Berufs-Dermatosen最新文献

Distributed on 66 occupational groups (and 170 individual occupations) the prevalence of lichen ruber planus within the groups was determined by examining nearly every person in the total populations of 39,418 persons in five different areas in Sweden. The prevalence of l.r.p. in the total population was 0.3 per cent for males and 0.1 per cent for females. When l.r.p. prevalences were compared between different occupational groups, disturbing influences from age differences between the groups were eliminated by the standard population method. The indices calculated by aid of computer were used for direct ranking of the occupational groups from those with the highest to those with the lowest prevalences. In 33 of the 66 occupational groups (and in 129 of 170 individual occupations) no l.r.p. was found. In 24 male and 6 female occupational groups an overaverage high prevalence of l.r.p. was found. In two occupational branches, i.e. agriculture and forestry work (male agricultural workers, farmers, gardeners, garden workers and forest workers) and engineering and building metal work (steel-workers, plate-workers, machine and engine repairers, machine and engine mechanics, engineering workers, plumbers, metal workers) an overaverage high prevalence of l.r.p. was found in nearly all occupational groups. The results indicate that l.r.p. is more prevalent in occupational groups, in which the work dirties the skin (with i.e. soil, oil, cement dust), while in occupational groups with "clean work" the disease was less prevalent. However, there were exceptions. 67.7% of the males, 55.5% of the females had their debute lesions on the lower legs; in 21% of the males and 22.2% of the females the l.r.p. lesions debuted on the wrists. These are areas liable to exposure for different chemical substances and trauma.

Changes of the skin by the external influence of drugs and occupational substances are to be divided up into direct toxical influences, deposits, pharmacodynamical effects and immunologically directed reactions. With easily penetrating substances serious general effects like the formation of methaemoglobin and the intoxication with mercury have been observed. Development, diagnostic, prophylaxis and therapy of the cellular immunological reaction are thoroughly set forth.

Peripheric circulatory disturbances and acrocyanosis in Moselle vinedressers injured by arsenic. During the years 1972--1975 a total number of 100 vine-dressers came for medical treatment because of late injures caused by arsenic intoxication. That is an average of 400 examinations per year 1600 control examinations within four years. These patients belonged to the age-classes 1890--1923, and the average time of exposure to arsenic was 20 years. After years of being exposed to arsenic, and even years after the exposure to it has stopped, there are those so-called late injures caused by arsenic. There are typical arsenic melanisms on the forehad-temple-rim where the hair begins to grow, on the nape of the neck, on the shoulders, chest, arms, and on the back of the hands which pass into precanceroses and carcinomas. The average time until the first late injuries caused by arsenic occur is 26 years. However, there have been latence periods of up to 50 years. This depends mainly on the amount of arsenic absorbed during the time. There are skin alterations which resemble very much an acrodermatitis chronica atrophicans Herxheimer. Histological examinations rather showed the symptoms of an endangiitis obliterans with atrophy of the cutis. These symptoms were found in 60--70% of the 50--60 years old patients, in 80--90% of the 60--70 years old patients, and in 90--95% of the 70--80 years old patients. Simultaneously there are distinct peripheric circulatory disturbances, cyanosis of the lips, dyspnoea, and an emphysema together with typical cardiac insufficiency. Foot and finger pulse are distinctly slower, and the temperature of the skin is remarkably lower. While people grow older the cyanosis gets worse. With a control group of patients who hadn't been exposed to arsenic these symptoms had only been found on 1--2%.

The cryotherapy is a simple, elegant and reliable method that can often be applied in out-patients, without anesthesia. The initial apparent failures were mainly due to the fact that the time of application of the cold had been too short, or that the region in which it had been brought to bearing was too small. Clinical and histological examinations have confirmed the good cosmetic results of the method despite an extraordinary deep action. The method has only two minor disadvantages: histological controls cannot be performed, and the non-bloody artifical necrosis must be protected for 2-3 weeks by the local administration of antibiotics.

133 female and 34 male workers of a detergents factory were subdivided into 3 groups according to the pathological state of their skin. The 129 persons of the first group showed slight disorders of the skin of their hands and forearms, the 31 subjects in the second group were free from skin disorders while the 7 persons of the third group showed eczematous symptoms. Patch tests were performed in these subjects using the following allergens: potassium dichromate, nickel sulfate, cobaltous chloride, formaline and paraphenylenediamine. Moreover, patch tests and wetting tests were carried out using the detergent powder manufactured in the factory. The results were mostly negative. In 66 cases of skin disorders, functional tests were performed that revealed disturbances of the barrier function of the skin (diminution of the alkali resistance by 62.2%, prolongation of the neutralization time by 75.6%, increase of the permeability by 33.2%). In 81.5% of the workers, a dermatosis due to overstrain was diagnosed.

Autologous full thickness skin autografts were carried out on 60 male guineapigs in such a way that the hair roots were destroyed. The light sensitivity of the skin towards UV B was then tested on the hairless skin by means of the Xenon lamp and the corresponding filter. Exploratory excisions were taken from another area of the graft and used to demonstrate the structure of the stratum corneum according to the method of Christophers. It could be shown that light erythema developed significantly less than when the columnar structure of the stratum cornuem was well developed.

In giving an opinion on arterial circulation disorders, an arterial occlusion is predominant. As a rule, the diagnosis based on anamnestic data, clinical examinations and some functional tests causes no difficulties. An angiography simplifies the evaluation, but it should be carried out only to distinguish a generalized vasculopathy from a local one. The arterial occlusion is a chronic and progressive disease with coronary vessels being mainly involved. The muscular force of the patient is reduced, local infections and traumatisms menace him thus reducing his working capacity. Anticoagulants must often be given continuously, the vascular systems of the heart and the brain may be impaired. It is extremely difficult to elucidate causal relationships, especially in case of injuries suffered during military service. It is the general opinion nowadays that cold-injuries entail a limited angiitis but no generalized vasculopathy.

After a longlasting psoriasis (25-30 years) and after an arsenotherapy of psoriasis per os fifteen years ago an arsenic-caused injury occured with formation of a melanoma within the surrounding psoriasis. In examinating comparable Moselle vine dressers with late arsenic-caused injuries during the years 1972-1975, altogether 1600 examinations, precancerosis, basaliomas, morbus-Bowen, spinaliomas, and transitional epithelium carcinomas have been found and have been histologically confirmed. No melano malignom has been found. Al in eleven other cases of vine dressers with arsenic-caused late injuries showing keratosis, precancerosis, and basaliomas together with a long-lasting psoriasis vulgaris no melano malignom has been found.

Contact-allergy eczemas due to dichloropropiophenone. Following an exposition to p-beta-dichloropropiophenone (DCP) of less than one year nine skilled chemical plant workers were taken ill with an eczema from contact allergy, particularly badly seizing their faces, necks, hands and forearms. In all workers in question has been recognized a job connected skin disease with bodily impairment of 20 to 30%. The test concentration of DCP was determined at 0.01% (testing vehicle: oil). Nonexposed persons showed response only at 0.5% DCP concentration (50 times higher percentage!) by falling sick of an uncomplicated irritation erythema, strickly localized. With regard to the almost obligatory tendency towards sensitization there must be strict observation of the stringent measures of a labour protection, and moreover, in the future there should be established a closed system of automatic control.