Diseases of the skin

The term dermatitis simply means an inflammation of the skin. When the condition is due to contact with a substance at work it is called occupational or industrial dermatitis. It is a common cause of occupational disease but the number of cases is declining owing to improv work conditions. 

The skin has two layers, the outer layer is called the epidermis and the inner the dermis. The epidermis has a protective function. It consists of densely packed flat cells, thicker in some areas, like the palms of the hands, which are more subject to injury. It is covered by a moist film known as an acid mantle, made up of secretions from sweat and sebaceous glands, that helps to protect from acids, alkalis, excessive water, heat and friction by preventing the skin from drying out. The natural grease of the skin can be removed by solvents. In the deeper layer of the epidermis are pigment cells which produce the tan following exposure to sunlight and protect the body from ultraviolet radiation. 

Sensitisers, on the other hand, do not cause dermatitis until the individual has first become sensitised by them. This involves an allergic response 

Persons with dermatitis or sensitive skin may need to be excluded from certain kinds of work. Good personal hygiene is essential and barrier creams may be helpful. Protective clothing should be considered. 

Workers clothes become begrimed with the offending substance, making close contact with the scrotum, the wrinkled skin of which favours the harbouring of the carcinogen. 

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Galen, a physician whose views outUved him by about a thousand years, died about 200 AD. He beUeved that mercurials were toxic, and did not use any mercury compound therapeutically. However, as a result of Arabian influence, the therapeutic uses of mercury were slowly recognized by Western Europe. In the thirteenth century mercury ointments were prescribed for treating chronic diseases of the skin. Mercury and its compounds, such as mercurous chloride, mercuric oxide, mercuric chloride, and mercuric sulfide, were used widely from the fifteenth to the nineteenth centuries, and to some extent in the twentieth century. During the first half of the twentieth century, the primary therapeutic uses of mercury included bactericidal preparations, such as mercuric chloride, mercuric oxycyanide, and mercuric oxide and diuretics, such as aryl HgX (Novasural) and mercurated ahyl derivatives (14). 

Products for use on the skin are designed to improve skin quality, to maintain (or restore) skin s youthful appearance, and to aid in alleviating the symptoms of minor diseases of the skin. Many of these products are subject to different regulations in different countries. Skin products are generally formulated for a specific consumer purpose. 

Pustule Scleroderma Small elevation of the skin filled with pus A disease of the skin... 

Fungicides have caused a number of human health disasters. In the late 1950s, approximately 4000 people in Turkey were poisoned by hexachlorobenzene that had been applied to seed grain to protect against soil fungus. Adults and particularly children developed diseases of the skin and bone. In Iraq, a similar incident occurred when people consumed grain coated with a mercury compound. 

Fiji. Fresh root is taken orally for asthma and indigestion. Fresh root juice is applied ophthalmically as drops for bloodshot eyes and other problems. Seed is taken orally for rheumatism and to treat hoarseness . Guatemala. Leaves are applied externally by adults for myasis, headache, and wounds " . A mixture of the leaf with menthol VapoRub is applied externally for children for cough . Fiot water extract of the dried leaf is applied externally for ringworms, fungal diseases of the skin L wounds, ulcers, bruises, sores, mouth lesions, stomatitis, and mucosa k The leaf is taken orally for kidney diseases . 

Diseases of the skin offer special opportunities to the clinician. In particular, the topical administration route is especially appropriate for skin diseases, although some dermatologic diseases respond as well or better to drugs administered systemically. 

Lupus erythematosus. A disease of the skin and of some deeper collagenous tissues, often associated with rheumatoid arthritis. 

Seborrhoeic dermatitis. A chronic inflammatory disease of the skin of unknown aetiology. Spasmolytic (antispasmodic). An agent to relieve muscular spasm, e.g. of the bowel. Synergism. The use of two drugs to produce an effect that is greater than the sum of their individual effects. 

A.G.Peterkin, "The Common Diseases of the Skin , Oliver Boyd, Edinburgh, 4th ed (1950), 282pp (Reviewed in Bull Johns Hopkins Hospital 87, 89 (1950) 20)H.O.Mackey, "A Handbook of... 

Diseases of the Skin , Fallon, Dublin (1952), 2l6pp (Reviewed in J Am Med Assoc 150, 1441 (1952) 21)S.Kubota, J Soc Org Synthetic Chem, Japan 14, 35L52 (1956) CA 51, 3143 (1957) (TNT dermatitis) 22)G.H.Percival, "An Introduction to Dermatology , Williams Wilkins, Baltimore, 12th ed (1956), 3 4pp 23)Sax (1957), 207-24 24)K-L.Golshmid, "Zabolevaniya Kozhi u Rabochikh Khimicheskikh Proizvodstv.Ikh Preduprezhdenie i Lechenie (Skin Diseases of the Workers of Chemical Industries), Knizh-Izdatel, Perm (I960), 71PP 25)R-L.Baer V. 

O. volvulus. This is the causal organism of human onchocerciasis, which is a disease of the skin and eyes. This disease affects between 20 and 40 million people in the world, frequently causing blindness and skin pathology. The tropical zones most affected are Africa, Guatemala and Mexico. A mild form of the disease threatens to spread in tropical South America. The microfilariae circulate in the peripheral blood day and night. Many mosquitoes, such as Culex, Anopheles, Mansonia, Aedes, and Simulium Spp., are vectors for this and other types of filariasis. 

Griseofulvin (Fulvicin and Grisactin) is a fungistatic effective against various dermatophytes, including Microsporum, Epidermophyton, and Trichophyton, that produce diseases of the skin, hair, and nails. It exerts its effect by inhibiting fungal mitosis. 

Vitamin A may be helpful in certain diseases of the skin, such as acne, psoriasis, Darier s disease, and ichthyosis. 

Not surprisingly, the cutaneous microbiome has been studied for its potential role in dermatologic conditions such as psoriasis, atopic dermatitis, and acne. Psoriasis, a chronic idiopathic inflammatory disease of the skin (170), has been associated with an overrepresentation of Firmicutes and underrepresentation of Actinobacteria when compared to both the unaffected skin of psoriatic patients and the skin of normal controls (171). Additionally, Pro-teobacteria were detected less frequently in psoriatic lesions compared to skin of healthy controls (171). Subsequent studies using pyrosequencing techniques confirmed that Actinobacteria were more abundant in controls compared to patients with psoriasis however, Proteobacteria were significantly higher in trunk skin samples from psoriatic patients compared to controls (172). 

Psoriasis is universal in occurrence. It is a disease of the skin characterized by variable clinical features. The cutaneous lesions are usually so distinct that a clinical diagnosis is easy to make. Psoriatic lesions are classified as erythrosquamous, which indicates that both the vasculature and the epidermis are involved.1... 

Some of the most important physiological steroids are the adrenocortical hormones, synthesized by the adrenal cortex. Most of these hormones have either a carbonyl group or a hydroxyl group at Cl 1 of the steroid skeleton. The principal adrenocortical hormone is cortisol, used for the treatment of inflammatory diseases of the skin (psoriasis), the joints (rheumatoid arthritis), and the lungs (asthma). Figure 25-10 compares the structure of natural cortisol with two synthetic corticoids fluocinolone acetonide, a fluori-nated synthetic hormone that is more potent than cortisol for treating skin inflammation and beclomethasone, a chlorinated synthetic hormone that is more potent than cortisol for treating asthma. 

Cunliffe B (2001) Diseases of the skin and their treatment acne. The Pharmaceutical journal 267 749-752. 

Diseases of the Skin , Fallon, Dublin (1952), 216PP (Reviewed in J Am Med Assoc 150, 1441 (I952) 21)S.Kubota, J Soc Org Synthetic Chem,... 

Vitamin D has recently found an association with psoriasis, a common disease of the skin. Psoriasis is not curable, but a variety of skin ointments can reduce the severity of the skin lesions. One of these ointments is a chemical analogue of vitamin D called calcipotrlene. Calcipotrienc was developed after initial observations that oral or topical caldtriol was effective against the disease, The drug results in improvement tn 60% of patients (Greaves and Weinstein, 1995),... 

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