Berufs-Dermatosen最新文献

During an 18-month period determinations of immunoglobulin E(IgE) in serum were made on all (631) new patients referred to the Department of Occupational Dermatology, Karolinska Sjukhuset, Stockholm. The mean for the entire series was 238 units/ml (U): 280 U for the 323 men and 196 U for the 308 women. The IgE values for the different age groups, clinical diagnoses and sexes are presented. About 20% of the patients with normal IgE (less than 250 U) had a history of atopy. On the other hand about 30% of the patients with pathological IgE value (greater than 1000 U) had no such history. No explanation of this rise of IgE without concurrent atopy was discovered despite detailed laboratory tests. Our impression is that the IgE value has a prognostic significance and that, especially for the question of choice or change of occupation in cases of dermatitis, the determination of IgE is of value.

Report of a 39 year old lathe worker which suffered from oil acne 10 years ago. The disease was registrated as occupational dermatosis. It healed up after the patient changed to a plant with better conditions of work. Pitch warts on the scrotum remained and were failed to notice. Multiple scrotal carcinomas developed many years later. The case report illustrates the necessity of regularly control examinations of every patient which was suffering from oil acne, and the importance of occupational hygienic conditions for the development of oil acne and lathe turner cancer.

During some hot summer-days in 1973 about 70 cases of acute feet dermatitis were reported among soldiers from one regiment. They had used newly laundered socks from the same batch. The socks were disinfected with a solution containing TBTO and a quarternary ammonium compound, but by mistake a roughly 7 times too high concentration of the solution had been used. Patch tests with TBTO, quarternary ammonium compound and standard substances were negative. There was no suspicion of phototoxicity in these cases, but according to the literature TBTO may be photodynamic and several case reports relate specifically to sunny summerdays. We consider our cases to be due to the primary irritant properties of TBTO. As the span between optimal concentration for disinfection and the primary irritant concentration is narrow, we consider it inappropriate to use this substance for disinfection of textiles which are to be in direct contact with the skin until it has been established whether, for example, sweat may extract TBTO from treated fibres.

The morphological presentation of the stratum corneum and simultaneously measurements of the alkali resistance and alkali neutralization time of the skin have been carried out in 26 guinea pigs. Whereas we could not demonstrate any association between the alkali neutralization time and the structure of the stratum corneum, a significantly better alkali resistance of the skin could be found when the columnar structure of the stratum corneum was most pronounced. The structure of the stratum corneum on full thickness skin autografts was also compared to that of normal skin in 26 animals. The columnar structure can be just as well pronounced on grafts as on normal skin. Significant differences between graft and normal skin could not be demonstrated but random samples showed that a disturbance in the columnar structure occurred more often in the grafts.

Workers in glassfiber industry are prone to develop skintroubles. Therefore an investigation was made to the factors responsible for symptoms. Patchtests were performed in 66 out of totally 160 workers on the spinfloor (spinners) with a standard series of common contact allergens and with raw materials and finishers used in glassfiber industry. In 36 (54%) persons positive tests were observed. Epoxy resin was found to be the most prominent allergen; 16 (or 24%) reacted to the substances. Positive reactions to finishers for the most part were caused by a hypersensitivity to this resin. Only 4 out of 56 spinners, intensively investigated for skintroubles, were found symptom-free. Besides burn and traumatic reactions to glassfiber the skintroubles ranged from a practically normal skin with some vesicles to extensive erythematous and papulous eruptions at the limbs, neck and face. Countings were made of the number of glassfibers present at the skin of the spinners after the end of the work. It was found that even after showering a great many glassfiber remain at the skin. The investigations indicate that skintroubles in workers in glassfiber industry may be elicited by two factors: an allergy to substances in the finishers, and traumatic (irritative) effects of glassfiber penetrating the skin.

Out of 335 persons of less than 25 years, 236 had an intermittent dyshidrosis; half of them showed an allergic contact eczema of the hands. Microscopical and cultural investigations revealed a foot mycosis in 24 persons, and in 13 a candidiasis of the hands. Hence, dyshidrosis is obviously not of mycotic origin. 113 out of 150 sensitized persons of this group of age were dyshidrotics; 50% of them had not yet finished their apprenticeship. Obviously, dyshidrosis favours an early sensitization in professions in which allergens are frequently encountered.

An occupational sensitization of the respiratory tract caused by hair and dust of laboratory animals (Mastomys natalensis) was reported in 3 persons. Intracutaneous tests confirmed the relationship between the professional activity and the clinical symptoms of an inhalation allergy. The very pronounced reaction to different dust extracts and the special conditions of exposure suggest an occupational sensitization to the dust of laboratory animals.

The late type contact sensitizing effect of alkaline protease enzymes (PE) on the intact human skin has been investigated in the present study. The immune process of sensitisation was induced with "Tenzym prilled" (TP, Grindstedvoerket) and with "Maxatase" (M, Gist-Brocades) protease enzymes in the epicutaneous test (ET), using concentration series and various durations of application. The ETs were made on the intact (symptom-free) skin, as well as under conditions promoting the subcorneal penetration of PE. Challenge was carried out at 21 to 30 days following induction of 2092 subjects, and at 2 to 5 months on 1624 subjects. Despite the large number of subjects tested, contact sensitisation developed in none of the cases, although the inducing exposure took place under conditions promoting the immune process of sensitisation. In 60 individuals suffereing from occupational dermatitis on regular contact with PE and having no symptoms of early type inhalative allergy (mucous membrane changes, bronchial asthma-like symptoms) were challenged also by the intradermal test. No reaction was noted in any of them at 10 and 30 minutes, as well as at 24 and 48 hours following the test. Next the influence of PE is analysed in the induction or increased severity of the irritation caused by bioactive laundry detergents. The studies involved the use of serial dilutions of "Biopon" (Bn) laundry detergent containing TP or M, or not containing PE, respectively, by means of the ET. A total of 740 series (5220 tests) of the three variants were applied in dilution series to intact skin surface, as well as to pathologically and arteficially lsioned skin areas. The Bn variants containing and not containing PE increased the number of irratative reactions in essentially the same degree. This suggests that the irritative effect is not due to the presence of PE, but to the laundry-active detergents (WAS) of Bn in the first place, and to a lesser extent to its other ingredients.