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Heichel T, Kersten JF, Braumann A, Krambeck K, Bonness S, Schröder-Kraft C, Ofenloch R, Weisshaar E, Strom K, Skudlik C, Sonsmann FK, Wilke A, Nienhaus A, John SM, Brans R. Evaluation of comfort gloves made of semipermeable and textile materials in patients with hand dermatoses: Results of a controlled multicenter intervention study (ProTection II). Contact Dermatitis 2024. [PMID: 39087393 DOI: 10.1111/cod.14649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/05/2024] [Accepted: 07/08/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Comfort gloves are used in the management of hand dermatoses. OBJECTIVES To compare the acceptance and tolerability of comfort gloves made of different materials in patients with hand dermatoses and their effects on skin lesions. METHODS In a prospective multicenter study, 284 patients with hand dermatoses were invited to wear either a cotton glove (COT) or a semipermeable Sympatex glove underneath a cotton glove (SYM/COT) for two subsequent phases of 19 consecutive nights each. A total of 88 controls were asked not to wear any comfort gloves overnight. The severity of skin lesions over time was examined. Questionnaires were used to assess health-related quality of life (HRQoL) and acceptance and tolerability of the gloves. RESULTS The hand dermatoses improved in all groups. No substantial intergroup differences regarding severity and HRQoL were observed. SYM/COT received better ratings regarding climate conditions and tactility while COT showed superiority in fit, wearing comfort, and practicality. CONCLUSIONS We confirmed that SYM/COT and COT are well tolerated and accepted suggesting that SYM/COT is a good alternative for COT as comfort gloves in patients with hand dermatoses. Individual requirements, needs, and preferences may direct the material choice.
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Affiliation(s)
- Theres Heichel
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
| | - Jan Felix Kersten
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Antje Braumann
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University and BG Klinikum, Hamburg, Germany
| | - Kathrin Krambeck
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University and BG Klinikum, Hamburg, Germany
| | - Sonja Bonness
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University and BG Klinikum, Hamburg, Germany
| | - Claudia Schröder-Kraft
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University and BG Klinikum, Hamburg, Germany
| | - Robert Ofenloch
- Section Occupational Dermatology, Department of Dermatology, Heidelberg University Hospital, Ruprecht Karls Universität Heidelberg, Heidelberg, Germany
| | - Elke Weisshaar
- Section Occupational Dermatology, Department of Dermatology, Heidelberg University Hospital, Ruprecht Karls Universität Heidelberg, Heidelberg, Germany
| | - Kerstin Strom
- Department of Dermatology, BG Hospital for Occupational Disease Bad Reichenhall, Bad Reichenhall, Germany
| | - Christoph Skudlik
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Lower-Saxonian Institute of Occupational Dermatology, Osnabrück University, Osnabrück, Germany
| | - Flora Karla Sonsmann
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Lower-Saxonian Institute of Occupational Dermatology, Osnabrück University, Osnabrück, Germany
| | - Annika Wilke
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Lower-Saxonian Institute of Occupational Dermatology, Osnabrück University, Osnabrück, Germany
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Swen Malte John
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Lower-Saxonian Institute of Occupational Dermatology, Osnabrück University, Osnabrück, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
- Lower-Saxonian Institute of Occupational Dermatology, Osnabrück University, Osnabrück, Germany
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Dietz JBN, Simonsen ABN, Menné T, Ahlstrøm MG, Flyvholm MA, Blomberg MH, Erichsen CY, Meyer HW, Viskum S, Ahrensbøll-Friis U, John SM, Johansen JD. Assessing the efficacy of a German-inspired intervention on occupational contact dermatitis in Denmark: A randomised controlled trial with 3-month follow-up. Contact Dermatitis 2024; 90:280-290. [PMID: 38052587 DOI: 10.1111/cod.14457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Occupational contact dermatitis (OCD) is a prevalent, often chronic disease that poses a risk for job loss and decreased quality of life. In Germany, a multi-step prevention programme emphasising early detection and highly specialised multidisciplinary treatment has been implemented with great success. OBJECTIVES To examine the effectiveness of a Danish-adapted version of the German prevention effort on OCD severity, quality of life and occupational consequences at 3-month follow-up. METHODS Randomised, controlled trial. Participants were recruited after the first referral from General Practitioner to Dermatologist with suspected OCD. The intervention group (IG) received a Danish-adapted, multidisciplinary intervention, while the control group (CG) navigated the Danish healthcare system without interference from the study. OCD severity, occupational consequences and quality of life were assessed at 3-month follow-up using self-reported questionnaires. RESULTS A statistically significant decrease in the severity of eczema was found at 3-month follow-up in the IG compared to the CG. The IG were statistically significantly more likely to have seen a dermatologist at 3-month follow-up. Higher treatment level in the IG was indicated by the results but was not statistically significant. No significant difference was found in quality of life or occupational consequences. CONCLUSIONS These initial findings suggest that early and specialised treatment of OCD improves OCD prognosis.
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Affiliation(s)
- Jojo Biel-Nielsen Dietz
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
| | - Anne Birgitte N Simonsen
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Torkil Menné
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Malin G Ahlstrøm
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Mari-Ann Flyvholm
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Maria H Blomberg
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Christina Y Erichsen
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Harald W Meyer
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sven Viskum
- Unit of Social Medicine, Copenhagen University Hospital Frederiksberg, Frederiksberg, Denmark
| | - Ulrik Ahrensbøll-Friis
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Swen M John
- Department of Dermatology, Environmental Health and Health Theory, University of Osnabrück and Institute of Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Jeanne D Johansen
- Department of Dermato-Allergology, National Allergy Research Centre, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
- University of Copenhagen, Copenhagen, Denmark
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Hübner A, John SM, Wilke A, Brans R. Programme for prevention of foot dermatoses in patients with work-related skin diseases: Follow-up data of a prospective cohort study (OCCUPES). Contact Dermatitis 2024; 90:299-309. [PMID: 37950527 DOI: 10.1111/cod.14453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND A programme based on health education has been developed to prevent foot dermatoses (FD) in patients with work-related skin diseases (WRSD). OBJECTIVE To evaluate the effectiveness of the programme in a prospective cohort study (OCCUPES). METHODS Six and 12 months after completing the programme, follow-up questionnaires were sent to 231 patients with WRSD and FD. Assessments included occupational footwear and foot care, self-reported disease course, and health-related quality of life. RESULTS Response to follow-ups was >70%. Wearing functional socks and changing footwear and socks during one work shift increased (all p < 0.001). Complaints about occupational footwear decreased, including sweating and exposure to moisture/wetness. More than 60% reported improved FD while quality of life significantly increased. After 12 months, all foot symptoms were less frequent, including itch (p = 0.009), pain when walking (p = 0.005), pain in rest (p = 0.015) and smell (p = 0.001). The programme received very good ratings by the participants. CONCLUSIONS The intervention was effective in improving occupational footwear, foot care and preventive behaviour. It resulted in a reduced burden of FD and should be implemented in the general care of patients with WRSD.
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Affiliation(s)
- Anja Hübner
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Swen Malte John
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Annika Wilke
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
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Brans R, John SM, Wilke A, Hübner A. Programme for prevention of foot dermatoses in patients with work-related skin diseases: Baseline data and first results of a prospective cohort study (OCCUPES). Contact Dermatitis 2023; 89:259-269. [PMID: 37599097 DOI: 10.1111/cod.14400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Programmes for prevention of hand dermatoses in patients with work-related skin diseases (WRSD) are well established. Similar interventions for foot dermatoses (FD) are widely missing. OBJECTIVE To evaluate the effectiveness of a programme for prevention of FD based on health education in patients with WRSD while investigating the impact and possible causative factors of FD. METHODS In a prospective cohort study (OCCUPES), 231 patients with WRSD and FD participating in the programme were recruited. The skin was examined and questionnaires were completed, including assessment of footwear, FD severity, symptoms and health-related quality of life. RESULTS The baseline and some early results are presented. A work-related causation of FD was likely in 60 patients (26.0%) with irritant contact dermatitis being the most frequent diagnosis. Work-related FD were associated with male sex (p = 0.012), sweating in footwear (p = 0.004) and wearing of safety footwear (p = 0.013). FD were often long-lasting with a high degree of work-absenteeism, quality of life impairment, itch and pain, particularly in work-related FD. CONCLUSIONS Interventions are needed to reduce the burden of FD in patients with WRSD. The programme addresses current shortcomings in prevention of FD. A long-term evaluation of its effectiveness follows.
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Affiliation(s)
- Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Swen Malte John
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Annika Wilke
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
| | - Anja Hübner
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, Germany
- Department of Dermatology, Environmental Medicine and Health Theory, Osnabrück University, Osnabrück, Germany
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Gill C, Fischer AK, Dicke K, Teigelake B, Brans R, Skudlik C, John SM, Symanzik C. Teledermatological Follow-Up Consultations in Individual Prevention of Occupational Dermatoses: A Monocentric Feasibility Study on Quality and Satisfaction by Patients and Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6127. [PMID: 37372714 DOI: 10.3390/ijerph20126127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/05/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Teledermatology has become very popular, and not only due to the SARS-CoV-2 pandemic. Patients with occupational skin diseases (OSDs) could also benefit from teledermatology services as part of their follow-up care, but the opportunities and challenges for patients and dermatologists, especially regarding quality and satisfaction, need exploration. In this single-center feasibility study, 215 patients taking part in a tertiary prevention program for OSD were invited to participate. After obtaining consent, a follow-up video consultation appointment with the center's dermatologists was made. Quality and satisfaction with the consultations were evaluated by fully standardized online questionnaires filled in by the patients and dermatologists. A total of 68 teledermatological follow-up consultations were conducted by 10 dermatologists on 42 patients. Half of the dermatologists (50.0%) and 87.6% of the patients were satisfied with the video consultations. However, the lack of physical examination seems to be a problem, especially from the physicians' point of view (75.8%). A total of 66.1% of the dermatologists and 87.5% of the patients saw video consultations as useful supplements to face-to-face consultations. The results of our feasibility study indicate general satisfaction of patients and physicians with teledermatological sessions in occupational dermatology, especially as a useful supplement to face-to-face consultation.
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Affiliation(s)
- Carina Gill
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Ann-Kristin Fischer
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Katja Dicke
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Björn Teigelake
- Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW), Gesundheitscampus-Süd 29, 44801 Bochum, Germany
| | - Richard Brans
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Lower Saxony Institute of Occupational Dermatology at the University of Osnabrück, 49076 Osnabrück, Germany
| | - Christoph Skudlik
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Lower Saxony Institute of Occupational Dermatology at the University of Osnabrück, 49076 Osnabrück, Germany
| | - Swen Malte John
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Lower Saxony Institute of Occupational Dermatology at the University of Osnabrück, 49076 Osnabrück, Germany
| | - Cara Symanzik
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
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Bentz P, Eyerich K, Skudlik C, Schröder-Kraft C, Löffler H, Pföhler C, Leitz R, Thölken K, Weisshaar E. [Hand eczema or psoriasis: update on the FB 323 study occupational dermatology cohort]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023:10.1007/s00105-023-05156-z. [PMID: 37162510 DOI: 10.1007/s00105-023-05156-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 05/11/2023]
Abstract
In daily dermatological practice, the distinction between eczema and psoriasis in dermatoses of the hands can be difficult. However, a clear diagnosis is necessary to initiate optimal therapy and management. In recent years, the so-called molecular classifier has been developed for optimized differentiation of eczema and psoriasis. An occupational dermatological cohort has been established at Heidelberg University Hospital since 2020. It is funded by the German Statutory Accident Insurance. The aim is to follow-up patients over 3 years where this new diagnostic method is used and to compare the results with a retrospective occupational dermatological cohort. Recruitment ended in December 2022. The current analysis reports participants' occupational activity, insurance status, disease progression, and number of sick days. A total of 287 patients were included; mean age was 50.4 years and 63.5% (n = 181) were undergoing treatment at the expense of the liable statutory accident insurance at the start of the study. About 50% of the patients worked in health professions, metal industry, or construction. The average duration of occupational dermatosis was 6.5 years. In 38.9% of the patients, the clinical diagnosis had been classified as unclear by the treating dermatologist. By using the molecular classifier, the diagnosis could be clarified in 98% of the cases (eczema vs. psoriasis). The first analyses demonstrate that the molecular classifier contributes to improving therapy by optimizing the diagnosis.
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Affiliation(s)
- Philipp Bentz
- Sektion Berufsdermatologie, Zentrum Hautklinik, Universitätsklinikum Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland.
| | - Kilian Eyerich
- Klinik für Dermatologie und Venerologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Christoph Skudlik
- Institut für Interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Osnabrück, Deutschland
| | - Claudia Schröder-Kraft
- Institut für interdisziplinäre dermatologische Prävention und Rehabilitation (iDerm), BG Klinikum Hamburg, Hamburg, Deutschland
| | - Harald Löffler
- Klinik für Dermatologie, Allergologie und Phlebologie, SLK-Kliniken Heilbronn, Heilbronn, Deutschland
| | - Claudia Pföhler
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - Reinhardt Leitz
- Hautarztpraxis Dr. Leitz und Kollegen, Stuttgart, Deutschland
| | - Karisa Thölken
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Elke Weisshaar
- Sektion Berufsdermatologie, Zentrum Hautklinik, Universitätsklinikum Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland
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Rocholl M, Wilke A, Meyer J, John SM, Ludewig M. Illness Perceptions of Patients with Occupational Skin Diseases in a Healthcare Centre for Tertiary Prevention: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5652. [PMID: 37174171 PMCID: PMC10178866 DOI: 10.3390/ijerph20095652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
Objectives: To investigate the illness perceptions of patients with occupational skin diseases (OSDs). Design: Cross-sectional study. Setting: Specialised healthcare centre for inpatient and outpatient individual prevention in occupational dermatology in Germany. Participants: A total of 248 patients with hand eczema (55.2% female; average age: 48.5 years, SD: 11.9) were included in the final analyses. Measures: A modified and recently validated version of the 'Revised Illness Perception Questionnaire' (IPQ-R) was used to assess illness perceptions. Severity of skin disease was evaluated with the Patient-Oriented Eczema Measure (POEM), the Osnabrueck Hand Eczema Severity Index (OHSI), and a single, self-reported global item. The Erlangen Atopy Score (EAS) was used for atopy screening. Results: We found strong illness identity, high emotional impact, and long timeline beliefs, meaning that study participants perceive their OSD on the hands as a highly symptomatic, emotionally burdening, and chronic condition. Results suggest that hand eczema has a major impact on how participants manage their own lives, particularly during everyday life and occupational activities. Study participants predominantly identified irritant or sensitising substances and activities at work as well as skin protection regimes as causes of their disease. Conclusions: Healthcare workers should consider the illness perceptions as well as the disease burden of patients with an OSD on the hands in clinical practice. Multi-professional approaches to patient care should be sought. Illness perception in (occupational) dermatological patients should be the subject of further research.
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Affiliation(s)
- Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Annika Wilke
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Julia Meyer
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Michaela Ludewig
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
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Prevalence, risk factors, and prevention of occupational contact dermatitis among professional cleaners: a systematic review. Int Arch Occup Environ Health 2023; 96:345-354. [PMID: 36409350 DOI: 10.1007/s00420-022-01937-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the prevalence, risk factors, and prevention of occupational contact dermatitis (OCD), as well as risk factors and consequences of OCD among professional cleaners. METHODS A systematic review following PRISMA guidelines was performed using Medline, EMBASE, and Cochrane Library. RESULTS Thirty-nine studies containing over 109.000 participants were included in the review. The prevalence of OCD varied between 2.2% and 30.1%. Main occupational risk factors for developing OCD among cleaners included wet work and irritants in cleaning products (bleach, chlorine, ammonia, multi-use-cleaning) and skin contact to metal. The most common contact allergies included rubber, biocides, nickel/cobalt, and perfumes. Other risk factors were inconsistent use of protective gloves and low educational level. Consequences associated with OCD included significant impairment in quality of life, tendency to have unscheduled absence from work, sick leave, increased rate of disability, and recognized degree of injury. Only one prevention study has been published investigating the effect of an educative course in skin-protective behavior in cleaners. The study reported a higher degree of knowledge of skin protection, a decrease in the severity of hand eczema, and a shift toward fewer daily hand washings at follow-up after 3 months. CONCLUSION Our study proves that OCD is common in cleaners, and the main risk factors included wet work, irritants, and contact allergies, as well as inconsistent use of protective gloves and low educational level. More focus and a greater number of studies are needed on skin protection in this population.
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Dickel H, Bauer A, Brehler R, Mahler V, Merk HF, Neustädter I, Strömer K, Werfel T, Worm M, Geier J. S1-Leitlinie Kontaktekzem. J Dtsch Dermatol Ges 2022; 20:711-734. [PMID: 35578429 DOI: 10.1111/ddg.14734_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 01/05/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Heinrich Dickel
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef-Hospital, Universitätsklinikum der Ruhr-Universität Bochum, Bochum
| | - Andrea Bauer
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden
| | - Randolf Brehler
- Klinik für Hautkrankheiten, Universitätsklinikum Münster, Münster
| | - Vera Mahler
- Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und biomedizinische Arzneimittel, Langen
| | | | | | | | - Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover
| | - Margitta Worm
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin, Berlin
| | - Johannes Geier
- Zentrale des IVDK, Universitätsmedizin Göttingen, Göttingen
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10
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Dickel H, Bauer A, Brehler R, Mahler V, Merk HF, Neustädter I, Strömer K, Werfel T, Worm M, Geier J. German S1 guideline: Contact dermatitis. J Dtsch Dermatol Ges 2022; 20:712-734. [DOI: 10.1111/ddg.14734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Heinrich Dickel
- Department of Dermatology Venereology and Allergology St. Josef Hospital University Medical Center of the Ruhr University Bochum Bochum Germany
| | - Andrea Bauer
- Department of Dermatology University Hospital Carl Gustav Carus Technical University Dresden Dresden Germany
| | - Randolf Brehler
- Department of Dermatology University Hospital Münster Münster Germany
| | - Vera Mahler
- Paul‐Ehrlich‐Institut Federal Institute for Vaccines and Biomedicines Langen Germany
| | - Hans F. Merk
- Department of Dermatology RWTH Aachen University Aachen Germany
| | - Irena Neustädter
- Department of Pediatrics Hallerwiese Cnopfsche Kinderklinik Nuremberg Germany
| | | | - Thomas Werfel
- Department of Dermatology Allergology and Venereology Hannover Medical School Hannover Germany
| | - Margitta Worm
- Department of Dermatology Venereology and Allergology Charité – Universitätsmedizin Berlin Berlin Germany
| | - Johannes Geier
- Center of IVDK University Medical Center Göttingen Göttingen Germany
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11
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Heichel T, Sonsmann FK, John SM, Krambeck K, Maurer J, Nienhaus A, Nordheider K, Stasielowicz L, Wilke A, Brans R. Effects and acceptance of semipermeable gloves compared to cotton gloves in patients with hand dermatoses: Results of a controlled intervention study. Contact Dermatitis 2022; 87:176-184. [PMID: 35396860 DOI: 10.1111/cod.14123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/16/2022] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Semipermeable gloves might be an alternative to cotton gloves in management of hand dermatoses. OBJECTIVES To compare acceptance and tolerability of gloves made of cotton or a semipermeable Sympatex membrane in patients with hand dermatoses and their effect on skin lesions when worn overnight. METHODS 199 patients with work-related symmetrical hand dermatoses were asked to wear a cotton glove (COT) on one hand and a Sympatex glove underneath a cotton glove (SYM/COT) on the other hand for nineteen consecutive nights. The severity of skin lesions was regularly examined. A questionnaire on acceptance and tolerability was used in a subset of 126 patients. RESULTS Data on skin lesions were available for 183 participating patients (92%). The severity did not differ substantially between hands covered with SYM/COT or COT over time. Questionnaire data were available for 120 patients (95%). SYM/COT received better ratings regarding climate conditions while COT showed superiority in wearing comfort, practicality and appearance. CONCLUSIONS Both SYM/COT and COT were well tolerated and accepted in patients with hand dermatoses. Hence, SYM/COT may serve as suitable alternative for COT as comfort gloves supporting therapeutic efforts. The observed slight differences may influence the decision when selecting the glove type. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Theres Heichel
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Flora K Sonsmann
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Lower-Saxonian Institute of Occupational Dermatology at the University of Osnabrück, Osnabrück, Germany
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Lower-Saxonian Institute of Occupational Dermatology at the University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Hamburg, Germany
| | - Kathrin Krambeck
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), Hamburg, Germany
| | - Julia Maurer
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Service Research in Nursing, Institute for Health Service Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kathrin Nordheider
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | | | - Annika Wilke
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Lower-Saxonian Institute of Occupational Dermatology at the University of Osnabrück, Osnabrück, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Lower-Saxonian Institute of Occupational Dermatology at the University of Osnabrück, Osnabrück, Germany
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12
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Abstract
Purpose of Review Recent Findings Summary
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Affiliation(s)
- Kajal Patel
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Level 1/80 Drummond Street, Carlton, 3053 Australia
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Level 1/80 Drummond Street, Carlton, 3053 Australia
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13
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Ahlström MG, Dietz JB, Wilke A, Johansen JD, John SM, Brans R. Evaluation of the secondary and tertiary prevention strategies against occupational contact dermatitis in Germany: a systematic review. Contact Dermatitis 2022; 87:142-153. [PMID: 35246851 DOI: 10.1111/cod.14099] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/14/2022] [Accepted: 02/23/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND In Germany, a stepwise multidisciplinary approach has been established to prevent occupational skin diseases (OSDs), primarily occupational contact dermatitis. OBJECTIVES To perform a systematic evaluation of the short- and long-term effects of the German secondary and tertiary individual prevention programmes (SIP and TIP) for OSD. Primary outcomes were continuation of employment, severity of hand dermatitis, and quality of life (QoL). METHOD The PubMed and Embase databases were searched for studies reporting the effects of the SIP and TIP. RESULTS A total of 19 studies encompassing 5527 patients with OSD were included: 11 studies evaluated the SIP and 8 studies evaluated the TIP. Following the SIP, approximately 70-90% and 60-70% of patients remained in their occupation after 1 and 5 years, respectively. At 3 years after the TIP, 82.7% of patients remained in their occupation and exhibited a significant decrease in hand dermatitis severity, as well as an increase in QoL. LIMITATIONS Most of these studies were uncontrolled and the interventions, outcomes, and measurement instruments used were heterogeneous. CONCLUSIONS The SIP and TIP lead to decreased disease severity, improved QoL and enabled most patients to continue working in their chosen professions. Implementing a similar multidisciplinary approach across Europe may be beneficial. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Malin G Ahlström
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jojo B Dietz
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Annika Wilke
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Swen Malthe John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
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14
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Thyssen JP, Schuttelaar MLA, Alfonso JH, Andersen KE, Angelova-Fischer I, Arents BWM, Bauer A, Brans R, Cannavo A, Christoffers WA, Crépy MN, Elsner P, Fartasch M, Larese Filon F, Giménez-Arnau AM, Gonçalo M, Guzmán-Perera MG, Hamann CR, Hoetzenecker W, Johansen JD, John SM, Kunkeler ACM, Ljubojevic Hadzavdic S, Molin S, Nixon R, Oosterhaven JAF, Rustemeyer T, Serra-Baldrich E, Shah M, Simon D, Skudlik C, Spiewak R, Valiukevičienė S, Voorberg AN, Weisshaar E, Agner T. Guidelines for diagnosis, prevention and treatment of hand eczema. Contact Dermatitis 2021; 86:357-378. [PMID: 34971008 DOI: 10.1111/cod.14035] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Jacob P Thyssen
- Dep. Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jose H Alfonso
- Dep. of Dermatology, Oslo University Hospital, Oslo, Norway.,Dep. of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Klaus E Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Irena Angelova-Fischer
- Department of Dermatology, Comprehensive Allergy Center, Kepler University Hospital, Linz, Austria
| | - Bernd W M Arents
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Alicia Cannavo
- Contact Dermatitis and Occupational Dermatoses, Hospital de Clínicas "José de San Martín", Buenos Aires University, Argentina
| | | | - Marie-Noelle Crépy
- Department of Occupational and Environmental Diseases, University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP, Paris, France.,Department of Dermatology, University Hospital of Centre of Paris, Cochin Hospital, AP-HP, Paris, France
| | - Peter Elsner
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Manigé Fartasch
- Institute for Prevention and Occupational Medicine (IPA) of the German Social Accident Insurance, Department of Clinical and Experimental Occupational Dermatology, Ruhr University Bochum, Bochum, Germany
| | | | - Ana M Giménez-Arnau
- Department of Dermatology, Hopsital del Mar, IMIM , Universitat Autònoma de Barcelona
| | - Margarida Gonçalo
- Clinic of Dermatology - University Hospital and Faculty of Medicine, University of Coimbra, Portugal
| | | | - Carsten R Hamann
- Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Wolfram Hoetzenecker
- Department of Dermatology, Kepler University Hospital and Kepler University Linz, Linz, Austria
| | - Jeanne Duus Johansen
- Department of Dermatology and Allergy, National Allergy Research Centre, Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Amalia C M Kunkeler
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Sonja Molin
- Division of Dermatology, Queen's University, Kingston, Canada
| | - Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Melbourne, Australia
| | - Jart A F Oosterhaven
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thomas Rustemeyer
- Department of Dermatology-Allergology and Occupational Dermatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Mili Shah
- Liverpool University Hospitals NHS Trust, Liverpool, UK
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Radoslaw Spiewak
- Department of Experimental Dermatology and Cosmetology, Jagiellonian University Medical College, Krakow, Poland
| | - Skaidra Valiukevičienė
- Department of Skin and Venereal Diseases, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Angelique N Voorberg
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elke Weisshaar
- Division of Occupational Dermatology, Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Tove Agner
- Dep. Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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15
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Fieten KB, John SM, Nowak D. Secondary and Tertiary Prevention: Medical Rehabilitation. Handb Exp Pharmacol 2021; 268:449-470. [PMID: 34196810 DOI: 10.1007/164_2021_511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Allergies are a major public health burden, and targeted measures are required in terms of prevention and treatment. The most common allergic conditions encompass atopic dermatitis (AD), food allergy (FA), allergic asthma (AA), and allergic rhino-conjunctivitis (AR). Primary prevention aims at preventing the onset of allergic disease, before the disease process begins. Secondary prevention aims at preventing progression and exacerbation of allergic disease whereas tertiary prevention aims at reducing disease burden in patients with established disease, by allergen immunotherapy (AIT) or medical rehabilitation. Rehabilitation programs are used for treatment of AA and AD and usually consist of extensive patient assessment, optimization of treatment management, patient education, and behavioral interventions, ideally involving a multidisciplinary treatment team and sometimes provided in a specific climate, usually alpine or maritime. Similarly, prevention of occupational skin diseases requires interdisciplinary approaches on the level of secondary and tertiary preventive intervention; if this is provided, then prevention programs have proven highly (cost-) effective. Unfortunately, the recently published Minimal Standards of Prevention of these dermatoses, underlining especially the importance of meticulous allergological diagnosis and subsequent multidisciplinary patient education, are so far being adhered to only in very few European countries.
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Affiliation(s)
- Karin B Fieten
- Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland.
| | | | - Dennis Nowak
- Munich Center of Health Sciences, Munich, Germany
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16
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Obermeyer L, Skudlik C, John SM, Brans R. Treatment with alitretinoin in patients taking part in a tertiary individual prevention program for work-related skin diseases. Contact Dermatitis 2021; 85:446-453. [PMID: 33966276 DOI: 10.1111/cod.13883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients taking part in a tertiary individual prevention program (TIP) for work-related skin diseases frequently have chronic hand eczema (HE) for which alitretinoin is a treatment option. OBJECTIVE To investigate treatment with alitretinoin before and during the TIP and related factors. METHODS Data of 1614 patients taking part in the TIP between January 2015 and December 2019 were analyzed retrospectively. RESULTS Three hundred forty-eight patients (21.6%) reported treatment with alitretinoin prior to the TIP showing an increase over time, particularly in men. In 45 patients (2.8%), alitretinoin treatment was initiated during the TIP. Treatment with alitretinoin was significantly less common among female than male patients, both prior to (P < .001) and during the TIP (P = .015). Female patients who had received alitretinoin in the past were significantly older than the other female patients (P < .001). Among patients treated with alitretinoin prior to the TIP, women had a significantly higher disease severity at admission than men (P = .007). CONCLUSIONS About twenty percent of patients reported treatment with alitretinoin prior to the TIP. The data indicate that treatment of female TIP patients with alitretinoin is less frequent than among male patients and depends on age and disease severity.
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Affiliation(s)
- Lara Obermeyer
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Christoph Skudlik
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Swen M John
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Richard Brans
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany.,Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
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17
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[Cohort study for long-term follow-up of patients in whom the so-called "molecular classifier" is used to distinguish eczema from psoriasis : Background and implementation]. Hautarzt 2021; 72:354-357. [PMID: 33655344 DOI: 10.1007/s00105-021-04774-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
A cohort of occupational dermatology patients will be set up at the University Hospital Heidelberg, Germany. In a 3-year prospective cohort study, the so-called molecular classifier will be applied in 262 patients to better differentiate between eczema and psoriasis. A retrospective cohort of 282 occupational health patients with the same suspected diagnosis but no molecular classifier designation was used as a control group. In 5 follow-up visits during 3 years, data will be obtained on diagnoses, disease course and severity, absence from work, occupation and quality of life. The research questions address whether early diagnoses will help to better identify the efficient treatment, disease course, absence from work and continuance of occupation. The study is sponsored by the public statutory employers' liability insurance (Deutsche Gesetzliche Unfallversicherung [DGUV]).
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18
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Brans R, John SM, Frosch PJ. Clinical Aspects of Irritant Contact Dermatitis. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Frosch PJ, Mahler V, Weisshaar E, Uter W. Occupational Contact Dermatitis: General Aspects. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema: Causative Factors, Diagnosis, Personal and Societal Consequences. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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Brans R, Wilke A, Rodríguez E, Boraczynski N, Weidinger S, Reich A, Geier J, Schön MP, Skudlik C, John SM. Effectiveness of secondary prevention in metalworkers with work-related skin diseases and comparison with participants of a tertiary prevention program: A prospective cohort study. Contact Dermatitis 2020; 83:497-506. [PMID: 32743831 DOI: 10.1111/cod.13682] [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: 05/30/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND In Germany, a multistep approach has been established to prevent work-related skin diseases (WRSDs). OBJECTIVES To evaluate the effect of a secondary individual prevention program (SIP) in metalworkers with WRSD and to compare their characteristics with those of participants of a tertiary individual prevention program (TIP). PATIENTS AND METHODS In a prospective cohort study, metalworkers with WRSD of the hands participating either in the SIP (n = 114) or in the TIP (n = 83) were recruited. At baseline and at the respective follow-up 8-12 weeks after the SIP or at dismissal from the TIP (3-4 weeks later), questionnaires were completed and the severity of WRSD was assessed. Saliva samples were collected for assessment of filaggrin (FLG) mutations and an explorative genome-wide association study (GWAS). RESULTS Ninety-three SIP patients (81.6%) attended the follow-up. Disease severity was significantly reduced, and knowledge and protective behavior were significantly improved compared to baseline. Significant differences between SIP and TIP patients were found regarding duration and severity of symptoms, work absenteeism, tobacco smoking, and presence of atopic dermatitis, but not regarding FLG mutations and by GWAS. CONCLUSIONS The SIP was effective in metalworkers with WRSDs. Individual factors may influence the course of the disease and the need for the TIP.
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Affiliation(s)
- Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| | - Annika Wilke
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| | - Elke Rodríguez
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Nicole Boraczynski
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Stephan Weidinger
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Anna Reich
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Johannes Geier
- Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany.,Information Network of Departments of Dermatology (IVDK), Institute at the University Medical Center Göttingen, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Lower Saxony Institute of Occupational Dermatology, University Medical Center Göttingen, Göttingen, Germany
| | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
| | - Swen M John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany.,Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück, Osnabrück, Germany.,Lower Saxony Institute of Occupational Dermatology, University of Osnabrück, Osnabrück, Germany
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Chernyshov PV, John SM, Tomas-Aragones L, Gonçalo M, Svensson A, Bewley A, Evers AWM, Szepietowski JC, Marron SE, Manolache L, Pustisek N, Suru A, Salavastru CM, Tiplica GS, Salek MS, Finlay AY. Quality of life measurement in occupational skin diseases. Position paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Occupational Skin Disease. J Eur Acad Dermatol Venereol 2020; 34:1924-1931. [PMID: 32662100 DOI: 10.1111/jdv.16742] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/03/2020] [Indexed: 12/19/2022]
Abstract
The European Academy of Dermatology and Venereology (EADV) has started the 'Healthy Skin @ Work' campaign aimed to raise awareness among the public and EU authorities on the frequency and impact of occupational skin diseases (OSDs). The EADV Task Forces (TFs) on Quality of Life and Patient Oriented Outcomes (QoL/PO) and on OSD present their mutual position statement on QoL assessment in OSDs. The EADV TFs recommend the use of the DLQI as a dermatology-specific instrument and SF-36 as a generic instrument in health-related (HR) QoL studies on OSDs. The OSD-specific questionnaire, LIOD, is not recommended for general use in its present form because of its three months recall period. The EADV TFs discourage the use of non-validated and of non-validated modifications of previously validated HRQoL instruments. The EADV TFs wish to encourage research into: the HRQoL impact of OSDs other than occupational contact dermatitis and hand eczema; comparisons between the effects of different treatments and other interventions on HRQoL in OSDs; and into the HRQoL impairment of patients with OSDs from different countries, and with different provoking factors, to predict if the results of successful therapeutic and educational interventions may be generalized across countries and between occupations.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - S M John
- Department of Dermatology, Environmental Medicine, Health Theory, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrueck, Osnabrueck, Germany
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Gonçalo
- Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - A W M Evers
- Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - J C Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - S E Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University, Hospital Miguel Servet, Zaragoza, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - A Suru
- Paediatric Dermatology Discipline, "Carol Davila" University of Medicine and Pharmacy, Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - G S Tiplica
- Department of Dermatology II, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Y Finlay
- Department of Dermatology and Wound Healing, Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Sonne M, Agner T, Nørreslet LB, Lund TT. The Efficacy to Prevent Irritant Hand Eczema: an Overview of the Interventional Procedures. CURRENT TREATMENT OPTIONS IN ALLERGY 2020. [DOI: 10.1007/s40521-020-00270-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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24
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Ofenloch RF, Weisshaar E, Apfelbacher C. New evidence for construct validity and interpretability of the German Quality of Life in Hand Eczema Questionnaire (
QOLHEQ
). Contact Dermatitis 2020; 83:189-195. [DOI: 10.1111/cod.13603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Robert F. Ofenloch
- Occupational Dermatology, Department of DermatologyUniversity Hospital, Ruprecht‐Karl University of Heidelberg Heidelberg Germany
| | - Elke Weisshaar
- Occupational Dermatology, Department of DermatologyUniversity Hospital, Ruprecht‐Karl University of Heidelberg Heidelberg Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems ResearchOtto von Guericke University Magdeburg Magdeburg Germany
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Andrees V, John SM, Nienhaus A, Skudlik C, Brans R, Augustin M, Krensel M. Economic evaluation of a tertiary prevention program for occupational skin diseases in Germany. Contact Dermatitis 2020; 82:361-369. [DOI: 10.1111/cod.13506] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Valerie Andrees
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health TheoryUniversity of Osnabrück Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück Osnabrück Germany
| | - Albert Nienhaus
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health TheoryUniversity of Osnabrück Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück Osnabrück Germany
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health TheoryUniversity of Osnabrück Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), University of Osnabrück Osnabrück Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
| | - Magdalene Krensel
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐Eppendorf (UKE) Hamburg Germany
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27
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema: Causative Factors, Diagnosis, Personal and Societal Consequences. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_61-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Papadatou Z, Williams H, Cooper K. Effectiveness of interventions for preventing occupational irritant hand dermatitis: a quantitative systematic review. ACTA ACUST UNITED AC 2019; 16:1398-1417. [PMID: 29894409 DOI: 10.11124/jbisrir-2017-003405] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
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.
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Affiliation(s)
- Zoi Papadatou
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
| | - Hector Williams
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
| | - Kay Cooper
- The Scottish Centre for Evidence-based Multi-professional Practice: a Joanna Briggs Institute Centre of Excellence.,School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
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Abstract
Apart from endogenous factors, hand eczema is often caused by irritant or allergic contact dermatitis related to occupational or non-occupational exposure to skin hazards. This enables several complementary approaches on the level of primary, secondary and tertiary prevention. A high priority is set on identification and subsequent reduction or elimination of causative exposures. Important preventive approaches include legal regulations, technical and organizational measures as well as correct use of adequate personal protective equipment (e.g. protective gloves). Interventions based on health education are conducted to improve individual protective behaviour. Even though evidence-based proof of effectiveness is limited, preventive measures are considered of particular importance for avoidance of occupational hand eczema and its adverse sequelae. Therefore, a complex, step-wise approach to occupational skin diseases has been established in Germany. In recent years, the positive impact of secondary and tertiary preventive measures of this approach has been demonstrated.
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Affiliation(s)
- R Brans
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland.
| | - C Skudlik
- Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm), Universität Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Deutschland
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31
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Brans R, John SM, Frosch PJ. Clinical Aspects of Irritant Contact Dermatitis. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_16-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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33
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_61-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wilke A, Gediga G, Goergens A, Hansen A, Hübner A, John SM, Nordheider K, Rocholl M, Weddeling S, Wulfhorst B, Nashan D. Interdisciplinary and multiprofessional outpatient secondary individual prevention of work-related skin diseases in the metalworking industry: 1-year follow-up of a patient cohort. BMC DERMATOLOGY 2018; 18:12. [PMID: 30541516 PMCID: PMC6292163 DOI: 10.1186/s12895-018-0080-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 11/30/2018] [Indexed: 11/10/2022]
Abstract
Background In Germany, work-related skin diseases are predominant within the spectrum of reported occupational diseases. Metal workers are among the high-risk professions. Offering effective prevention programs to affected patients is of utmost importance to avoid deterioration of the disease and job loss. We conducted a 1-year follow-up in patients who participated in a multidisciplinary, complex outpatient prevention program representing a standard procedure of patient care by the respective statutory accident insurance. Methods The multi-component prevention program consists of multiprofessional individual patient counseling, a structured skin protection seminar in a group, as well as workplace visits and on-site counseling in terms of appropriate skin protection (e.g. gloves). An observational study with a 1-year follow-up and four measurements (T1-T4, longitudinal pre/post-test design) including dermatological examinations and standardized written questionnaires was conducted between 2013 and 2016 to assess changes over time regarding job loss and disease severity. Results Data from 94 patients (87 male, mean age: 45.4 years) were included in the analysis. One year after the skin protection seminar (T4), 83 patients (88.3%) remained in their original professional metalworking activity and four patients (4.3%) had given up their profession because of their skin disease. At baseline (T1), irritant contact dermatitis of the hands was the most frequent diagnosis (80.7%). Methods for self-reported disease severity showed good correlation with the clinical gold standard at T1 and T2 (dermatological examination with the Osnabrück Hand Eczema Severity Index / OHSI), and a significant decrease of the self-reported disease severity was found over time from T1 to T4 (p < 0.001). Further results indicate an improved self-perceived disease control and an overall satisfaction with the prevention program. Conclusions The results of this observational study demonstrate that the comprehensive prevention program positively influences the course of work-related skin diseases, increases the possibility to continue working in a “high-risk” profession and improves the disease management of metal workers. In the long term, the prevention program may lead to cost savings by preventing high therapy costs or professional retraining. Electronic supplementary material The online version of this article (10.1186/s12895-018-0080-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Annika Wilke
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany. .,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.
| | - Günther Gediga
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Andreas Goergens
- German Social Accident Insurance Institution for the woodworking and metalworking industries, district administration in Dortmund, Semerteichstraße 98, 44263, Dortmund, Germany
| | - Andreas Hansen
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Anja Hübner
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Swen Malte John
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Kathrin Nordheider
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Marc Rocholl
- Institute for Health Research and Education, Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany.,Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076, Osnabrück, Germany
| | - Sabine Weddeling
- Department of Dermatology, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Germany
| | - Britta Wulfhorst
- Faculty of Human Sciences/Department of Educational Sciences, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Dorothée Nashan
- Department of Dermatology, Klinikum Dortmund gGmbH, Beurhausstr. 40, 44137, Dortmund, Germany
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Brans R, Schröder-Kraft C, Skudlik C, John SM, Geier J. Tertiary prevention of occupational skin diseases: Prevalence of allergic contact dermatitis and pattern of patch test results. Contact Dermatitis 2018; 80:35-44. [DOI: 10.1111/cod.13098] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/11/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Richard Brans
- Department of Dermatology; Environmental Medicine and Health Theory, University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Osnabrück Germany
- Lower-Saxonian Institute of Occupational Dermatology at the Georg-August University, Göttingen, Germany, and at the University of Osnabrück; Osnabrück Germany
| | - Claudia Schröder-Kraft
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), BG Hospital Hamburg; Hamburg Germany
| | - Christoph Skudlik
- Department of Dermatology; Environmental Medicine and Health Theory, University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Osnabrück Germany
- Lower-Saxonian Institute of Occupational Dermatology at the Georg-August University, Göttingen, Germany, and at the University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), BG Hospital Hamburg; Hamburg Germany
| | - Swen M. John
- Department of Dermatology; Environmental Medicine and Health Theory, University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück; Osnabrück Germany
- Lower-Saxonian Institute of Occupational Dermatology at the Georg-August University, Göttingen, Germany, and at the University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm), BG Hospital Hamburg; Hamburg Germany
| | - Johannes Geier
- Lower-Saxonian Institute of Occupational Dermatology at the Georg-August University, Göttingen, Germany, and at the University of Osnabrück; Osnabrück Germany
- Information Network of Departments of Dermatology (IVDK), Georg-August University; Göttingen Germany
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Papadatou Z, Cooper K, Klein S, MacDuff C, Steiner M. Effectiveness of interventions for preventing occupational irritant hand dermatitis. ACTA ACUST UNITED AC 2016; 14:72-81. [DOI: 10.11124/jbisrir-2016-003159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Brans R, Kolomanski K, Mentzel F, Vollmer U, Kaup O, John SM. Colonisation with methicillin-resistant Staphylococcus aureus and associated factors among nurses with occupational skin diseases. Occup Environ Med 2016; 73:670-5. [PMID: 27358469 DOI: 10.1136/oemed-2016-103632] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 06/14/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To evaluate the prevalence of colonisation with methicillin-resistant Staphylococcus aureus (MRSA), associated factors and the effectiveness of decolonisation procedures among nurses with occupational skin diseases (OSD). METHODS In a retrospective cohort study, the medical records of 319 nurses from Germany who were screened consecutively for MRSA when participating in a tertiary individual prevention programme (TIP) for severe OSD between July 2009 and December 2014 were evaluated. RESULTS 90.3% of nurses with severe OSD suffered from hand eczema. 43 were colonised with MRSA on admission (13.5%), mainly in the nose (n=35, 81.4%). However, the hands were affected in more than half of the MRSA carriers (n=24, 55.8%). Risk factors for MRSA colonisation were atopic skin diathesis (OR 2.01, 95% CI 1.03 to 3.92, p=0.049) and presence of atopic dermatitis on other body parts than the hands (OR 4.33, 95% CI 2.23 to 8.43, p<0.001). Hand eczema was significantly more severe in MRSA carriers than in non-carriers (OR 1.23, 95% CI 1.10 to 1.37, p<0.001) and showed a higher prevalence of vesicles, erosions or fissures. MRSA eradication was successful in 67.4% after the first attempt. CONCLUSIONS Nurses with OSD have a twofold to threefold higher prevalence of MRSA colonisation than what has been reported for point-prevalence screenings among healthcare workers in Germany. Atopic skin diathesis, atopic dermatitis and severe hand eczema are the main risk factors. Thus, prevention and treatment of OSD could be important elements in reduction of colonisation with MRSA among nurses and transmission to others.
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Affiliation(s)
- Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Katarzyna Kolomanski
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Franziska Mentzel
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
| | - Ulrike Vollmer
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Olaf Kaup
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Osnabrück, Germany
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Brans R, Skudlik C, Weisshaar E, Scheidt R, Ofenloch R, Elsner P, Wulfhorst B, Schönfeld M, John SM, Diepgen TL. Multicentre cohort study ‘Rehabilitation of Occupational Skin Diseases - Optimization and Quality Assurance of Inpatient Management (ROQ)’: results from a 3-year follow-up. Contact Dermatitis 2016; 75:205-12. [DOI: 10.1111/cod.12614] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre; Trauma Hospital; 21033 Hamburg Germany
| | - Christoph Skudlik
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre; Trauma Hospital; 21033 Hamburg Germany
| | - Elke Weisshaar
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University of Heidelberg; 69115 Heidelberg Germany
| | - Reginald Scheidt
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University of Heidelberg; 69115 Heidelberg Germany
| | - Robert Ofenloch
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University of Heidelberg; 69115 Heidelberg Germany
| | - Peter Elsner
- Department of Dermatology; University Hospital Jena; 07743 Jena Germany
- Statutory Accident Insurance Clinic of Occupational Diseases; 08233 Falkenstein Germany
| | - Britta Wulfhorst
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre; Trauma Hospital; 21033 Hamburg Germany
| | - Michael Schönfeld
- Clinic for Occupational Diseases of the VBG (Statutory Accident Insurance); 83435 Bad Reichenhall Germany
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre; Trauma Hospital; 21033 Hamburg Germany
| | - Thomas L. Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University of Heidelberg; 69115 Heidelberg Germany
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Braun R, Dotterud LK. Occupational skin diseases from 1997 to 2004 at the Department of Dermatology, University Hospital of Northern Norway (UNN): an investigation into the course and treatment of occupational skin disease 10-15 years after first consultations with a dermatologist. Int J Circumpolar Health 2016; 75:30100. [PMID: 27172061 PMCID: PMC4864832 DOI: 10.3402/ijch.v75.30100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/01/2016] [Accepted: 03/07/2016] [Indexed: 11/21/2022] Open
Abstract
Objectives We investigate the impact of occupational skin disease consultations among outpatients at the Dermatological Department, University Hospital, Northern Norway. Study design From 1997 until 2004, 386 patients with occupational skin disease were examined and given advice on skin care, skin disease treatment, skin protection in further work, and on the legal rights of patients with this disease. Ten to fifteen years later, we wanted to look at these patients in terms of their work situation, the current status of their disease, the help they received from the labour offices, and their subjective quality of life. Material and methods In the autumn of 2011 until the spring of 2012, a number of the patients examined in the period from 1997 to 2004 were selected and sent a questionnaire, which they were asked to answer and return, regarding their work situation and the progress and current status of their occupational disease. Results A total of 153 (77%) patients answered the questionnaire; 71% of these patients were still in work, and further 15% had old-age retired, 13% were working until then; 16% had retired early because of disability; 54% had changed jobs because of their occupational skin disease; 86% of the patients indicated that the skin disease had improved since our previous investigation. Conclusions Our investigation into patients with occupational skin disease documented that the majority of patients who had received professional dermatological consultation and intervention offers were still in the labour market and had good control of their skin disease 10–15 years later. We discovered that 71% of the patients were still employed. 13% had remained in work until they became old age pensioners. Only 16% dropped out of work because of disability. These high percentages may indicate that our intervention has contributed positively to patients’ work conditions and the course of their skin disease.
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Affiliation(s)
- Rosemarie Braun
- Department of Dermatology, University Hospital, Tromsø, Norway; @unn.no
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Mollerup A, Harboe G, Johansen JD. User evaluation of patient counselling, combining nurse consultation and eHealth in hand eczema. Contact Dermatitis 2016; 74:205-16. [PMID: 26822623 DOI: 10.1111/cod.12534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 12/08/2015] [Accepted: 12/08/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE This study reports the findings from a user evaluation of a counselling programme for hand eczema patients in which face-to-face encounters were supplemented with user access to a new website. PATIENTS AND METHODS Patients treated for hand eczema in two different settings were included consecutively. Website utilization was examined by use of the transaction log. Comparisons were made between participants who used the website and those who did not. The patients' perspectives were explored by the use of interviews. RESULTS Among potential website users (n = 140), 88 patients (63%) had an average of 5.1 site visits. At follow-up, the website users had improved more in quality of life (p = 0.014), current burden of disease (p = 0.053), and itching (p = 0.042). The website users reported more changes in habits than did the non-website users (p = 0.024). No differences in clinical severity of hand eczema were found. The interviewees were generally satisfied with the counselling and the website. The strict log-on procedures were considered to be an obstacle to using the site. The consecutive inclusion of participants was considered to be a barrier to engagement in the dialogue forum. CONCLUSIONS The website users benefited from the website, although this was not substantiated by clinical measurements. The trial design partly hampered website utilization. An initial feasibility study could have been warranted.
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Affiliation(s)
- Annette Mollerup
- The National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark
| | - Gitte Harboe
- Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark
| | - Jeanne D Johansen
- The National Allergy Research Centre, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, 2900, Hellerup, Denmark
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John SM, Thielitz A. Berufsallergosen/Berufsdermatologie. ALLERGOLOGIE 2016. [DOI: 10.1007/978-3-642-37203-2_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mahler V. Handekzeme - Differenzialdiagnosen, Diagnostik und Therapien. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.150_12922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brans R, John S. Clinical patterns and associated factors in patients with hand eczema of primarily occupational origin. J Eur Acad Dermatol Venereol 2015; 30:798-805. [DOI: 10.1111/jdv.13515] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/02/2015] [Indexed: 11/30/2022]
Affiliation(s)
- R. Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Trauma Hospital Hamburg; Osnabrück/Hamburg Germany
- Lower Saxonian Institute of Occupational Dermatology; University of Osnabrück and University Medical Center Göttingen; Osnabrück/Göttingen Germany
| | - S.M. John
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Trauma Hospital Hamburg; Osnabrück/Hamburg Germany
- Lower Saxonian Institute of Occupational Dermatology; University of Osnabrück and University Medical Center Göttingen; Osnabrück/Göttingen Germany
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Brans R, Hübner A, Gediga G, John SM. Prevalence of foot eczema and associated occupational and non-occupational factors in patients with hand eczema. Contact Dermatitis 2015; 73:100-7. [DOI: 10.1111/cod.12370] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 01/10/2015] [Accepted: 01/19/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; D-49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück; D-49090 Osnabrück Germany
- Lower-Saxonian Institute of Occupational Dermatology, University of Osnabrück; D-49090 Osnabrück Germany
| | - Anja Hübner
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; D-49090 Osnabrück Germany
| | - Günther Gediga
- FB 7 Psychology: Methodology & Statistics; University of Münster; D-48149 Münster Germany
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; D-49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm), University of Osnabrück; D-49090 Osnabrück Germany
- Lower-Saxonian Institute of Occupational Dermatology, University of Osnabrück; D-49090 Osnabrück Germany
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Breuer K, John S, Finkeldey F, Boehm D, Skudlik C, Wulfhorst B, Dwinger C, Werfel T, Diepgen T, Schmid-Ott G. Tertiary individual prevention improves mental health in patients with severe occupational hand eczema. J Eur Acad Dermatol Venereol 2015; 29:1724-31. [DOI: 10.1111/jdv.12975] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 12/19/2014] [Indexed: 11/30/2022]
Affiliation(s)
- K. Breuer
- Department of Allergology and Occupational Dermatology; Dermatologikum Hamburg; Hamburg Germany
| | - S.M. John
- Department of Dermatology, Environmental Medicine, Health Theory; University of Osnabrueck; Osnabrueck Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck; Dermatologic Centre; Trauma Hospital; Hamburg Germany
| | - F. Finkeldey
- Department of Dermatology; Elbe-Klinikum Buxtehude; Buxtehude Germany
| | - D. Boehm
- Institute for Innovative Rehabilitation; Hospital Management and Distress Medicine (IREHA); Lielje Group; Löhne Germany
| | - C. Skudlik
- Department of Dermatology, Environmental Medicine, Health Theory; University of Osnabrueck; Osnabrueck Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck; Dermatologic Centre; Trauma Hospital; Hamburg Germany
| | - B. Wulfhorst
- Department of Dermatology, Environmental Medicine, Health Theory; University of Osnabrueck; Osnabrueck Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrueck; Dermatologic Centre; Trauma Hospital; Hamburg Germany
| | - C. Dwinger
- Department of Psychology; Employers' Liability Insurance Association Hospital for Accidents; Hamburg Germany
| | - T. Werfel
- Division of Immunodermatology and Allergy Research; Department of Dermatology and Allergy; Hannover Medical School; Hannover Germany
| | - T.L. Diepgen
- Department of Clinical Social Medicine; Center of Health System Research, Occupational and Environmental Dermatology; University of Heidelberg; Heidelberg Germany
| | - G. Schmid-Ott
- Institute for Innovative Rehabilitation; Hospital Management and Distress Medicine (IREHA); Lielje Group; Löhne Germany
- Department of Psychosomatic Medicine; Berolina Clinic; Löhne Germany
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Skudlik C, Weisshaar E. Individuell ambulante und stationäre Prävention bei Berufsdermatosen. Hautarzt 2015; 66:160-6. [DOI: 10.1007/s00105-014-3562-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mahler V, Diepgen T, Skudlik C, Becker D, Dickel H, Fartasch M, Geier J, Häberle M, Hillen U, Krohn S, John SM, Weisshaar E, Werfel T, Zagrodnik F. Psoriasis predisposition and occupational triggering factors in the appraisal of occupational medical expertises. J Dtsch Dermatol Ges 2015; 12:519-29. [PMID: 24889306 DOI: 10.1111/ddg.12262] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Psoriasis is an immune-mediated disease with a genetic background. Local psoriatic changes can be triggered by exogenous mechanical or irritant factors. Causative occupational factors have to be distinguished from the spontaneous course of psoriasis in occupational medical evaluations. The objective of this work is to demonstrate the medico-legal grounds for a homogenous assessment. PATIENTS AND METHODS The presented recommendations were developed in a working group for Occupational and Environmental Dermatology (ABD) and the German contact dermatitis group (DKG) of the German Dermatologic Society (DDG) based on the German medico-legal framework. RESULTS Causality between the insured activity and the appearance of psoriasis is a prerequisite for the recognition of the occupational nature of the disease. This is the case if the occupational activity is the exclusive or a legally essential contributing factor either for first manifestation or aggravation of the disease. A connection must be denied if everyday events are sufficient to trigger the psoriasis. From 1995 to 2010, 130 cases of psoriasis have been recognized as occupationally related by the German statutory accident insurance. CONCLUSIONS The appraisal of psoriatic disease in the occupational medical evaluation is subject to the case assessment of the expert witness. In this position paper we present recommendations for a homologous basis for diagnosis, causality assessment, estimation of reduction in earning capacity and rehabilitation of occupational psoriasis.
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Affiliation(s)
- Vera Mahler
- Department of Dermatology, University Hospital, Erlangen
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Brans R, Skudlik C, Weisshaar E, Gediga K, Scheidt R, Wulfhorst B, Elsner P, Schönfeld M, John S, Diepgen T. Association between tobacco smoking and prognosis of occupational hand eczema: a prospective cohort study. Br J Dermatol 2014; 171:1108-15. [DOI: 10.1111/bjd.13169] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2014] [Indexed: 11/28/2022]
Affiliation(s)
- R. Brans
- Department of Dermatology, Environmental Medicine, Health Theory University of Osnabrück 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre Trauma Hospital 21033 Hamburg Germany
| | - C. Skudlik
- Department of Dermatology, Environmental Medicine, Health Theory University of Osnabrück 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre Trauma Hospital 21033 Hamburg Germany
| | - E. Weisshaar
- Department of Clinical Social Medicine Centre of Health Systems Research, Occupational and Environmental Dermatology University of Heidelberg 69115 Heidelberg Germany
| | - K. Gediga
- Department of Dermatology, Environmental Medicine, Health Theory University of Osnabrück 49090 Osnabrück Germany
| | - R. Scheidt
- Department of Clinical Social Medicine Centre of Health Systems Research, Occupational and Environmental Dermatology University of Heidelberg 69115 Heidelberg Germany
| | - B. Wulfhorst
- Department of Dermatology, Environmental Medicine, Health Theory University of Osnabrück 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre Trauma Hospital 21033 Hamburg Germany
| | - P. Elsner
- Department of Dermatology University Hospital Jena 07740 Jena Germany
- Statutory Accident Insurance Clinic of Occupational Diseases 08223 Falkenstein Germany
| | - M. Schönfeld
- Clinic for Occupational Diseases of the VBG (Statutory Accident Insurance) 83435 Bad Reichenhall Germany
| | - S.M. John
- Department of Dermatology, Environmental Medicine, Health Theory University of Osnabrück 49090 Osnabrück Germany
- Institute for Interdisciplinary Dermatologic Prevention and Rehabilitation (iDerm) at the University of Osnabrück and Dermatologic Centre Trauma Hospital 21033 Hamburg Germany
| | - T.L. Diepgen
- Department of Clinical Social Medicine Centre of Health Systems Research, Occupational and Environmental Dermatology University of Heidelberg 69115 Heidelberg Germany
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Clemmensen KKB, Randbøll I, Ryborg MF, Ebbehøj NE, Agner T. Evidence-based training as primary prevention of hand eczema in a population of hospital cleaning workers. Contact Dermatitis 2014; 72:47-54. [DOI: 10.1111/cod.12304] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 08/09/2014] [Accepted: 08/13/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Kim K. B. Clemmensen
- Department of Dermatology; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| | - Ingelise Randbøll
- Department of Dermatology; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| | - Malene F. Ryborg
- Department of Dermatology; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| | - Niels E. Ebbehøj
- Department of Occupational and Environmental Medicine; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
| | - Tove Agner
- Department of Dermatology; Bispebjerg Hospital; Bispebjerg Bakke 23 2400 Copenhagen NV Denmark
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