinger, Rita
2017-09-01
Pruritus, or itch, is a common vulvar complaint that is often treated empirically as a yeast infection; however, yeast infections are just one of the many conditions that can cause vulvar itch. Ignoring other conditions can prolong pruritus unnecessarily. Atopic dermatitis, irritant contact dermatitis, and allergic contact dermatitis are extremely common noninfectious causes of vulvar itch that are often underdiagnosed by nondermatologists. Identifying these conditions and treating them appropriately can significantly improve a patient's quality of life and appropriately decrease health care expenditures by preventing unnecessary additional referrals or follow-up visits and decreasing pharmaceutical costs. Copyright © 2017 Elsevier Inc. All rights reserved.