个人防护装备:原因还是后果?临床病例

Sofia Talambas, Dina Pita, Carlos Meneses, M. Claudino, M. Manzano
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摘要

接触性皮炎占所有职业性皮肤病的70-90%,经常导致功能性残疾。如果怀疑是接触性皮炎,患者的职业史可以指导临床怀疑,也可以指导需要检测的过敏原。病例报告一名63岁男性电工,在出现症状两年后,因手脚瘙痒性红斑鳞状病变而去皮肤科就诊。皮肤测试结果显示,重铬酸钾、对苯二胺、羊毛脂醇和纺织混合物呈阳性。结合病变特点、分布、职业暴露及皮肤贴试验结果,建立变态反应性接触皮炎的诊断。有可能建立工人使用的个人防护装备与症状之间的关系,并建立职业性皮炎的推定诊断。最好的治疗方法是识别和去除药物,因为避免过敏原可以改善临床状况。工作场所分析以及制定预防战略对职业健康至关重要。必须鼓励公司减少/消除接触危险因素的机会,促进工人的健康和安全。结论接触性皮炎对个人和职业的影响较大,可导致缺勤、生产力下降和残疾。职业保健医生在向工人宣传安全工作做法和正确使用个人防护装备方面发挥着积极作用,以便将这些装备用于保护,而不是用于疾病的根源。关键词:皮炎,过敏性接触,接触性皮炎;职业性皮炎;职业健康。
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Equipamento de Proteção Individual: Causa ou Consequência? Caso Clínico
Introduction Contact dermatitis comprises 70–90% of all occupational skin diseases, leading frequently to functional disability. If contact dermatitis is suspected, the patient’s occupational history can guide the clinical suspicion as well as the allergens to be tested. Case Report A 63-year-old male electrician, who went to a Dermatology Specialist with pruritic erythematous-scaly lesions on the hands and feet, two years after the onset of symptoms. An epicutaneous test was performed, and Potassium Dichromate, Paraphenylenediamine, Lanolin Alcohols and Textile Blends were found positive. Considering the characteristics of the lesions, their distribution, occupational exposure and the results of skin patch tests, the diagnosis of Allergic Contact Dermatitis was established. Discussion It was possible to establish a relationship between the Personal Protective Equipment used by the worker and the symptoms, as well as establish the presumptive diagnosis of Occupational Dermatitis. The best approach for treatment is to identify and remove the agent, since avoiding the allergens can improve the clinical condition. Workplace analysis, as well as the development of preventive strategies are essential for Occupational Health. It is important to encourage companies to reduce/eliminate exposure to risk factors, promoting the health and safety of workers. Conclusion Contact Dermatitis is associated with a high personal and professional impacts, which can result in absenteeism, reduced productivity and disability. The Occupational Health Care Physician plays an active role in informing workers, with regards to safe working practices and the correct use of Personal Protective Equipment, so that these are used for protection instead of the source of the illness. Keywords: Dermatitis, Allergic contact, Contact Dermatitis; Occupational Dermatitis; Occupational Health.
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