Dermatological examination

A few selected safety measurements and tests for specialized dermatological examination are listed in Table 20.15. 

TABLE 20.15. Selected Examples of Safety Measurements and Tests for a Specialized Dermatological Examination... 

Eczema is caused by environmental influences affecting genetically predisposed individuals [146(111), 147(111)]. It is the most frequent inflammatory skin disease in childhood. Prevalence estimates for eczema ranged between 1.1 and 3.1% in the early literature, however, in newer studies these figures reach 25% based upon questionnaires, and 12.9% based upon dermatological examinations. There is evidence that the IgE-associated subgroup of eczema, atopic eczema, has increased in frequency over the past decades. 

Information bias Ascertainment of cases varied from dermatological examination to self-administered questionnaires... 

E dermatological examination Q questionnaire Includes mild cases... 

Dermatologic examination during the job-fitness evaluation is especially useful in the event of chronic or recurrent non-occupational dermatoses. We will describe only the most frequent chronic or recurrent dermatoses and mainly fiiose that, due to their location, can cause functional limitations or alter social relationships. In addition, we will deal with those dermatoses that might be worsened by occupational factors or might favour the development of allergic diseases (Fisher et al. 1986 Fitzpatrick et al. 1993 Rook et al. 1993). 

Routine self-examination of the skin is a method in which individuals can take responsibility for identifying MM early when it is curable. Pamphlets and online information describing the method of skin self-examination are available from agencies such as the American Cancer Society (www.cancer.org), the American Academy of Dermatology (www.AAD.org), and the Skin Cancer Foundation (www.skincancer.org). Patients should be given the following instructions for doing total skin self-examination 36... 

Dermal Effects. Hexachloroethane exposed workers reported a slightly higher prevalence of dry skin and dry mucous membranes as well as itching and other skin problems than the unexposed controls (Selden et al. 1994). Clinical examinations of the 11 exposed workers did not reveal signs of abnormal dermatological or mucous membrane status. Plasma hexachloroethane levels in these workers, who wore protective equipment, were 7.3 + 6.04 pg/L at the time of the examinations (Selden et al. 1993). The investigators indicate that the dermal effects may also have been a result of a local trauma effect of the protective equipment. 

Clinical examinations of the 11 exposed workers did not reveal signs of abnormal dermatological status. The investigators indicate that the dermal effects may also have been a result of a local trauma effect of the protective equipment. 

Bommannan, D., Potts, R. O. and Guy, R. H. Examination of stratum comeum barrier function in vivo by infrared spectroscopy. Journal of Investigative Dermatology 95(4) 403-408, 1990. 

Another disease of prominent dermatological interest is pellagra, in which pyridoxine deficiency seems to represent one of the pathogenetic factors even though of less importance than the fundamental niacin deficiency. For this reason Csermely and Zardi (G13) examined 12 patients with this disease in an attempt to demonstrate a pyridoxine deficiency by determining xanthurenic acid after loading wiA L-tryptophan (100 mg/kg). The results obtained (C13) show that an abnormal excretion of xanthurenic acid occurred in 5 of 12 patients. Furthermore, the clinical picture of the disease does not differ in patients with normal or abnormal xanthurenic acid output. These data provide no definite information in regard to this disease, in which more than one metabolite would have to be measured. 

The selected peel must be applied in strict accordance with the instructions for use. The practitioner should always bear in mind that the deeper the peel, the more effective it is, but also the more dangerous it is and that phenotype does not always correspond to genotype an individual who appears to have a light complexion may react dermatologically like a much darker phenotype. With this in mind, family anamnesis might well prove worthwhile. Examining... 

Self-examination of the skin places the responsibilities of identification on the individual. Identification of early melanoma allows the opportunity to treat the lesions when they are thin and curable. Educational pamphlets describing the method of self-examination (Table 133-2) for the public are available through the American Cancer Society, the American Academy of Dermatology, and the Skin Cancer Foundation. If a newly discovered pigmented lesion is identified or if a preexisting pigmented lesion changes, the individual should be evaluated by a physician immediately. 

The results of early treatment emphasize the role for early detection and prevention. The American Academy of Dermatology recommends monthly self-examination of skin to serve as a mechanism of recognizing moles or marks on the skin that may be melanoma. Patients with a strong family history should have a clinical examination, and in some cases, screening photography to document size, shape, and location of moles. 

We examined ALA-indueed porphyrin fluorescence in various dermatological disorders, particularly skin tumors. In the case of epithelial tumors, correlation was made between the elinieally detectable fluorescence extension and tumor margins as examined histopathologieally [12]. 

---