Berufs-Dermatosen最新文献

If urea, a physiologic substance, is applied locally, it has a favorable effect on the skin, it keeps the horny layer moist. However, high concentrations might impair the functions of the skin, for urea penetrates easily into the skin, exerts mucolytic and keratolytic effects, changes the keratin structure, and promotes just like dimethylsulfoxide, the permeation and the resorption of active ingredients. Moreover, urea causes a thinning of the epidermis by influencing the epidermal prolifertion. The properties of urea are of considerable interest in dermatotherapy. However, high concentrations of urea should only be applied for long periods of time, and on large surfaces of the skin, for instance in the treatment of dry skin, in the form of cosmetics, under medical supervision.

Clinical trials of the anti-inflammatory activity of corticosteroids for external use The influence on skin temperature of 4 corticoid-containing formulations and 3 steroid-free bases was tested in 9 subjects in whom no pathological skin changes were present but who were known to be sensitive to metal ions (chromium and nickel). The effect of the preparations on the healthy skin (vasoconstrictive effect) after a duration of action of 2 and 6 h was compared with the effect on skin sites treated subsequently with the contact allergens for a period of 24 h. In the procedure used the trial preparations were allowed to act for 2 and 6 h under occlusive dressing, or for 4 and 8 h, the dressing being removed for 2 h in each case. The allergization produced an increase in temperature at the skin surface which was influenced in various ways by the trial preparations. Whereas no statistically significant differences in the effect of the individual steroid topicals were found the healthy skin, in the evaluatin of the overall anti-inflammatory effect on the pathological skin processes, some distinct differences in effect were found. On comparing the results the following lowing order was obtained for the overall anti-inflammatory effect: 1. Fluprednylidene acetate 0.1% score 4.5, 2. Difluocortolone-valerate 0.1% score 8.5, 3. Fluocortolone trimethylacetate 0.25% + fluocortolone caproate 0.25% score 12, 4. Desoxymethasone 0.1% score 15, The steroid-free bases tested simultaneously did not exhibit clear effects on the temperature in the normal or inflamed skin. The results of the test procedure described are reproducible and can be evaluated by statistical method; the method thus seems appropriate for comparative studies of steroid-containing topicals. The special value in the procedure is the possibility of testing the effect of the preparations directly in a standardised inflammation model which is directly related to use in patients with inflammatory skin diseases, and of establishing in this way in which preparations the anti-inflammatory effect obtained exceeds the general effect common to all steroids.

Some clinically recognized factors promoting allergic contact dermatitis include the colour and structure of the skin, disorders affecting blood-vessels, the microclimate, friction and implantation. A survey is given according to the areas of the body which are influenced more or less by one of these factors. The area around an ulcer is especially easily sensitized by many applied chemicals. The part played by the microclimate in sensitization mainly depends on the amount of sweat and the hyperhydration of the skin. Some recent publications concerning friction and implantation are reviewed.

The pathogenesis of the epidermal and cutaneous reactions to a microbic invasion comprises many criteria for the diagnosis of a nummular microbial eczema. Detection of the focus, healing of the eczema after focal sanitation, positive reactions to bacterial antigens, decrease of Igm and IgG, and other parameters represent the cutaneous component of the disease, while the lack of epidermal sensitizations to low-molecular haptenes and the predominantly negative epicutaneous tests constitue the accentuating criteria. The results obtained in 95 patients with nummular microbic eczema show the part played by epidermal alterations in the development of occupational an iatrogenic contact sensitizations. Moreover, these alterations allow to recognize to what extent these dermatoses are due to occupational causes.

A worker employed in a textile printing-shop showing a rebellious eczema on hands and forearms, was submitted to three series of patch-tests which disclosed a polysensitization to chromium, to formaldehyde, to the urea-formaldehyde resin and to some pigments (Helizarine BASF, Fluolac FMC). The chemical analysis of some of these pigments shows an interesting relation between allergenicity for a certain pigment and the presence of formaldehyde. Thus, it is an allergy to the pigment-support and not to the pigment itself.

During the years 1972--1976 an overall number of 122 vine-dressers of the middle Moselle region called for examination, control, and medical treatment because of late damages caused by arsenic intoxication. In 1976 there were twenty-two new cases. By keratolytic treatment, excision, cauterization, and X-ray therapy a considerable reduction of precancerous and carcinous degenerations of the skin caused by arsenic in the form of keratosis and melanosis of the head, rump, arms, chest, volae and plantae could be achieved. By comparing two groups of vine-dressers with skin damages caused by arsenic a distinct reduction of praecancerous and carcinous degenerations of the predestined skin regions could be seen in those who had had medical treatment. A 3 months' dermatological survey of the patients is required.

Allergic contact eczema and vitiliginous depigmentations caused by paratertiary butylphenol. In a case of allergic contact eczemas due to an occupational contact with paratertiary butylphenol, vitiliginous depigmentations appeared after a latency period of several years. Disorders of cellular immune reactions, struma and hepatosis were absent. Paratertiary butylphenol might have been absorbed by the epidermis. It is suggested for prophylactic purposes to declare the components of adhesives in order to avoid occupational contacts with dangerous substances.