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Lu J, Jiang G. Guarding skin under PPE: Mechanistic insights and technological innovations. Skin Res Technol 2023; 29:e13520. [PMID: 38009022 PMCID: PMC10626285 DOI: 10.1111/srt.13520] [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: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 11/28/2023]
Abstract
In the presence of diseases transmitted through respiratory droplets and direct contact, healthcare workers (HCWs) necessitate the use of personal protective equipment (PPE). For optimal safety, PPE should securely conform to the skin during extended wear. However, conventional PPE often lacks adequate air permeability and hygroscopicity, trapping heat and moisture emitted by the body within the enclosure. Such a hot and humid internal environment can induce skin damage, such as erythema, rash, pruritus, and itching among others, leading to microbial growth on the skin surface, the production of inflammatory mediators at the wound site and an increased risk of infection. This review strives to comprehensively elucidate the fundamental mechanisms triggering adverse skin reactions and their resultant manifestations. Furthermore, we explore recent advancements aimed at inhibiting these mechanisms to effectively mitigate the occurrence of skin lesions.
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Affiliation(s)
- Junru Lu
- Department of DermatologyAffiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsuChina
- Xuzhou Medical UniversityXuzhouJiangsuChina
| | - Guan Jiang
- Department of DermatologyAffiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsuChina
- Xuzhou Medical UniversityXuzhouJiangsuChina
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Özkaya E, Elinç Aslan MS. Occupational allergic contact dermatitis: A 24-year, retrospective cohort study from Turkey. Contact Dermatitis 2021; 85:503-513. [PMID: 34263479 DOI: 10.1111/cod.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Limited data exist on occupational allergic contact dermatitis (OACD) in Turkey. OBJECTIVES To investigate the epidemiologic profile of OACD in Turkey. METHODS A retrospective cohort study on 294 patients with OACD among 2801 consecutively patch-tested patients in the Allergy Unit of the Dermatology Department of İstanbul Faculty of Medicine between 1996 and 2019. RESULTS The overall prevalence of OACD was 10.5%, showing a male predominance. OACD was most frequently seen in construction workers (45.2%), followed by hairdressers, metalworkers, health care workers, and miscellaneous. The main relevant allergens were chromium in cement, thiurams in rubber gloves, hairdressing chemicals, resins/glues/plastics, metals, isothiazolinones, and fragrances. Hands were the mainly involved site (95.6%). Airborne eczema was observed in 21.4%. Hand and foot eczema and co-sensitizations to chrome and thiuram and chrome and cobalt were significantly associated with being a construction worker. Sensitizations to isothiazolinones in house painters, ammonium persulfate and p-phenylenediamine in hairdressers, and colophonium increased after 2010. CONCLUSION This was the largest group of data on OACD from Turkey, reflecting the importance of rubber glove allergy in all occupations and the striking increase in ammonium persulfate allergy among hairdressers. Chrome and cobalt were still the main cement allergens in Turkey, where the cement directive is not yet in force.
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Affiliation(s)
- Esen Özkaya
- Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Meryem Sevinç Elinç Aslan
- Department of Dermatology and Venereology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.,Department of Dermatology, Saltat Klinik, İstanbul, Turkey
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Zhou NY, Yang L, Dong LY, Li Y, An XJ, Yang J, Yang L, Huang CZ, Tao J. Prevention and Treatment of Skin Damage Caused by Personal Protective Equipment: Experience of the First-Line Clinicians Treating 2019-nCoV Infection. INTERNATIONAL JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2020; 3:IJDV-20-019. [PMID: 34192087 PMCID: PMC7147274 DOI: 10.1097/jd9.0000000000000085] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/03/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Nuo-Ya Zhou
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
| | - Liu Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
- Hunan Normal University School of Medicine, Changsha, Hunan 410013, China
| | - Li-Yun Dong
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
| | - Yan Li
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
| | - Xiang-Jie An
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
| | - Jing Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
| | - Liu Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
| | - Chang-Zheng Huang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
| | - Juan Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, Hubei 430022, China
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Corrêa-Fissmer M, Dalazen CC, Ferreira BP, Iser BPM. Assessment of patch test results carried out during ten years in a city in southern Brazil. An Bras Dermatol 2019; 93:807-812. [PMID: 30484523 PMCID: PMC6256204 DOI: 10.1590/abd1806-4841.20185023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 08/24/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Contact dermatitis affects up to 20% of the population. Patch testing for contact allergy may be needed to confirm the diagnosis. OBJECTIVES To describe and discuss the results of patch tests performed in a city in southern Brazil. METHODS A cross-sectional analysis was performed on all skin test results over ten years. Variables such as gender, age at the time of testing, and test results were evaluated. Triggering factors, duration of complain, and previous medications used related to the clinical history were retrieved for some patients by reviewing their medical records. RESULTS The sample was composed of 539 patch tests, of which 411 (76.2%) were from women. The age of the tested subjects ranged from 5 to 87 years. The prevalence of positive reactions in the patch tests was 391 (72.5%). The most prevalent positive reaction was to nickel sulfate (196; 36.4%), which had statistical significance when associated with female gender (p<0,001). STUDY LIMITATIONS Database obtained through secondary sources (the reports of the exams and the medical records), occurring the incomplete registration of some information. CONCLUSIONS Data analysis at the local level is important to define preventive policies.
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Affiliation(s)
- Mariane Corrêa-Fissmer
- Outpatient Clinic of Medical Specialties, Universidade do Sul de
Santa Catarina, Tubarão (SC), Brazil
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Plombom GY, Oliveira MSD, Tabushi FL, Kassem AJ, Purim KSM, Nisihara RM. Epidemiological analysis of occupational dermatitis notified in Brazil in the period 2007 to 2012. An Bras Dermatol 2017; 91:732-736. [PMID: 28099592 PMCID: PMC5193182 DOI: 10.1590/abd1806-4841.20164762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 11/03/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Occupational dermatitis affects the quality of life and productivity of
workers. Studies on the subject are scarce in Brazil. It is estimated that
the disease is underreported and that many affected patients do not seek
health care. OBJECTIVES To conduct an epidemiological analysis of occupational dermatitis notified
via SINAN in Brazil from January 2007 to December 2012; evaluate the profile
of patients assisted; and check the main etiological agents involved. METHODS We analyzed the compulsory notification forms of cases of occupational
dermatitis filled nationwide during January 2007 to December 2012. RESULTS During the study period 3027 cases of occupational dermatitis were notified
in Brazil. In 61.4% of cases patients were men aged between 35-49 years
(39.6%). The most described etiological agent was chromium (13.9%). The
location of the body most affected was the hands, with 28.4% of cases. The
construction sector is implicated in 28.7% of cases and domestic services by
18%. Allergic contact dermatitis is the most prevalent occupational
dermatitis (20.6%) and the region with the highest number of notifications
was the Midwest, with 376.4 cases per million inhabitants. CONCLUSIONS The profile of patients most affected by occupational dermatitis in Brazil
during the study period was: men with elementary school, aged between 20 and
49 years old and working in the construction industry. The most common
occupational dermatitis were allergic contact dermatitis caused by chromium
after years of exposure, being the hands and head the parts of the body most
affected.
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Fonacier L, Bernstein DI, Pacheco K, Holness DL, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles S, Wallace D. Contact dermatitis: a practice parameter-update 2015. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 3:S1-39. [PMID: 25965350 DOI: 10.1016/j.jaip.2015.02.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 01/08/2023]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, which represents the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Contact Dermatitis: A Practice Parameter-Update 2015." This is a complete and comprehensive document at the current time. The medical environment is changing and not all recommendations will be appropriate or applicable to all patients. Because this document incorporated the efforts of many participants, no single individual, including members serving on the Joint Task Force, are authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information or interpretation of this practice parameter by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, and the Joint Council of Allergy, Asthma & Immunology. These parameters are not designed for use by the pharmaceutical industry in drug development or promotion. Previously published practice parameters of the Joint Task Force on Practice Parameters for Allergy & Immunology are available at http://www.JCAAI.org or http://www.allergyparameters.org.
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Zorba E, Karpouzis A, Zorbas A, Bazas T, Zorbas S, Alexopoulos E, Zorbas I, Kouskoukis K, Konstandinidis T. Occupational dermatoses by type of work in Greece. Saf Health Work 2013; 4:142-8. [PMID: 24106644 PMCID: PMC3791082 DOI: 10.1016/j.shaw.2013.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 06/27/2013] [Accepted: 06/28/2013] [Indexed: 11/24/2022] Open
Abstract
Background To elucidate the relationship between seven occupational dermatoses (ODs) and 20 types of work in Greece. Methods This was a prevalence epidemiologic study of certain ODs among 4,000 workers employed in 20 types of enterprise, in 104 companies, in 2006–2012, using data from company medical records, questionnaires, occupational medical, and special examinations. The χ2 test was applied to reveal statistically significant relationships between types of enterprises and occurrence of ODs. Results A high percentage (39.9%) of employees included in the study population suffered from ODs. The highest prevalence rates were noted among hairdressers (of contact dermatitis: 30%), cooks (of contact dermatitis: 29.5%), bitumen workers (of acne: 23.5%), car industry workers (of mechanical injury: 15%), construction workers (of contact urticaria: 29.5%), industrial cleaning workers (of chemical burns: 13%), and farmers (of malignant tumors: 5.5%). We observed several statistical significant correlations between ODs (acute and chronic contact dermatitis, urticaria, mechanical injury, acne, burns, skin cancer) and certain types of enterprises. There was no statistically significant correlation between gender and prevalence of ODs, except for dermatoses caused by mechanical injuries afflicting mainly men [χ2 (1) = 13.40, p < 0.001] and for chronic contact dermatitis [χ2 (1) = 5.53, p = 0.019] afflicting mainly women. Conclusion Prevalence of ODs is high in Greece, contrary to all official reports by the Greek National Institute of Health. There is a need to introduce a nationwide voluntary surveillance system for reporting ODs and to enhance skin protection measures at work.
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Affiliation(s)
- Eleni Zorba
- Program of Postgraduate Studies, Health and Safety in Workplaces, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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