RESUMEN
BACKGROUND: Semipermeable membranes might be suitable for glove liners or comfort gloves in individuals with irritant contact dermatitis (ICD). OBJECTIVES: To evaluate the effects of different glove materials on inflammation and epidermal barrier impairment after experimental skin irritation. METHODS: Nine test areas on the volar forearms of 24 healthy volunteers were irritated with sodium lauryl sulfate (1%) and afterward covered for 6 days (6 or 8 h/day) with semipermeable Sympatex (SYM), vinyl (OCC), combinations of vinyl with Sympatex (SYM/OCC) or cotton (COT/OCC), or left uncovered (CON). Up to day 10, measurements of transepidermal water loss (TEWL), erythema (a*), skin humidity (SH) and visual scoring (VS) were applied. RESULTS: No significant differences in skin parameters were found between COT/OCC and SYM/OCC as well as between each of the combinations and CON. SYM, COT/OCC and SYM/OCC led to better results for most skin parameters than OCC alone. CONCLUSIONS: Occlusive material has a negative impact on skin barrier recovery and inflammation after skin irritation whereas SYM is not inferior to uncovered areas indicating good tolerability. Altogether, the data suggest that SYM is a useful alternative to COT as material for glove liners and comfort gloves in ICD patients.
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Dermatitis Alérgica por Contacto , Dermatitis Irritante , Humanos , Dermatitis Alérgica por Contacto/metabolismo , Pérdida Insensible de Agua , Piel/metabolismo , Epidermis , Dermatitis Irritante/etiología , Dermatitis Irritante/prevención & control , Dermatitis Irritante/metabolismo , Inflamación/metabolismo , Dodecil Sulfato de Sodio/efectos adversosRESUMEN
BACKGROUND: To prevent irritant contact eczema even in occupational fields with heavy-duty soiling, it is generally recommended to use 'mild' hand cleansers (mild detergent without grits, MC). On the other hand, since grit-containing cleansers (GC) show a higher washing power that minimizes washing time, their usage is generally preferred in specific occupational fields. OBJECTIVES: To compare whether a shorter, intense washing period might cause less skin damage than a longer washing period with an MC. METHODS: Differences in cleaning time were first verified in a pilot study using standardized model dirt. In the main study, the forearms of 35 healthy volunteers were washed with three standardized procedures over a period of 3 days, either using 2 min of MC with/without hand brush or 1-min GC. Clinical scoring, transepidermal water loss (TEWL), corneometry, colourimetry and scaliness/roughness (Visioscan) were used to evaluate the epidermal barrier, topography and irritation. RESULTS: The pre-study showed that washing time doubled when using MC vs. GC. Using GC resulted in stronger barrier disruption, even after a shorter washing period - median ΔT4-T1 TEWL 0.96 g/m2 /h vs. 4.91 g/m2 /h respectively, p < 0.0001. The most harmful procedure for the skin was the additional application of a hand brush (18.86 g/m2 /h). CONCLUSIONS: Short-time washing with GC damages the skin barrier more significantly in comparison to a longer application of an MC. When washing with MC, the strongest irritant reaction occurred when accompanied with hand brushing.
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Dermatitis Alérgica por Contacto , Dermatitis Irritante , Humanos , Irritantes/efectos adversos , Proyectos Piloto , Dermatitis Alérgica por Contacto/complicaciones , Piel , Dermatitis Irritante/etiología , Dermatitis Irritante/prevención & control , Agua , Pérdida Insensible de AguaRESUMEN
BACKGROUND: Glove occlusion might enhance skin sensitivity to a subsequent detergent challenge (occlusion effect). Thus, some skin protection creams (PC) claim to protect against this effect of occlusion, and are recommended to be used before wearing liquid-proof gloves. OBJECTIVES: To evaluate the effect of PC applied prior to glove occlusion on the 'occlusion effect'-refers to increased susceptibility of the skin to a model detergent. METHODS: One hundred and eleven volunteers were enrolled in a single-blind, randomized study. Seven PCs were applied before glove occlusion over 7 days (D1-D7). After sodium lauryl sulphate (SLS) challenge, we compared the irritation between the areas treated with PC and occlusion alone. Clinical scoring and bioengineering methods (capacitance, transepidermal water loss [TEWL], and colourimetry [erythema]) were used to quantify the irritant reactions. RESULTS: After 1 week of occlusion and PC application, we did not observe significant changes in TEWL, nor in erythema, whereas skin hydration raised in three cream-treated areas. On day 10, after a challenge with SLS, some products significantly aggravated the skin irritation as compared to occlusion alone. CONCLUSIONS: The 'occlusion effect'-shown as higher skin susceptibility to a model detergent-was not mitigated by PCs when applied prior to glove occlusion. On the contrary, some PCs might have negative effects on skin barrier function and augment such sensitivity.
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Dermatitis Alérgica por Contacto , Dermatitis Irritante , Humanos , Dermatitis Irritante/etiología , Dermatitis Irritante/prevención & control , Método Simple Ciego , Detergentes/efectos adversos , Piel , Dodecil Sulfato de Sodio/efectos adversos , Eritema/inducido químicamente , Eritema/prevención & control , Emolientes , Agua , Pérdida Insensible de AguaRESUMEN
Adverse reactions to sunscreens are uncommon in relation to their widespread use [Loden et al. Br J Dermatol. 2011;165(2):255-62; Jansen et al. J Am Acad Dermatol. 2013;69(6):867 e861-814; quiz 881-862] and can be related to both active and inactive ingredients in sunscreen products [DiNardo et al. J Cosmet Dermatol. 2018;17(1):15-19; Barrientos et al. Contact Dermatitis. 2019;81(2):151-52]. Pathogenetically, the main cutaneous adverse reaction patterns to sunscreens can be divided into allergic and irritant contact dermatitis, phototoxic and photoallergic contact dermatitis, contact urticaria, and, in solitary cases, anaphylactic reactions [Lautenschlager et al. Lancet. 2007;370(9586):528-37]. A summary is provided in Table
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Dermatitis Alérgica por Contacto/etiología , Dermatitis Irritante/etiología , Neoplasias Cutáneas/prevención & control , Protectores Solares/efectos adversos , Rayos Ultravioleta/efectos adversos , Dermatitis Alérgica por Contacto/patología , Dermatitis Alérgica por Contacto/prevención & control , Dermatitis Irritante/patología , Dermatitis Irritante/prevención & control , Unión Europea , Humanos , Vehículos Farmacéuticos/efectos adversos , Vehículos Farmacéuticos/química , Piel/efectos de los fármacos , Piel/patología , Piel/efectos de la radiación , Neoplasias Cutáneas/etiología , Protectores Solares/administración & dosificación , Protectores Solares/química , Titanio/administración & dosificación , Titanio/efectos adversos , Óxido de Zinc/administración & dosificación , Óxido de Zinc/efectos adversosRESUMEN
BACKGROUND: Occupational contact dermatitis often results in work disruption. Return-to-work (RTW) is an important outcome. OBJECTIVE: The objective of this study was to determine RTW outcomes and factors associated with such outcomes using a multidisciplinary clinic model. METHODS: Chart abstraction was performed for 194 workers who received RTW assistance over a 6-year period. Elements abstracted included demographic and diagnostic information and information about the RTW program including principles, program components, barriers, and facilitators. RESULTS: Of the 902 workers seen for dermatologic assessment, 194 received RTW assistance. At initial assessment, 37% were not working because of their skin disease, and at follow-up, 7% were not working because of their skin disease. The RTW plan components included a graduated or trial of RTW, specific recommendations for avoiding exposure, personal protective equipment, skin management, and ongoing skin monitoring. Principles associated with successful RTW included good communication and the availability of modified work and a worker adherence to the plan. Barriers included lack of modified work, unresponsive employers, and ongoing skin problems. CONCLUSIONS: Specific approaches are important to identify if RTW is to be successful for workers with occupational contact dermatitis.
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Dermatitis Alérgica por Contacto/terapia , Dermatitis Irritante/terapia , Dermatitis Profesional/terapia , Reinserción al Trabajo , Adulto , Anciano , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/prevención & control , Dermatitis Irritante/diagnóstico , Dermatitis Irritante/prevención & control , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Educación del Paciente como Asunto , Equipo de Protección Personal , Evaluación de Programas y Proyectos de Salud , Estudios Retrospectivos , Cuidados de la Piel , Adulto JovenAsunto(s)
COVID-19/prevención & control , Dermatitis Irritante/etiología , Dermatitis Profesional/etiología , Higiene de las Manos , Personal de Salud , Dermatitis Irritante/prevención & control , Dermatitis Profesional/prevención & control , Guantes Protectores/efectos adversos , Humanos , SARS-CoV-2RESUMEN
BACKGROUND: Skin protection products, formerly named as barrier creams, are being used as primary and secondary prevention measures against occupational dermatoses. Many of these cosmetic products are claimed by manufacturers to be efficacious against wet work-induced skin barrier impairment if applied prior to exposure. However, results of validated and standardized in vivo efficacy tests allowing the comparison of different products are lacking. MATERIAL AND METHODS: Efficacy of six skin protection products against sodium lauryl sulphate-induced irritant contact dermatitis was investigated in a double blind, randomized and controlled repetitive irritation study in healthy volunteers using skin physiological methods. Transepidermal water loss (TEWL) results were used to calculate an efficacy index of protection by mathematical/statistical means according to a protocol developed in a German Statutory Accident Insurance (DGUV) multicenter study (research project FP 275). RESULTS: All tested products had a demonstrable, protective effect against SLS compared to controls, but their relative efficacy varied significantly. Differences were also seen upon evaluation of other parameters such as corneometry and clinical irritation score (visual score). CONCLUSIONS: Product ranking as a result of the established differences allows improved selection of appropriate skin protection products based on objective parameters, as compared to heterogenous product claims.
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Dermatitis Irritante , Pérdida Insensible de Agua , Dermatitis Irritante/diagnóstico , Dermatitis Irritante/etiología , Dermatitis Irritante/prevención & control , Método Doble Ciego , Humanos , Piel , Fenómenos Fisiológicos de la Piel , Dodecil Sulfato de SodioRESUMEN
BACKGROUND: There are no reported cases of 2,4-dichloro-5-methylpyrimidine (DCP)-induced irritant contact dermatitis (ICD). OBJECTIVE: The aim of the study was to summarize the clinical features, treatment, and protective measures for DCP-induced ICD. METHODS: We retrospectively reviewed the clinical data from 64 patients with DCP-induced ICD and the protective measures in a DCP manufacturing factory. RESULTS: Disease onset occurred 1 to 10 minutes after DCP single exposure in all 64 patients. The contact site developed edematous erythematous skin lesions with clear boundaries. Other symptoms included a burning sensation (n = 48), pruritus (n = 16), headache (n = 4), nausea/vomiting (n = 3), and syncope (n = 1). Ten patients developed pruritic rash over the whole body 1 to 4 days after contacting DCP. Histopathologic examination of the lesions was performed in 8 patients; all 8 showed manifestations of ICD. A patch test with 1% DCP ethanol solution was performed in 7 patients. One patient withdrew because of pruritus and massive erythema over the whole body. Four patients had a strong reaction, and 2 patients had a very strong reaction. All patients were cured. Positive-pressure inflatable protective clothing protected workers from the outside environment to prevent DCP-induced ICD. CONCLUSIONS: 2,4-Dichloro-5-methylpyrimidine exposure induces acute ICD and a delayed allergic reaction in some patients (15.6%). Positive-pressure inflatable protective clothing prevents DCP-induced ICD.
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Dermatitis Irritante/fisiopatología , Dermatitis Profesional/fisiopatología , Edema/fisiopatología , Eritema/fisiopatología , Prurito/fisiopatología , Enfermedad Aguda , Adulto , Industria Química , Dermatitis Irritante/etiología , Dermatitis Irritante/prevención & control , Dermatitis Irritante/terapia , Dermatitis Profesional/etiología , Dermatitis Profesional/prevención & control , Dermatitis Profesional/terapia , Femenino , Cefalea/fisiopatología , Humanos , Masculino , Instalaciones Industriales y de Fabricación , Persona de Mediana Edad , Náusea/fisiopatología , Pruebas del Parche , Ropa de Protección , Pirimidinas/efectos adversos , Vómitos/fisiopatologíaRESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: Cutaneous inflammatory diseases, such as irritant contact dermatitis, are usually treated with topical corticosteroids, which cause systemic and local adverse effects limiting their use. Thus, the discovery of new therapeutic alternatives able to effectively treat skin inflammatory disorders, without causing adverse effects, is urgently needed. AIM OF THE STUDY: To investigate the topical anti-inflammatory effect of oleic acid (OA), a monounsaturated fatty acid, into Pemulen® TR2-based semisolid dosage forms, employing a croton oil-induced irritant contact dermatitis model in mice. MATERIALS AND METHODS: Male Swiss mice were submitted to skin inflammation protocols by acute and repeated applications of croton oil. The anti-inflammatory activity of Pemulen® TR2 hydrogels containing OA was evaluated by assessing oedema, inflammatory cell infiltration, and pro-inflammatory cytokine IL-1ß levels. The mechanisms of action of OA were evaluated using cytokine IL-1ß application or pretreatment with the glucocorticoid antagonist mifepristone. Possible toxic effects of OA were also assessed. RESULTS: Pemulen® TR2 3% OA inhibited the acute ear oedema [maximal inhibition (Imax) = 76.41 ± 5.69%], similarly to dexamethasone (Imax = 84.94 ± 2.16%), and also inhibited ear oedema after repeated croton oil application with Imax = 85.75 ± 3.08%, similar to dexamethasone (Imax = 81.03 ± 4.66%) on the day 7 of the experiment. Croton oil increased myeloperoxidase activity, which was inhibited by Pemulen® TR2 3% OA (Imax = 71.37 ± 10.97%) and by 0.5% dexamethasone (Imax = 96.31 ± 3.73%). Pemulen® TR2 3% OA also prevented the increase in pro-inflammatory cytokine IL-1ß levels induced by croton oil (Imax = 94.18 ± 12.03%), similar to 0.5% dexamethasone (Imax = 87.21 ± 10.58%). Besides, both Pemulen® TR2 3% OA and 0.5% dexamethasone inhibited IL-1ß-induced ear oedema with an Imax of 80.58 ± 2.45% and 77.46 ± 1.92%, respectively. OA and dexamethasone anti-inflammatory effects were prevented by 100% and 91.43 ± 5.43%, respectively, after pretreatment with mifepristone. No adverse effects were related to Pemulen® TR2 3% OA administration. CONCLUSIONS: OA demonstrated anti-inflammatory efficacy similar to dexamethasone, clinically used to treat skin inflammatory conditions, without presenting adverse effects.
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Antiinflamatorios/farmacología , Dermatitis Irritante/prevención & control , Ácido Oléico/farmacología , Piel/efectos de los fármacos , Administración Cutánea , Animales , Antiinflamatorios/administración & dosificación , Antiinflamatorios/toxicidad , Aceite de Crotón , Dermatitis Irritante/etiología , Dermatitis Irritante/metabolismo , Dermatitis Irritante/patología , Modelos Animales de Enfermedad , Mediadores de Inflamación/metabolismo , Interleucina-1beta/metabolismo , Masculino , Ratones , Ácido Oléico/administración & dosificación , Ácido Oléico/toxicidad , Piel/metabolismo , Piel/patologíaAsunto(s)
Vendajes , Dermatitis Irritante/prevención & control , Dermatitis Profesional/prevención & control , Respiradores N95/efectos adversos , Adulto , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/transmisión , Dermatitis Irritante/etiología , Dermatitis Profesional/etiología , Cara , Femenino , Personal de Salud , Humanos , Masculino , Respiradores N95/normas , Pandemias/prevención & control , Proyectos Piloto , Piel , Diseño Centrado en el UsuarioAsunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/prevención & control , Dermatitis Irritante/prevención & control , Oído/lesiones , Máscaras/efectos adversos , Pandemias/prevención & control , Neumonía Viral/prevención & control , COVID-19 , Infecciones por Coronavirus/epidemiología , Dermatitis Irritante/etiología , Estudios de Factibilidad , Personal de Salud , Humanos , Control de Infecciones/instrumentación , Control de Infecciones/normas , Neumonía Viral/epidemiología , Guías de Práctica Clínica como Asunto , SARS-CoV-2RESUMEN
OBJECTIVE: To determine the feasibility of an adequately powered trial testing a long-acting cyanoacrylate skin protectant to prevent incontinence-associated dermatitis in critically ill patients. METHODS: This open-label pilot randomized controlled feasibility study was conducted in the adult ICU of an Australian quaternary referral hospital. Patients were allocated to either an intervention group or a control group (usual care). The intervention was the application of a skin protectant (a durable, ultra-thin, transparent, waterproof, no-removal barrier film). Data collected by trained research nurses included demographic and clinical variables, skin assessment, and incontinence-associated dermatitis presence and severity. Data were analyzed using descriptive and inferential statistics. RESULTS: Of the 799 patients screened, 85% were eliminated because of a short ICU stay or other exclusion criteria. The mean proportion of patients not meeting any of the exclusion criteria was 22% on each screening day. Protocol fidelity was followed for 90% of intervention participant study days. Retention of participants was 86% (31 participants out of 36), 15 in the intervention group and 16 in the control group. Enrolled patients had a mean age of 59 years, 50% were obese, 67% were male, and 36% were smokers. Two patients (11%) in the intervention group developed incontinence-associated dermatitis, compared with three (17%) in the control group. CONCLUSIONS: This study reports no significant findings between the two groups. Difficulty in recruitment and feasibility issues might be overcome with changes to inclusion criteria and study design.
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Enfermedad Crítica/enfermería , Dermatitis Irritante/enfermería , Incontinencia Fecal/enfermería , Cuidados de la Piel/enfermería , Incontinencia Urinaria/enfermería , Adulto , Australia , Cuidados Críticos , Dermatitis Irritante/prevención & control , Incontinencia Fecal/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria/prevención & controlRESUMEN
BACKGROUND: Alcohol-based hand rub (ABHR) is recommended for hand hygiene, and application on dry skin is generally well tolerated. However, hydration of the skin may lead to increased susceptibility to ABHR. OBJECTIVES: To evaluate if increased skin hydration changes skin barrier response to ABHR, as compared to application on dry skin. METHODS: Twenty healthy volunteers participated in a 3-day experimental setup. Intervention areas on the forearms were exposed to either water immersion or occlusion followed by repeated exposures to ABHR. Skin barrier function was assessed by measurement of transepidermal water loss (TEWL), electrical conductance, pH, and erythema at baseline and day 3. RESULTS: The area exposed to water immersion preceding ABHR showed a significant increase in TEWL from baseline to day 3 (P = .04), and for the occluded area the same trend was found (P = .11), with an additional decrease in electrical conductance (P = .03). No significant differences were found for the control area. The assessments did not differ significantly between intervention and control sites. CONCLUSION: Our results indicate that extensive skin hydration may lead to increased susceptibility to ABHR. Further evaluation of this observation is important, since ABHRs are widely used, particularly among health care workers in whom hand eczema is a huge problem.
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Etanol/administración & dosificación , Desinfección de las Manos/métodos , Higiene de las Manos/métodos , Pruebas de Irritación de la Piel/métodos , Administración Cutánea , Adulto , Dermatitis Irritante/prevención & control , Femenino , Humanos , Inmersión , MasculinoRESUMEN
OBJECTIVE: Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis. It is categorised by persistent erythema and can be associated with denudation and/or colonisation and infection. IAD is challenging to treat and affects 3.4-50% of patients. This case series evaluates a novel, elastomeric, advanced skin protectant (3M Cavilon Advanced Skin Protectant) in a UK acute health-care setting, for the management of IAD in patients suffering from moisture-associated skin damage (MASD) in the sacral/genital area. METHOD: The patient's skin was assessed by clinicians using the GLOBIAD classification tool at the point of recruitment and to monitor progress throughout the study period. The product was applied as a single layer in accordance with the instructions for use. Patients, when able, were asked to assess their own pain level using the Wong-Baker FACES pain scale. Photographs were taken as part of the ongoing assessment. RESULTS: The skin protectant was used on average every 2.28 days. Of the 18 IAD patients recruited, 79% (n=11) were classified as IAD-free, based on the GLOBIAD categorisation tool, by the end of the evaluation period. Skin deterioration during the evaluation period was seen in one patient (6%), and of the patients able to complete pain assessments, 55% (n=6) reported a reduction in pain. CONCLUSION: These results suggest that the elastomeric skin protectant, applied every three days, plays a role in the improvement of IAD. The skin protectant adheres to wet and weeping partial-thickness wounds and may aid IAD management. Reducing application to every third day supports a change in practice which may offer benefits to patients and caregivers.
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Cianoacrilatos/administración & dosificación , Dermatitis Irritante/terapia , Elastómeros/administración & dosificación , Incontinencia Fecal/complicaciones , Sustancias Protectoras/administración & dosificación , Incontinencia Urinaria/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Nalgas , Dermatitis Irritante/etiología , Dermatitis Irritante/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Piel/lesiones , Cuidados de la Piel/métodosAsunto(s)
Cicatriz Hipertrófica/prevención & control , Presión de las Vías Aéreas Positiva Contínua/efectos adversos , Dermatitis Irritante/prevención & control , Geles de Silicona , Apnea Obstructiva del Sueño/terapia , Adulto , Cicatriz Hipertrófica/etiología , Presión de las Vías Aéreas Positiva Contínua/instrumentación , Dermatitis Irritante/etiología , HumanosAsunto(s)
Industria de la Belleza/tendencias , Productos Biológicos/efectos adversos , Cosméticos/efectos adversos , Etiquetado de Productos/normas , Cuidados de la Piel/tendencias , Productos Biológicos/química , Productos Biológicos/normas , Cosméticos/química , Cosméticos/normas , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/prevención & control , Dermatitis Irritante/etiología , Dermatitis Irritante/prevención & control , Humanos , Trastornos por Fotosensibilidad/inducido químicamente , Trastornos por Fotosensibilidad/prevención & control , Cuidados de la Piel/efectos adversos , Cuidados de la Piel/normasRESUMEN
An estimated 14 million adults experience incontinence in England alone, and this population is at a very high risk of developing incontinence-associated dermatitis (IAD). The risk associated with developing IAD is further increased among older adults, due to the effects of the ageing process, which leave the skin thinner and more fragile. Understanding the causative factors of IAD in addition to understanding the impact of IAD on the skin enable the clinician to make informed choices regarding treatment, management and prevention. Additionally, understanding the association between IAD and pressure ulcers is a critical component of IAD management, as IAD and pressure ulcers often coexist or develop alongside each other.
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Dermatitis Irritante/enfermería , Envejecimiento de la Piel/fisiología , Dermatitis Irritante/etiología , Dermatitis Irritante/fisiopatología , Dermatitis Irritante/prevención & control , Incontinencia Fecal/complicaciones , Humanos , Úlcera por Presión/complicaciones , Incontinencia Urinaria/complicacionesRESUMEN
Fiberglass dermatitis is a common form of occupational irritant contact dermatitis. Individuals experience a negative reaction to fiberglass fragments because of mechanical irritation. This review comprehensively analyzes the information in the existing literature on fiberglass dermatitis. Recognizing the different environmental risks factors for acquiring fiberglass dermatitis is necessary for better diagnosis and prevention. In addition to the identification of high-risk populations exposed to fiberglass particles, the common clinical presentation and preventive measures that can reduce the risk of acquiring fiberglass dermatitis are thoroughly discussed.
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Dermatitis Irritante/diagnóstico , Dermatitis Profesional/diagnóstico , Vidrio , Exposición Profesional/efectos adversos , Administración Cutánea , Administración Oral , Dermatitis Irritante/tratamiento farmacológico , Dermatitis Irritante/etiología , Dermatitis Irritante/prevención & control , Dermatitis Profesional/tratamiento farmacológico , Dermatitis Profesional/etiología , Dermatitis Profesional/prevención & control , Glucocorticoides/administración & dosificación , Antagonistas de los Receptores Histamínicos/administración & dosificación , Humanos , Microscopía Confocal , Pruebas del Parche , Ropa de Protección , Factores de Riesgo , Piel/diagnóstico por imagenRESUMEN
Sacran, a polysaccharide isolated from the alga Aphanothece sacrum (Suizenji-nori), has unique physical and physiological characteristics. In a previous study, we reported that sacran improves skin conditions in individuals who suffer from atopic dermatitis (AD), focusing on its trapping function against extrinsic stimuli compared with hyaluronic acid (HA). First, we examined the penetration of sacran through stratum corneum (SC) with an impaired barrier function using immature reconstructed human epidermal equivalents. Sacran penetrates the SC to living cell layers of the epidermis, which suggested that sacran would attenuate adverse influences in keratinocytes caused by extracellular factors such as irritants or proinflammatory cytokines such as interleukin 1α (IL-1α). Sacran markedly reduced the cell damage induced by a nonionic detergent, sodium lauryl sulfate (SLS). Moreover, sacran restored the elevation of intracellular reactive oxygen species (ROS) levels stimulated by SLS and by IL-1α. These effects of sacran were superior to those of HA. In order to investigate the restoration effects of sacran, the influence of sacran on the physical properties of lipid bilayers was evaluated by measuring the order parameter using the ESR spin-labeling method. Because sacran failed to cause changes in the order parameters of liposomes and HaCaT keratinocytes, these results indicate that sacran does not interact with lipid bilayers although it restored changes in the order parameter caused by SLS. The sum of these results demonstrates that sacran reduces the influence of extracellular stimuli by its trapping effects. We conclude that the improving action of sacran is based on its trapping effect.
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Cianobacterias/química , Dermatitis Irritante , Queratinocitos/efectos de los fármacos , Polisacáridos/farmacología , Sustancias Protectoras/farmacología , Piel/efectos de los fármacos , Dodecil Sulfato de Sodio/efectos adversos , Productos Biológicos/farmacología , Dermatitis Atópica/prevención & control , Dermatitis Irritante/metabolismo , Dermatitis Irritante/prevención & control , Fármacos Dermatológicos/farmacología , Epidermis/efectos de los fármacos , Humanos , Interleucina-1alfa/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Piel/citología , Piel/metabolismoRESUMEN
OBJECTIVE: 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). INTRODUCTION: 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. INCLUSION CRITERIA: 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. METHODS: 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". RESULTS: There were no studies located that met the inclusion requirements of this review. CONCLUSION: 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.