ABSTRACT
Resumen Introducción: El jabón para el aseo cutáneo es de empleo común entre la población, sin embargo, es posible que cause daño a las células de la piel y modifique la barrera cutánea. Objetivo: Determinar el efecto citotóxico de los jabones en queratinocitos cultivados in vitro y correlacionarlo con la irritación clínica. Método: Se realizó una encuesta para conocer los jabones comerciales más utilizados y su cantidad; posteriormente, se evaluó su citotoxicidad en cultivos de queratinocitos humanos mediante el método de resazurina. Los jabones con mayor y menor citotoxicidad se aplicaron en piel de voluntarios sanos para evaluar su efecto en la barrera cutánea mediante ensayos de colorimetría y pérdida transepidérmica de agua. Resultados: De los jabones analizados, 37 % demostró ser tóxico para los queratinocitos in vitro. El jabón con mayor toxicidad indujo el mayor índice de eritema y pérdida transepidérmica de agua, en comparación con el jabón menos tóxico y el vehículo empleado como solución control. Conclusión: Los jabones comercializados para el aseo cutáneo pueden incluir ingredientes químicos que dañan los queratinocitos humanos y causan irritación subclínica de la barrera cutánea. Su utilización puede agravar dermatosis preexistentes, generar dermatitis xerósica o de contacto irritativa y causar atrofia y dermatoporosis.
Abstract Introduction: The use of soap for skin cleansing is common among the population. However, it is possible that it causes damage to skin cells and disrupts the skin barrier. Objective: To determine the cytotoxic effect of soaps on in vitro-cultured keratinocytes and to correlate it with clinical irritation. Method: A survey was conducted to find out the most widely used commercial soaps and their number. Subsequently, their cytotoxicity was evaluated in human keratinocyte cultures using the resazurin assay. The soaps with the highest and lowest cytotoxicity were applied to the skin of healthy volunteers to assess their effect on the skin barrier using colorimetry and transepidermal water loss (TEWL) assays. Results: Of the analyzed soaps, 37 % were shown to be toxic to keratinocytes in vitro. The soap with the highest toxicity induced the highest rate of erythema and TEWL, in comparison with the least toxic soap and the vehicle used as the control solution. Conclusion: Soaps marketed for skin cleansing can contain chemical ingredients that damage human keratinocytes and cause skin barrier subclinical irritation. Their use can worsen preexisting dermatoses, generate xerotic or irritant contact dermatitis, and cause atrophy and dermatoporosis.
Subject(s)
Humans , Soaps/adverse effects , Keratinocytes/drug effects , Skin Irritancy Tests , Irritants/adverse effects , Skin/drug effects , Soaps/chemistry , Body Water , Cells, Cultured , Dermatitis, Irritant/etiology , Colorimetry , Erythema/chemically induced , Healthy Volunteers , Hydrogen-Ion ConcentrationABSTRACT
Los accidentes causados por los estadios larvarios de los lepidópteros se conocen como erucismo. El contacto accidental con las orugas del género Lonomia spp. puede desencadenar síndromes hemorrágicos que en casos severos puede llegar a producir injuria renal aguda y hemorragia intracraneal. Se presenta el caso de un varón de 48 años procedente la selva central del Perú, quien mientras estaba en el campo, incidentalmente entra en contacto con una oruga, cursando luego con un síndrome hemorrágico caracterizado por coagulopatía y hemorragia subaracnoidea. El cuadro se resolvió satisfactoriamente luego de la administración del suero antilonómico. Se discute los aspectos fisiopatológicos, clínicos y laboratoriales que condujeron al diagnóstico, así como la efectividad reportada del tratamiento. (AU)
The accidents caused by the larval stages of the Lepidoptera are known as erucism. Accidental contact with caterpillars of the genus Lonomia spp. can trigger hemorrhagic syndromes that in severe cases can lead to acute renal injury and intracranial hemorrhage. We present the case of a 48 year-old male from Peruvian Central Jungle who while was working in the forest comes in contact with a caterpillar, after which he developed an hemorrhagic syndrome characterized by coagulopathy and subarachnoid hemorrhage. The clinical picture resolved satisfactorily after administration of antilonomic serum. The pathophysiological, clinical and laboratory aspects that led to the diagnosis are discussed, as well as the reported effectiveness of treatment. (AU)
Subject(s)
Humans , Male , Middle Aged , Dermatitis, Irritant , LepidopteraABSTRACT
Abstract: BACKGROUND: Occupational dermatoses are common, especially contact dermatitis. Epidemiological studies on these dermatoses are scarce in Brazil and they are necessary as part of the public policy to protect workers' health. OBJECTIVES: To identify sociodemographic and clinical profile of patients with occupational contact dermatitis seen between 2000 and 2014 at an occupational dermatology service. METHODS: It is a cross-sectional and retrospective study, based on information obtained from the service's database. RESULTS: Of 560 patients with conclusive patch test, 289 (46.9%) presented occupational dermatoses and 213 occupational contact dermatitis with predominance of the allergic type in relation to the irritative type (149:64 respectively). The odds of occupational dermatoses were higher among men and lower among patients aged 50 years or older and with higher level of education. Regarding the possibility of presenting occupational allergic contact dermatitis, only the gender variable was statistically significant. The professions most seen were cleaners, construction workers, painters, mechanics/metallurgists and cooks. The commonest allergens were nickel sulfate, potassium dichromate, cobalt chloride, carba-mix and formaldehyde. STUDY LIMITATIONS: The main limitations of this study are the fact that it was carried out in a tertiary service of occupational dermatoses and the lack of access to some allergens outside the patch test baseline series. CONCLUSIONS: It was possible to identify the sociodemographic and clinical profile of patients with suspected occupational contact dermatitis seen at the Service, beyond the professional groups and allergens related to a high risk of occupational contact dermatitis in this population.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Occupational Exposure/statistics & numerical data , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Occupational/epidemiology , Potassium Dichromate/adverse effects , Socioeconomic Factors , Brazil/epidemiology , Patch Tests/statistics & numerical data , Caustics/adverse effects , Construction Industry , Sex Factors , Cross-Sectional Studies , Retrospective Studies , Occupational Exposure/adverse effects , Age Factors , Dermatitis, Irritant/etiology , Dermatitis, Irritant/epidemiology , Dermatitis, Allergic Contact/etiology , Dermatitis, Occupational/etiology , Educational Status , Hand Dermatoses/chemically induced , Hand Dermatoses/epidemiology , Irritants/adverse effects , Nickel/adverse effectsABSTRACT
PURPOSE: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. METHODS: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. RESULTS: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. CONCLUSION: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.
Subject(s)
Humans , Dermatitis, Irritant , Education , Evidence-Based Nursing , Evidence-Based Practice , Intertrigo , Korea , Organizational Policy , Skin Care , SkinABSTRACT
Introducción: La Dermatitis ocupacional es una inflamación de la piel provocada por el entorno laboral o contacto de una sustancia perjudicial, siendo considerada el problema de salud más frecuente en el ámbito laboral. Objetivo: Describir las características de los pacientes con Dermatitis ocupacional atendidos en una consulta de Dermatología durante 2015. Material y Métodos: Se realizó una investigación descriptiva transversal con una muestra de 56 personas diagnosticadas con esta enfermedad y que acudieron a consulta de Dermatología del Policlinico Pedro Fonseca durante todo 2015. Resultados: El 58,9 por ciento fue del sexo femenino, quienes llevaban más de 5 años de trabajo e iniciaron los síntomas más de 12 meses antes. El 100 por ciento de los pacientes tenían lesiones eritematosas y 94,6 por ciento presentaron liquenificación. La presentación de las lesiones costrosas fue de 69,6 por ciento más evidente en manos y muñecas. Conclusiones: Los pacientes con diagnóstico de Dermatitis ocupacional fueron los más frecuentes en la consulta de Dermatología de nuestra área de salud durante 2015. La Dermatitis ocupacional atópica superó en número de casos diagnosticados y en severidad de las lesiones a la Dermatitis ocupacional irritativa, siendo además la de mayor tiempo de evolución de los síntomas(AU)
Introduction: The occupational Dermatitis is an inflammation of the skin caused by the labor environment or contact of a harmful substance, being considered the more frequent health problem in the labor environment. Objective: To describe the characteristics of the patients with occupational Dermatitis assisted in a consultation of Dermatology during 2015. Material and Methods: He/she was carried out a traverse descriptive investigation with a sample of 56 people diagnosed with this illness and that they went to consultation of Dermatology of the Policlinic Pedro Fonseca during everything 2015. Results: 58,9 percent was of the feminine sex who had more than 5 years of work and they began the symptoms before more than 12 months. 100 percent of the patients had erythematous lesions and 94,6 percent of them presented lichenification. The presentation of the scabby lesions was of 69,6 more evident percent in hands and risks. Conclusions: The patients with diagnostic of occupational Dermatitis were the most frequent in the consultation of Dermatology of our health area during 2015. The atopic occupational Dermatitis overcame in number of diagnosed cases and in severity of the lesions to the occupational irritating Dermatitis, being also the one with the bigger time of evolution of the symptoms(AU)
Subject(s)
Humans , Male , Female , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/epidemiology , Dermatitis, Atopic/diagnosis , Epidemiology, Descriptive , Cross-Sectional Studies , Dermatitis, Irritant/etiologyABSTRACT
Resumen.La primera barrera con el medio ambiente que protege contra sustancias nocivas y organismos es la piel. Las actividades humanas son sumamente diversas y muchas de los trabajos pueden actuar en detrimento de esta barrera natural provocando enfermedades dermatológicas asociadas con la dinámica laboral. El 90% de todas las dermopatías laborales son dermatitis de contacto, la cual puede ser irritativa o alérgica. En la mayoría de los casos se trata de un eczema en zonas expuestas del cuerpo y con cierta frecuencia en las manos. El diagnóstico se basa en una historia clínica y examen físico detallados, conocimiento de las sustancias que permita diferenciar los irritantes de los alérgenos y una correcta interpretación de las pruebas de alergia. Este es conocimiento básico para peritar en el ámbito médico legal.
Abstract.The skin is the primary interface with external environment and performs quite efficiently as a barrier against noxious chemicals or living organisms. The range of human activities is extremely diversified and many occupations can lead to break down of the epidermal barrier, with subsequent development of work-related dermatoses.Occupational contact dermatitis accounts for 90% of all causes of work-related cutaneous disorders. It can be divided into irritant contact dermatitis, wich occurs in 80% of cases and allergic contact dermatitis. In most cases, both types will present as eczematous lesions on exposed parts of the body, notably the hands. Accurate diagnosis relies on meticulous history taking, thorough physical examination, careful distinguishing between irritants and allergens, and comprehensive patch testing to confirm or ruled out allergic sensitization. This is a basic review to issue a forensic professional judgement.
Subject(s)
Humans , Occupational Risks , Dermatitis, Irritant/pathology , Dermatitis, Allergic Contact/pathology , Occupational Diseases/diagnosis , Occupational Health , Forensic MedicineABSTRACT
Resumen:La dermatosis profesional es aquella alteración dermatológica que se ve originada o empeorada por las condiciones de trabajo. Los estudios comparativos entre países se ven limitados por las diferencias existentes en la notificación de enfermedades profesionales, siendo muchas veces su incidencia subestimada a pesar de ser de gran impacto socioeconómico, pues éstas son una causa frecuente de incapacidad y/o discapacidad relacionada con el trabajo, pudiendo constituir un porcentaje importante de las indemnizaciones económicas en muchas naciones. Es difícil establecer la relación de causalidad entre las dermatosis y una profesión o actividad laboral específica sin disponer de parámetros objetivos, por lo que este artículo busca dar un amplio panorama de cómo abordar el problema médico legal de las dermatosis ocupacionales en las pericias diarias de un médico legista.
Abstract:The professional dermatosis is a dermatological alteration that is originated or worsened by conditions of work. The comparative studies among different countries are limited by the differences in the notification system of occupational diseases, in such a manner that is often underestimated even though they have a socioeconomic impact. In the case of the occupational dermatosis, in many countries they constitute an important percentage of the economic indemnifications, and also a frequent reason of disability related to the job itself. Being able to establish a relation of causality between the dermatosis and a profession or specific labor activity without having objective parameters is most of the time difficult, so that this article seeks to give a wide panorama of how to approach the medical legal problem of the occupational dermatosis in the daily expertise of a forensic doctor.
Subject(s)
Humans , Dermatitis, Irritant/diagnosis , Dermatitis, Occupational/diagnosis , Forensic MedicineABSTRACT
Contexto: Estudos epidemiológicos em Dermatite Ocupacional e uso de Equipamentos de Proteção Individual (EPIs) no Brasil são raros porque não há notificação obrigatória dessa doença. Estima-se que existam casos de subdiagnóstico, pois muitos trabalhadores não procuram o serviço de saúde temendo a perda do emprego e, além disso, o mau uso de EPIs decorrente de dermatite pode expor o trabalhador à fatores agressores presentes em sua atividade profissional. Objetivos: Verificar a relação entre a ocorrência da dermatite de contato irritativa e o uso dos EPIs, identificando fatores de risco e medidas adotadas. Métodos: Foram selecionados 100 trabalhadores, no período de julho a dezembro de 2013, que utilizam diariamente EPIs para suas atividades profissionais e que foram encaminhados ao ambulatório da empresa INMETRA. Todos foram convidados a preencher um questionário sobre lesões de pele e EPIs. Resultados: De acordo com os dados obtidos, nota-se que a incidência de dermatites é 27%, a doença atinge principalmente mulheres (p<0,001), acomete principalmente mãos (96,3%) e não se correlaciona ao compartilhamento de EPIs entre colegas, mas sim ao uso prolongado na jornada de trabalho (p<0,002) e uso por mais de 1 dia (p<0,044). Conclusões: Este estudo nos fez refletir sobre a importância da propagação do conhecimento sobre a dermatite de contato irritativa (DCI) junto aos trabalhadores, quanto a orientação correta sobre o diagnóstico e medidas a serem tomadas para o tratamento e ainda a avaliação de um EPI adequado para as pessoas acometidas pela doença.
Context: Epidemiological studies in Occupational Dermatitis and use of Personal Protective Equipment (PPE) in Brazil are rare because there is no mandatory reporting of this disease. There are some cases of underdiagnosis because many workers do not seek health services fearing to lose their jobs and, moreover, the misuse of PPE due to dermatitis may expose the employee to the aggressive factors present in their professional activity is estimated. Objectives: To investigate the relationship between the occurrence of irritant contact dermatitis and use of PPE, identifying all the risk factors and measures adopted. Methods: There were selected 100 workers in the period from July to December 2013 using PPE for their daily professional activities, that were referred to the outpatient clinic of the company INMETRA. All of them were asked to complete a questionnaire about skin lesions and PPE. Results: According to the data obtained, we noted that the incidence of dermatitis is 27%, mainly affects women (p<0.001), mainly affects the hands (96.3%) and does not correlate to the IPE sharing between colleagues, but the prolonged use of working hours (p<0.002) and the use for more than 1 day (p<0.044). Conclusions: This study made us reflect on the importance of spreading knowledge about the DCI with the workers, as the correct guidance on the diagnosis and measures to be taken for treatment and further evaluation of PPE suitable for people affected by disease.
Subject(s)
Protective Devices , Occupational Health , Dermatitis, Irritant , Dermatitis, Occupational , Dermatitis, Contact/prevention & control , Risk FactorsABSTRACT
The cosmopolitan beetles of the Paederus genus (potós) cause a severe dermatitis when the insect is crushed against the skin of exposed areas (the cervical region is the most affected). Toxins (pederin and others) from the hemolymph of the insect cause plaques and/or bizarre, linear lesions with erythema, edema, blisters, pustules, crusts and exulcerations. There may be a burning sensation and severe conjunctivitis. Lesions disappear after 10 days and may leave hyperchromic macules. Treatment is made with topical corticosteroids and intensive washing.
Subject(s)
Animals , Female , Humans , Animals, Poisonous , Arthropod Venoms/poisoning , Coleoptera , Dermatitis, Irritant/etiology , Dermatitis, Irritant/pathologyABSTRACT
La dermatitis de contacto (DC) es una respuesta inflamatoria de la piel, como resultado del contacto de la misma con múltiples factores externos, frecuentemente contenidos en cosméticos. Las pruebas del parche son el pilar diagnostico. Se evaluó la prevalencia de la dermatitis alérgica de contacto por cosméticos, determinando las relaciones epidemiológicas como: edad, sexo, localización, ocupación y sensibilización. El 70% de los pacientes estudiados fueron DAC y el 30% fuerondermatitis irritativas por contacto (DIC). El 57% de las dermatitis alérgicas estaban asociadas a cosméticos,predominando en el sexo femenino.
Contact dermatitis (AD) is an inflammatory response of the skinas a result of contact with multiple external factors, often containedin cosmetics. Patch tests are the diagnostic pillar. Prevalence of allergic contact dermatitis to cosmetics was evaluatedby determining the epidemiological relationships as age, sex, location, occupation and awareness.70% of the patients studied were DAC and 30% were irritant contact dermatitis (ICD).57% of allergic dermatitis were associated with cosmetics, predominantly in females.
Subject(s)
Humans , Male , Female , Dermatitis, Allergic Contact/diagnosis , Dermatitis, Allergic Contact/epidemiology , Dermatitis, Allergic Contact/immunology , Dermatitis, Irritant/diagnosis , Dermatitis, Irritant/immunology , Patch Tests/statistics & numerical data , Patch Tests/methodsABSTRACT
La enfermedad de Hirschsprung o megacolon congénito es una anomalía rara, caracterizada por la ausencia de las células ganglionares del intestino. Esto genera una falla en su relajación distal, que impide la eliminación de la materia fecal y causa una obstrucción inmediata después del nacimiento. El tratamiento es eminentemente quirúrgico y a las semanas de la reanastomosis coloanal los pacientes presentan diarrea. Por su parte, la dermatitis de Jacquet es una forma infrecuente de la dermatitis del pañal por irritante primario, provocada por el contacto prolongado de la piel de esta región con la orina o heces acuosas. Comunicamos el caso de un niño con enfermedad de Hirschsprung que, luego de la intervención quirúrgica, presentó una dermatitis de Jacquet asociada a diarrea grave...
Hirschsprung´s disease, also known as congenital aganglionic megacolon, is a rare anomaly, marked by the absence of ganglionic cells of the large intestine, resulting in failure of its distal looseness, blocking evacuation and causing obstruction right after birth. The treatment is mainly surgical and weeks after coloanal reanastomosis, these patients develop diarrhea. Jacquet dermatitis is an unusual presentation of irritant diaper dermatitis, caused by prolonged contact of the skin of this region with urine and/or watery diarrhea. We report a case of a child with Hirschsprung´s disease that, after surgical treatment, presented Jacquet dermatitis as an outcome of severe diarrhea...
Subject(s)
Humans , Male , Infant , Diaper Rash , Hirschsprung Disease , Dermatitis, IrritantABSTRACT
<p><b>OBJECTIVE</b>To explore the effects of mechanical irritation to the skin, eyes, and upper respiratory tract in workers exposed to rock wool.</p><p><b>METHODS</b>The gravimetric concentration of total dust and number concentration of fibre in the air of the rock wool workplace were determined . 109 rock wool manufacturing and processing workers were taken as the exposed group, 104 workers from an air separation plant, a papermaking plant and cover making plant were served as control group. All subjects accepted the questionnaire interview and clinical examination of the skin, eyes, nose and the pharynx.</p><p><b>RESULTS</b>10.1% of the exposed group had the irritant contact dermatitis, which showed linear trend with the current gravimetric concentration of total dust (P < 0.05) but no association with the exposure age (P > 0.05), and the detection rate of conjunctivitis of the exposed group (12.8%) was significantly higher than the control group (2.8%) (P < 0.05). The percentages of shin and eye itching symptoms of the exposed group (54.1% and 42.9%) were significantly higher than the control group (11.5% and 26.5%) (P < 0.05), but the differences among/between the exposed subgroups with different exposure level and different exposure age were not statistically significant (P > 0.05). The differences of the detection rate of chronic rhinitis and chronic pharyngitis and the percentages of the symptoms of nose and pharynx between the exposed group and control group were not statistically significant (P > 0.05), except the rhinorrhea symptom.</p><p><b>CONCLUSIONS</b>Occupational exposure to rock wool had some degree of the mechanical irritation effects on the skin and eyes. The current exposure level of total dust should be emphatically controlled.</p>
Subject(s)
Adult , Humans , Male , Middle Aged , Asbestos , Case-Control Studies , Conjunctivitis , Epidemiology , Dermatitis, Irritant , Epidemiology , Dust , Occupational Exposure , Physical Stimulation , WorkplaceABSTRACT
A ocupação desordenada de ambientes e a sinantropia aumentam os acidentes por artrópodes de importância médica em áreas urbanas. De outubro de 2009 a abril de 2010, após forte calor e chuvas, foram identificados na zona urbana de Viçosa, Minas Gerais, Brasil, 19 casos de dermatite vesicante, com observação de correlação entre as histórias clínico-epidemiológicas, aspectos clinico-morfológicos e evolutivos da dermatite por pederina. Dois coleópteros identificados na Universidade Federal de Viçosa como Paederus sp. foram coletados neste período, embora não correlacionados aos casos. Este relato de caso visa registrar a presença da dermatite vesicante e a ocorrência atípica do agente causticante no município, contribuindo com aspectos epidemiológicos e clínicos para o diagnóstico e tratamento desta dermatose.
The disordered occupation and the synanthropy of urban environments increase the number of accidents of medical importance caused by arthropods in urban areas. After intense heat and rain, from October 2009 to April 2010 were identified in the city of Viçosa, Minas Gerais, Brazil, 19 cases of dermatitis vesicant, with observation of correlation between the clinical histories, epidemiological and evolutionary clinical-morphological aspects of the dermatosis by pederin. Two beetles, identified at the Federal University of Viçosa, as Paederus sp. were collected during this period although not correlated to the occurrences. This case report aims to show the presence of the vesicant dermatitis, its clinical and therapeutic implications for human health and record the atypical occurrence of blistering agent in Viçosa, contributing with epidemiological and clinical aspects to the development of dermatosis research work in the region.
La ocupación desordenada de los entornos y la sinantropia aumentan los accidentes por artrópodos de importancia médica en las zonas urbanas. De octubre de 2009 a abril de 2010, después de un intenso calor y lluvias, fueron identificados en la zona urbana de Viçosa, Minas Gerais, Brasil, 19 casos de dermatitis vesicante, con la observación de la correlación entre las historias clínico-epidemiológicas, los aspectos clínico-morfológicos y evolutivos de la dermatitis por pederina. Dos coleópteros identificados en la Universidad Federal de Viçosa como Paederus sp fueron recogidos durante este período, aunque no estaban correlacionados con las ocurrencias. Este informe tiene como objetivo mostrar la presencia de dermatitis vesicante, sus implicaciones clínicas y terapéuticas para la salud y registrar la aparición atípica del agente caustícate en Viçosa, contribuyendo con aspectos epidemiológicos y clínicos para el diagnóstico y tratamiento de esta dermatosis, atípica de la región.
Subject(s)
Coleoptera , Dermatitis, Irritant , Urban Area , Diagnosis, DifferentialABSTRACT
Hand dermatitis is commonly seen in primary care, although it is often underdiagnosed. Exogenous causes should always be considered and a detailed environmental and occupational history taken, especially in patients presenting in adulthood. Although not life-threatening, the condition may have significant impact on the patient's quality of life and employment. Refractory cases or those suspected to be due to exogenous workplace agents may need to be referred for further investigation. Hand dermatitis can be treated effectively using pharmacotherapy and prevented by minimising subsequent exposure to irritants and allergens. Occupational skin disorders, once diagnosed, should be notified to the relevant authorities, i.e. the Ministry of Manpower in Singapore.
Subject(s)
Adult , Female , Humans , Dermatitis, Irritant , Diagnosis , Dermatitis, Occupational , Diagnosis , Therapeutics , Eczema , Diagnosis , Therapeutics , Hand , Pathology , Occupational Diseases , Diagnosis , Therapeutics , Primary Health Care , Methods , SingaporeABSTRACT
Over the past years, hydrocolloid dressings have been introduced routinely in the treatment of various types of wounds. They provide a moist environment promoting autolytic debridement, and stimulate angiogenesis. However, long-term application often leads to inflammation of the skin in the immediate area of the ulcer, causing irritant dermatitis in many cases, but sometimes also leads to contact sensitization. A 32 year-old woman burnt herself by an iron, and presented to our clinic and was treated with Duoderm extrathin(R). Nine days later, she again presented with an erythematous oozing patch with edema, and allergic contact dermatitis was suspected. A patch test (TRUE test) was performed and a positive reaction to colophonium was obtained. Duoderm extrathin(R) contains hydrogenated rosin (colophonium) as the tackifying agent, so we could diagnose this case as allergic contact dermatitis due to the hydrogenated rosin in Duoderm extrathin(R). We report another case of allergic contact dermatitis due to Duoderm extrathin(R) in a 32 year-old woman.
Subject(s)
Female , Humans , Bandages, Hydrocolloid , Debridement , Dermatitis, Allergic Contact , Dermatitis, Irritant , Edema , Hydrogen , Inflammation , Iron , Patch Tests , Resins, Plant , Skin , UlcerABSTRACT
Organic solvents are hydrocarbon-based substances that dissolve another substance. Organic solvents are usually lipid soluble, volatile and commonly used for painting, printing, degreasing, cleaning, thinning and extraction. Due to their volatility and lipid solubility, organic solvents are easily absorbed across the alveolar-capillary membrane and through the skin. Because organic solvents are lipophilic, they tend to be distributed to lipid-rich tissue, such as adipose tissue, nervous system and liver. Almost all organic solvent can induce skin diseases such as acute irritant dermatitis and chronic eczema. Some organic solvents are associated with allergic contact dermatitis. General and nonspecific central nervous system depression is another common toxic effect induced by most organic solvents. It shows symptoms which are the same as those from alcohol drinking, and those symptoms are completely resolved by removal from exposure to solvents. Long term and repeated exposures to organic solvents can also lead to chronic adverse neurobehavioral effects. These effects are also called as chronic toxic encephalopathy, chronic solvent intoxication and psycho-organic syndrome, and commonly reported symptoms of them are headache, depression, anxiety, and impairment of recent memory. Organic brain lesions can be found in workers suffering from psycho-organic syndrome, and in this case, there is a possibility of persistent disabilities. Carbon disulfide, n-hexane, and methyl n-butyl ketone are specifically toxic to the peripheral nervous system, and cause a symmetric ascending sensory and motor polyneuropathy. Halogenated hydrocarbons including carbon tetrachloride show toxic effects on the heart, liver, kidney, and blood. Toluene can sensitize the heart to arrhythmogenic effects of epinephrine, so sudden death in young and healthy people can be ensued from glue sniffing. Benzene is able to induce any type of leukemia, especially in victims with benzene-associated aplastic anemia. Exposure to some solvents during pregnancy has potential to induce congenital malformation and spontaneous abortion. In the treatment of diseases by organic solvents, the first step should be removal from exposure to the causative solvent.
Subject(s)
Female , Humans , Pregnancy , Abortion, Spontaneous , Adipose Tissue , Alcohol Drinking , Anemia, Aplastic , Anxiety , Benzene , Brain , Carbon Disulfide , Carbon Tetrachloride , Central Nervous System , Death, Sudden , Depression , Dermatitis , Dermatitis, Allergic Contact , Dermatitis, Irritant , Eczema , Epinephrine , Headache , Heart , Hexanes , Hydrocarbons, Halogenated , Inhalant Abuse , Kidney , Leukemia , Liver , Membranes , Memory , Methyl n-Butyl Ketone , Nervous System , Neurotoxicity Syndromes , Occupational Diseases , Paint , Paintings , Peripheral Nervous System , Polyneuropathies , Resin Cements , Skin , Skin Diseases , Solubility , Solvents , Stress, Psychological , Toluene , VolatilizationABSTRACT
BACKGROUND: Self-inflicted dermatosis is a kind of self-inflicted skin disease. Most Vietnam veterans from Korea have visited the Veterans Hospitals for dermatological examination to determine the relationship between their skin diseases and Agent Orange. We were suspicious of the possibility that several Vietnam veterans intentionally produced their own skin lesions. OBJECTIVE: We conducted this study to determine the clinical characteristics of self-inflicted dermatoses of Korean Vietnam veterans. METHODS: From January, 1999 to December, 2007, a total 24 Vietnam veterans who were diagnosed as having self-inflicted dermatoses during their dermatological examinations at our hospital were included in this study. We investigated their clinical presentation, the laboratory examinations, the pathologic examinations, the medical records and the associated diseases. RESULTS: Itching was the most common subjective complaint and the duration of the itching was as follows; 20 to 30 yrs (50.0%), 1 to 10 yrs (25.0%), 10 to 20 yrs (20.8%) etc. The skin lesions were all multiple, and the involved area was as follows; upper extremities (83.3%), trunk (75.0%), lower extremities (70.8%) etc. There were two categories of clinical skin presentation. The first was the cases with lesion that were thought to be made by physical trauma such as stinging or excoriation, and the second more common cases had lesions that were thought to be made by chemical agents (70.8%). These cases resembled allergic or toxic irritant dermatitis and the lesions were composed of vesicles, erosions, ulcers and crusts that were within an arm's reach. Only 4 cases admitted to intentionally inflicting their skin lesions because of intense itching, and the others denied that they made the skin lesions by themselves. Skin biopsies were carried out in 19 of the total 24 cases, and the most common finding was spongiotic dermatitis (57.8%). CONCLUSION: This study showed the distribution and characteristics of self-inflicted dermatoses, and the study provides fundamental data for dermatologists to assess patients with self-inflicted dermatoses.
Subject(s)
Humans , 2,4,5-Trichlorophenoxyacetic Acid , 2,4-Dichlorophenoxyacetic Acid , Biopsy , Bites and Stings , Citrus sinensis , Dermatitis , Dermatitis, Irritant , Hospitals, Veterans , Intention , Korea , Lower Extremity , Medical Records , Pruritus , Skin , Skin Diseases , Polychlorinated Dibenzodioxins , Ulcer , Upper Extremity , Veterans , VietnamABSTRACT
BACKGROUND: Floods are natural disasters that occur occasionally in Thailand. The most common form skin diseases due to floods are infectious dermatoses especially superficial fungal infection. However the microbiologic evidences have not been evaluated. OBJECTIVE: To evaluate the most common skin diseases during floods and identify the organism that causes skin maceration at web space(s) of toes (Hong Kong foot). MATERIAL AND METHOD: Patients who complained of skin problems were evaluated at the temporary outpatient clinic during October 2006. Skin specimens from all patients who had itches and skin maceration at web space(s) of toes were cultured. RESULTS: Ninety-six patients were evaluated (38 males and 58 females). Eczema was the most prevalent dermatosis, which accounted for 34.5% of the total skin problems and the great majority of these cases were irritant contact dermatitis. Sixteen cases presented with itch and skin maceration at web space(s) of toes. All of them were colonized with various microorganisms. Gram-negative bacilli were the most prevalent ones and were found in 14 out of 16 specimens. Fungal culture was positive in only two specimens. CONCLUSION: Eczema is the most common dermatosis during floods. Skin maceration at web space(s) of toes, which were thought to be fungal infection, are chronic irritant dermatitis with secondary bacterial colonization. Only a few cases were fungal infection. Microbiologic investigation should be done in these patients. Unfortunately, it is not practical in such a situation. Topical medications that have the combination of antiinflammatory, antibacterial and antifungal properties are the most suitable medications.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Dermatitis, Irritant/epidemiology , Disasters , Environmental Exposure/adverse effects , Epidemiologic Studies , Female , Humans , Male , Middle Aged , Skin Diseases/epidemiology , Thailand/epidemiologyABSTRACT
BACKGROUND: Beetle dermatitis is a very common condition in western Orissa. It is often misdiagnosed and causes significant morbidity among the rural population. AIM: This study was conducted to determine the epidemiological and clinical profile of beetle dermatitis in western Orissa. METHODS: All clinically diagnosed cases of beetle dermatitis were included in the study. Detailed history was taken and thorough clinical examination was conducted in all the cases. One urban and three rural localities were visited regularly to detect the epidemiological trends of the disorder. RESULTS: A total of 590 cases were studied: 486 males and 104 females. The age of the patients ranged from 2 to 65 years. Forty-four percent of the patients belonged to the pediatric age group. Majority of the cases (85%) presented during the months of March to July, indicating a distinct seasonal trend. The disorder was prevalent in the localities nearer to paddy and sugarcane fields and grasslands with stagnant water. The clinical lesions included papules, erosions, crusted lesions, urticarial plaques and vesiculobullous lesions. Distribution was mainly linear, but kissing lesions were also observed. Head, neck and upper extremities were the most commonly involved sites. Lymphadenopathy and systemic features such as fever and malaise were observed in 24% and 15% of the cases, respectively. CONCLUSION: Beetle dermatitis should be included in the differential diagnosis of the acute onset of vesiculobullous lesions in the endemic areas.
Subject(s)
Adolescent , Adult , Aged , Animals , Coleoptera , Child , Child, Preschool , Dermatitis, Irritant/epidemiology , Female , Humans , India/epidemiology , Lymphatic Diseases/etiology , Male , Middle Aged , Seasons , Skin/pathologyABSTRACT
BACKGROUND: The Government Pharmaceutical Organization of Thailand (GPO) has developed many products using liposome nanotechnology and Thai herbal extracts. OBJECTIVE: Evaluate the irritation potential of GPO products on human skin using the single application closed patch test under occlusion. The authors also studied the moisturizing efficacy of a commercial curmin extract cream (GPO curmin cream). MATERIAL AND METHOD: Thirty-six female volunteers were tested with 12 test materials developed by GPO including liposome, curmin extract: tetrahydrocurcuminoids (THC), and commercial curmin cream. Two and a half percent sodium dodecyl sulfate (SDS) was used as positive control. Standard Finn chambers on Scanpor tape with webril cotton were used as occlusive patch test devices. Cutaneous irritation responses were graded after patch removal and the incidence of irritation compared to the positive control was used for evaluation. Corneometer was used to measure skin hydration before and after application of curmin cream. RESULTS: All volunteers completed the present study. The skin irritation effects from the test materials were significantly lower (p-value < 0.001, McNemar statistic test) than the positive control. Measurement of skin hydration after twice daily application of GPO curmin cream was significantly higher (p-value < 0.001, paired t-test) than the control skin. CONCLUSION: The test materials and finished products developed by the GPO are not likely to induce skin irritation under normal conditions of use. Furthermore, twice-daily application of the commercial GPO curmin cream can significantly increase skin hydration.