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Plotnik I, Bar J, Solomon-Cohen E, Solomon M, Moshe S, Slodownik D. The Characteristics of Allergic Contact Dermatitis in Military and Civilian Populations: A Multicenter Cross-Sectional Study. Dermatitis 2023; 34:509-515. [PMID: 37219963 DOI: 10.1089/derm.2022.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Background: Contact dermatitis is a common condition in the general population, with a global prevalence of 20%. It is an inflammatory skin disease that is classified as irritant contact dermatitis (80%) and allergic contact dermatitis (ACD) (20%). In addition, it is the most common presentation of occupational dermatoses and is one of the primary reasons for seeking medical attention among military personnel. Only few studies have compared the characteristics of contact dermatitis in soldiers and civilians. Objective: To compare the characteristics of ACD between civilians and soldiers. Methods: This large retrospective study was conducted in Israel and involved 1800 civilians and 750 soldiers with suspected ACD. All patients underwent relevant patch tests based on their clinical presentation and medical history. Results: At least 1 positive allergic reaction was found in 382 civilians (21.22%) and 208 soldiers (27.73%) (nonsignificant). Moreover, 69 civilians (18.06%) and 61 soldiers (29.32%) had at least 1 positive occupational allergic reaction (P < 0.05). Widespread dermatitis was significantly more common among soldiers. The most frequent occupations among civilians with positive allergic reactions were hairdressers/beauticians. "Professional, technical, and managerial occupations" were the most frequent categories among soldiers (24.6%), with computing professionals being the most common occupation (46.67%). Conclusion: Military personnel and civilians have different characteristics associated with ACD. Therefore, considering these characteristics before placement in a workplace can help prevent ACD.
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Affiliation(s)
- Ira Plotnik
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Avov, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Jonathan Bar
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Avov, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Efrat Solomon-Cohen
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
- Clalit Healthcare Services, Petah Tikva, Israel
| | - Michal Solomon
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Ramat-Gan, Israel
| | - Shlomo Moshe
- Occupational Medicine Department, Maccabi Healthcare Services, Rishon Lezion, Israel
- Division of Environmental and Occupational Medicine Public Health School, Sackler Faculty of Medicine, Tel-Aviv, Israel
| | - Dan Slodownik
- From the Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Avov, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Inglis DM, Bailey MS. Unusual presentations of cutaneous larva migrans in British military personnel. BMJ Mil Health 2020; 169:e78-e81. [PMID: 33243768 DOI: 10.1136/bmjmilitary-2020-001677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/11/2020] [Accepted: 11/15/2020] [Indexed: 11/03/2022]
Abstract
Cutaneous larva migrans (CLM) is one of numerous skin diseases that occur in British military personnel on deployments to the tropics and sub-tropics. It is typically managed by military primary healthcare services, but diagnostic uncertainty or unavailability of anti-helminthic medication may prompt referral to UK Role 4 healthcare services. Cases of CLM seen at the UK Role 4 Military Infectious Diseases & Tropical Medicine Service from 2005 to 2020 were identified and their case notes were reviewed to identify learning and discussion points. There were 12 cases identified, of which five came from Brunei and three were from Belize. Causes for referral were due to diagnostic uncertainty (58%) and the unavailability of anti-helminthic medication (42%). Several cases had CLM in an unusual distribution due to specific military activities performed in endemic areas. Telemedicine was very useful in making some of the diagnoses in theatre and avoiding the need for medical evacuation. Military personnel may have unusual presentations of CLM due their unique military activities. In areas that are endemic for CLM, clinicians should maintain high clinical suspicion for CLM, carry appropriate anti-helminthic medications and consider screening cases of CLM and their colleagues for other infections with similar aetiology (eg, human hookworm infection and strongyloidiasis).
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Affiliation(s)
- David Michael Inglis
- Institute of Naval Medicine, Gosport, UK .,Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK
| | - M S Bailey
- Department of Infection & Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK.,Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
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Henning JS, Firoz BF, Lehman KA. Allergic Contact Dermatitis in Operation Iraqi Freedom: Use of the T.R.U.E. Test in the Combat Environment. Dermatitis 2009. [DOI: 10.2310/6620.2009.09018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Slodownik D, Wohl Y, Mansura A, Moshe S, Sarbagil-Maman H, Shochat T, Levi Y, Brenner S, Ingber A. Allergic contact dermatitis among maintenance and clerical workers in a military population. Contact Dermatitis 2006; 55:335-7. [PMID: 17101007 DOI: 10.1111/j.1600-0536.2006.00978.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Contact dermatitis is one of the leading causes of occupational morbidity and absenteeism and has become an intolerable cause of missed workdays and health problems in the Israeli military. The aim of this study was to determine the rate of contact dermatitis in maintenance and clerical workers, the common allergens causing it, and the background of atopy in the subjects in order to design preventive measures. Medical records of all recruits to the Israel Defense Forces from 2000 to 2003 were reviewed for contact dermatitis. The 102 cases found were further assessed for job assignment, atopic background, and allergens. Of the 102 cases, 60 had irritant contact dermatitis and 42 had allergic contact dermatitis, of which 33 (78.6%) were maintenance workers, mainly mechanics. 13 soldiers in the maintenance job category (39%) and 2 soldiers in the clerical group (22.2%) had atopic background. There were 55 positive reactions in patch tests, 25 of them to oil and cooling fluids, with 14.5% attributed to methylchloroisothiazolinone/methylisothiazolinone) (Kathon CG). Atopy was found to be a risk factor for allergic contact dermatitis in our study and should be screened for in job assignment procedures in the military. Oil and greases contain significant allergens, especially their preservatives.
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Affiliation(s)
- Dan Slodownik
- Department of Dermatology, Hadassah University Hospital, Faculty of Medicine, Jerusalem, Israel.
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