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1.
Contact Dermatitis ; 81(4): 274-279, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31334857

RESUMO

BACKGROUND: Dental students are at high risk of developing adverse skin reactions following practical work during the dentistry degree program. They encounter multiple irritants and allergens that may cause skin reactions on exposed parts of the body, notably the hands. OBJECTIVES: To estimate the prevalence of skin reactions related to the pre-clinical and clinical training courses of the dentistry program and associated risk factors in Bulgarian dental students. METHOD: A cross-sectional study was performed using a self-report questionnaire. RESULTS: A total of 467 dental students completed the questionnaire (response 51.8%). The prevalence of self-reported skin symptoms was 21.2%. According to logistic regression analysis, the most important risk factors for work-related skin symptoms were a personal history of atopic dermatitis (odds ratio [OR] 3.92, 95% confidence interval [CI]: 1.99-7.72), allergic rhinoconjunctivitis and/or asthma (OR 1.94, 95%CI: 1.03-3.68), personal history of contact allergy (OR 2.19, 95%CI: 1.06-4.55), and hand washing >16 times a day (OR 2.42, 95%CI: 1.06-5.52). CONCLUSIONS: The results of this study suggest that work-related skin symptoms are frequent among dental students and indicate the need to establish effective primary preventive programs for occupational skin disorders at a national level.


Assuntos
Dermatite Ocupacional/epidemiologia , Dermatoses da Mão/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Estudantes de Odontologia/estatística & dados numéricos , Adulto , Asma/epidemiologia , Bulgária/epidemiologia , Conjuntivite Alérgica/epidemiologia , Dermatite Alérgica de Contato/epidemiologia , Dermatite Atópica/epidemiologia , Dermatite Ocupacional/etiologia , Feminino , Luvas Protetoras/estatística & dados numéricos , Dermatoses da Mão/etiologia , Desinfecção das Mãos , Humanos , Masculino , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/prevenção & controle , Prevalência , Rinite Alérgica/epidemiologia , Fatores de Risco , Autorrelato , Adulto Jovem
2.
Cutis ; 103(6): 315-317, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31348454

RESUMO

The advent of acrylate-based nail treatments-known as gels, dips, or shellac-has resulted in an uptick in nail-related acrylate allergy. Acrylate dermatitis related to nail services can affect both clients and technicians and can present on the hands, fingers, and wrists, as well as on the face and neck. Nail acrylate allergy occurs from sensitization to acrylate monomers; 2-hydroxyethyl methacrylate (HEMA), 2-hydroxypropyl methacrylate, ethyl cyanoacrylate, and others have been identified as relevant allergens. Patch testing with HEMA and ethyl cyanoacrylate can screen for nail acrylate allergy. Avoidance is key, and we recommend less-permanent, acrylate-free nail polishes as alternatives.


Assuntos
Acrilatos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatoses da Mão/etiologia , Unhas , Acrilatos/imunologia , Alérgenos/imunologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/imunologia , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/imunologia , Humanos , Testes do Emplastro
3.
Contact Dermatitis ; 81(4): 242-248, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31125134

RESUMO

BACKGROUND: Cobalt contact allergy is common, but clinical relevance is often difficult to determine. OBJECTIVES: To examine the aetiology, prevalence and clinical characteristics of cobalt-allergic patients who were patch tested between 2002 and 2017 at the Department of Dermatology and Allergy, Herlev-Gentofte Hospital. METHODS: Patch test data, along with patient characteristics and causative exposures, from all adult dermatitis patients seen and tested between 2002 and 2017 were analysed. Associations were tested with the χ 2 test and logistic regression. RESULTS: A total of 13 475 adults aged 18 to 99 years were patch tested. The overall prevalence of cobalt allergy and the prevalence of isolated cobalt allergy were 3.3% and 1.5%, respectively. The prevalence of isolated cobalt allergy decreased from 2.4% in 2006 to 2009 to 1.1% in 2014 to 2017 (Ptrend = 0.00003). Leather exposure as a relevant cause of allergic cobalt dermatitis increased from 3.7% in 2002 to 2009 to 8.3% in 2010 to 2017 (P = 0.04). The current clinical relevance of positive patch test reactions, that is, a positive reaction to cobalt combined with a history of current skin exposure to a source of cobalt, was 20.1%. CONCLUSIONS: We conclude that cobalt allergy is relatively common, but causative exposures are largely unknown, and the proportion of positive patch test reactions with clinical relevance is low. It is therefore currently unclear how we can better protect consumers and workers from cobalt exposure.


Assuntos
Cobalto/efeitos adversos , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatoses Faciais/epidemiologia , Dermatoses do Pé/epidemiologia , Dermatoses da Mão/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Dinamarca/epidemiologia , Dermatoses Faciais/etiologia , Feminino , Dermatoses do Pé/etiologia , Luvas Protetoras/efeitos adversos , Dermatoses da Mão/etiologia , Humanos , Joias/efeitos adversos , Masculino , Pessoa de Meia-Idade , Testes do Emplastro , Prevalência , Fatores Sexuais , Sapatos/efeitos adversos , Adulto Jovem
4.
Contact Dermatitis ; 81(4): 266-273, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31077398

RESUMO

BACKGROUND: Hairdressing apprentices are at high risk for developing occupational contact dermatitis. OBJECTIVES: The objective of this study was to analyse whether there are differences in skin health, skin protection and health-related quality of life between apprentices from two Croatian regions (Zagreb and Dalmatia). MATERIALS AND METHODS: Final-year hairdressing apprentices from Zagreb (n = 101) and Dalmatia (n = 77) were enrolled in the study. Clinical examination of hands was performed by use of the Osnabrück Hand Eczema Severity Index. Transepidermal water loss (TEWL) was measured on forearm and hand. A history of self-reported skin symptoms, work-related exposure to skin hazards and health-related quality of life were assessed with validated questionnaires. RESULTS: Apprentices from Zagreb reported having been engaged in practical work more days per month than Dalmatian apprentices (median 12 days vs 8 days, respectively, P < 0.001), and washing their hands >20 times per day more frequently (28% vs 10%, respectively, P = 0.004), and consequently more frequently having dry hands (37% vs 16%, respectively, P = 0.002), and significantly higher TEWL values on the hand and forearm, which was confirmed by the results obtained with multiple linear regression models. CONCLUSIONS: A higher extent of exposure to skin hazards was related to poorer skin barrier function, which confirms the need for improvement of appropriate safety practices in hairdressing schools.


Assuntos
Barbearia , Dermatoses da Mão/etiologia , Dermatoses da Mão/fisiopatologia , Exposição Ocupacional/efeitos adversos , Qualidade de Vida , Adolescente , Barbearia/educação , Croácia , Eritema/etiologia , Exantema/etiologia , Feminino , Antebraço , Desinfecção das Mãos , Humanos , Prurido/etiologia , Inquéritos e Questionários , Perda Insensível de Água , Adulto Jovem
12.
Dermatol Online J ; 25(1)2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30710900

RESUMO

Bullous lupus erythematosus is a rare clinical form of lupus. The diagnosis is challenging and involves the exclusion of other subepidermal bullous dermatoses. We present a 21-year-old woman with erythematosus, polycyclic plaques with vesiculobullae along the periphery, creating an erythema gyratum repens-like pattern on acral regions. The cutaneous biopsy, analytical, and autoimmune studies support the diagnosis of systemic lupus erythematosus. Dapsone and glucocorticosteroids were given with prompt resolution of the lesions within two weeks. To our knowledge this is the first case of bullous lupus erythematosus with this atypical acral presentation.


Assuntos
Dermatoses do Pé/diagnóstico , Dermatoses da Mão/diagnóstico , Dermatoses da Perna/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Dermatopatias Vesiculobolhosas/diagnóstico , Anti-Infecciosos/uso terapêutico , Dapsona/uso terapêutico , Eritema , Feminino , Dermatoses do Pé/tratamento farmacológico , Dermatoses do Pé/etiologia , Dermatoses do Pé/patologia , Glucocorticoides/uso terapêutico , Dermatoses da Mão/tratamento farmacológico , Dermatoses da Mão/etiologia , Dermatoses da Mão/patologia , Humanos , Dermatoses da Perna/tratamento farmacológico , Dermatoses da Perna/etiologia , Dermatoses da Perna/patologia , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Dermatopatias Vesiculobolhosas/etiologia , Dermatopatias Vesiculobolhosas/patologia , Adulto Jovem
14.
Nat Rev Rheumatol ; 15(2): 113-122, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30610219

RESUMO

Dactylitis is diffuse swelling of the digits that is usually related to an underlying inflammatory or infiltrative disorder. Psoriatic arthritis (PsA) is the most common severe disease thought to cause dactylitis. Our understanding of the pathogenesis of PsA-related dactylitis comes from experimental animal models of PsA-like disease, as well as advances in imaging and other clinical studies. Clinical trials in PsA have increasingly included dactylitis as an important secondary outcome measure. These studies indicate that cytokines drive multi-locus microanatomical pan-digital pathology. Given the importance of pro-inflammatory cytokines, the pathogenesis of dactylitis is best understood as an initial aberrant innate immune response to biomechanical stress or injury, with subsequent adaptive immune mechanisms amplifying the dactylitis inflammatory response. Regarding the treatment of dactylitis, no studies have been conducted using dactylitis as the primary outcome measure, and the current knowledge comes from analysis of dactylitis as a secondary outcome measure.


Assuntos
Artrite Psoriásica/complicações , Dermatoses do Pé/etiologia , Dermatoses da Mão/etiologia , Animais , Artrite Psoriásica/diagnóstico por imagem , Artrite Psoriásica/tratamento farmacológico , Modelos Animais de Doenças , Dermatoses do Pé/diagnóstico por imagem , Dermatoses do Pé/tratamento farmacológico , Dermatoses da Mão/diagnóstico por imagem , Dermatoses da Mão/tratamento farmacológico , Humanos , Fenômenos Imunogenéticos , Índice de Gravidade de Doença
18.
Clin Rev Allergy Immunol ; 56(1): 60-71, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30171459

RESUMO

Occupational skin disease is common. It affects workers more often than reported. Contact dermatitis, both irritant and allergic, accounts for the majority of occupational skin diagnoses. Occupational contact dermatitis (OCD) frequently affects the hands and may have a profound impact on an employee's ability to perform a job. Severe OCD can affect a worker's activities of daily living and can even lead to job loss. Numerous irritants have been described in the workplace, from the common (wet work) to the more obscure (warm, dry air). Several contact allergens may be work-related, and the majority of established occupational allergens are also known nonoccupational allergens. Emerging occupational allergens are continually described in the literature. Patch testing is the gold standard for the workup of allergic contact dermatitis. Patch testing in the setting of OCD may require extended or unique allergen trays, as well as a thorough occupational history and collection of workplace Material Safety Data Sheets (MSDS). These MSDS contain valuable information but may not be complete or accurate. Proof of occupational causation can be aided by employing the Mathias criteria. Certain industries and occupations are associated with higher rates of OCD, and as expected, the industries with direct contact with irritants and allergens are highly represented. The differential diagnosis for occupational dermatitis is broad and should be considered when evaluating an employee with suspected OCD. Some other diagnoses to consider include atopic dermatitis, psoriasis, and manifestations of internal disease, as well as an overlap syndrome of more than one diagnosis. OCD treatment should ideally follow the public health hazard controls' stepwise approach. Prevention and early intervention are key to promoting occupational health and preventing OCD. Multidisciplinary teams have been successful in the treatment of OCD, and newly described topical treatments may provide additional modalities for use in the occupational setting.


Assuntos
Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/etiologia , Dermatoses da Mão/epidemiologia , Dermatoses da Mão/etiologia , Alérgenos/imunologia , Comorbidade , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/terapia , Diagnóstico Diferencial , Saúde Global , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/terapia , Humanos , Imunidade , Exposição Ocupacional/efeitos adversos , Testes do Emplastro , Fenótipo , Mudança Social
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