Irritant hand dermatitis

A Bauer, J Bong, P J Coenraads, P Eisner, J English, H C Williams, 2003 Interventions for preventing occupational irritant hand dermatitis .(protocol). Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No. CD004414. DOI 10.1002/146S18S8.CD004414. 

A number of individual factors for irritant dermatitis have been identified. Although occupational, irritant hand dermatitis is more frequent in females (Meding 1990), no sex difference of irritant reactivity could be established experimentally (Hogan et al. 1990). It is... 

The use of topical corticosteroids, used in the successful treatment of ACD, has been questioned as a treatment for irritant dermatitis (van der Valk and Maibach 1989). They may be effective in chronic, hyperkeratotic irritant dermatitis, but their prolonged use may lead to epidermal atrophy and, consequently, increased irritant sensitivity. Other therapeutic options in irritant dermatitis include topical tars and phototherapy (ultraviolet B or psoralen plus ultraviolet A). In difficult cases of chronic, irritant hand dermatitis, radiation may be indicated (Goldschmidt and Pan-izzon 1991). Bacterial superinfection may be a complication of contact dermatitis it is treated with topical or systemic antibiotics. Potential irritants, such as irritant cleansing products, must be identified and (whenever possible) eliminated, not only in the workplace but in the home (Frosch 1989). 

Eisner P, Baxmann F, Liehr HM (1995) Metal working fluid dermatitis a comparative follow-up study in patients with irritant and non-irritant hand dermatitis. In Eisner P, Maibach HI (eds) Irritant dermatitis new clinical and experimental aspects. Karger, Basel, pp 77-86 Emtestam L, Ollmar S (1993) Electrical impedance index in human skin measurements after occlusion in 5 anatomical regions and in mild irritant contact dermatitis. Contact Dermatitis 28 104-108... 

Tertiary prevention of occupational skin disease addresses mainly chronic irritant hand dermatitis or allergic contact dermatitis. Apart from clearing the current skin disease, efforts should be directed toward a marked improvement of working conditions, e.g., completely eliminating skin contact with known indi-... 

Keezkes K, Bhate SM, Wyatt EH (1983) The outcome of primary irritant hand dermatitis. Br J Dermatol 109 665-668... 

Many work activities, such as wet work or work resulting in physical damage to the skin or contact with soap, detergents, other technical products or foods, involve the risk of contracting irritant hand dermatitis. The work also involves exposure to many common allergens, such as nickel, colophony and cosmetic ingredients. 

Metal workers are exposed to numerous exogenous factors that play a substantial role in tbe development of allergic as well as irritant contact dermatitis (ICD). Even though nickel is regarded as the most frequent source of all reported metal allergies [i], metal-work fluids (MWFs) are the most important cause of irritant hand dermatitis. Other factors such as metal dust, friction, pressure, heat and humidity also contribute to the irritation of the skin [2]. However, the metal industry is a wide fleld, and exposure may vary widely depending on the kind of job and the type of metal industry. 

In one Australian study, out of 954 patients with occupational contact dermatitis, 61 % reported having had lost time at the workplace due to their skin disorder [69], As noted in previous section, irritant hand dermatitis as in the case of hand eczema are the most common of all occupational skin disorders reported [72], Also the hands are the primary site of involvement in 80 % of cases of occupational dermatitis, followed by the wrists and forearms [70],... 

Jungbauer FHW, van dur Vleuten P, Groothoff JW, et al. Irritant hand dermatitis severity of disease, occupational exposure to skin irritants and preventive measures 5 yetu after inititil diagnosis. Contact Dermatitis. 2004 50 245-51. 

Ten of 12 workers experienced acute irritant contact dermatitis of the hands after 2 days of direct contact. In the most severe case, a woman with no previous skin problems, who wore latex gloves intermittently, had painful swelling of the fingers of both hands with redness and vesicles on the palms. The affected skin later became thickened and showed a brownish discoloration. Another worker noticed small vesicles on the forehead, probably due to scratching with contaminated fingers. All cutaneous reactions cleared within 3 weeks of termination of exposure. Gas chromatograph analysis of the NMP used at the factory did not reveal any contaminating compounds. 

Unspecific irritations of skin and mucosa membrane structures can be caused by solvents. Various solvents are significant occupational irritants, e.g., solvents which cause irritant contact dermatitis."" Intact skin structures can be destroyed by solvents which dissolve grease and fat. Typically, the dermatitis is characterized by dryness, scaling and fissuring and is usually located on the hands. It is often caused by handling solvent-contaminated products or by cleaning procedures." ""... 

Cronin E (1995) Hand eczema. In Rycroft RJG, Menne T, Frosch PJ (eds) Textbook of contact dermatitis. Springer, Berlin Heidelberg New York, pp 207-218 Darre E, Vedel P, Jensen JS (1987) Skin protection against methylmethacrylate. Acta Orthop Scand 58 236-238 de Boer EM, van Ketel WG, Bruynzeel DP (1989) Dermatoses in metal workers I Irritant contact dermatitis. Contact Dermatitis 20 212-218... 

Mozzanica N (1992) Pathogenetic aspects of allergic and irritant contact dermatitis. Clin Dermatol 10 115-121 Nilsson E (1986) Individual and environmental risk factors for hand eczema in hospital workers. Acta Derm Venereol Suppl (Stockh) 128 1-63... 

Seidenari S (1996) Skin sensitivity, interindividual factors atopy. In van der Valk PGM, Maibach HI (eds) The irritant contact dermatitis syndrome. CRC, New York, pp 267-277 Singgih SI, Lantingha H, Nater JP, Woest TE, Kruyt-Gaspersz JA (1986) Occupational hand dermatoses in hospital cleaning personnel. Contact Dermatitis 14 14-19 Skogstad M, Levy F (1994) Occupational irritant contact dermatitis and fungal infection in construction workers. Contact Dermatitis 31 28-30... 

Figs. la,b. Carpenter with frictional irritant contact dermatitis involving only the sites in contact with screws and nails the rest of the hand was spared... 

Paulsen E, Andersen KE (1991) Irritant contact dermatitis of a gardener s hands caused by handling fur-covered plant ornaments. Am J Contact Dermat 2 113-116... 

One of the major risk factors is a history of AD. The possibility of hand eczema occurring later in life increases significantly if the AD was severe during childhood and was localised in the hands (60-90% of these patients and 40% of patients with moderate AD develop hand eczema later in working life). The risk of hand dermatitis decreases if the AD was mild. The risk of developing hand dermatitis has been estimated to be threefold in atopic relative to non-atopic workers if there is exposure to skin-irritating factors. Episodes of hand eczema can occur in patients predisposed to AD, even if they are not in working life or are just in clean, dry office work. 

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