Occupational contact psoriasis

Kanerva L, Jolanki R, Toikkanen J, Tarvainen K, Estlander T (1995) Statistics on occupational dermatoses in Finland. In Eisner P, Maibach HI (eds) Irritant dermatitis. New clinical and experimental aspects. Curr Probl Dermatol 23 28-40 Kanerva L, Talvi A, Estlander T (1998) Occupational contact psoriasis. Eur J Dermatol 8 217-218 Lammintausta K, Kalimo K, Havu VK (1982) Occurrence of contact allergy and hand eczema in hospital wet work. Contact Dermatitis 8 84-90... 

Moroni et al. (1988) reported that occupational contact psoriasis probably accounted for 1.2% of all the occupational dermatoses in 3000 patients observed over a 5-year period (1980-1985) in their department. 

Ancona et al. (1986) proposed the following diagnostic criteria for occupational contact psoriasis (1) clinically demonstrable psoriasis localised to hands, mainly palms, without significant involvement elsewhere, or (2) psoriasis affecting other sites except the hands with further development of lesions on this location after engaging in a particular job. 

Pre-employment evaluation of workers serves the purpose of primary prevention against occupational skin disease. Screening prospective workers for an increased risk of developing occupational contact psoriasis, by looking for personal and familial psoriatic background and the physical markers of the disease, may be important in job placement. Workers with predisposition to psoriasis should be discouraged from holding jobs that expose them to risk of skin injury and repetitive trauma. 

The importance of preventing occupational contact psoriasis in the work environment goes beyond the morbidity and cost in managing these patients. As trauma may incite or trigger new lesions of psoriasis, it is potentially a medico-legal issue, especially in countries where workman s compensation is a major concern (Rietschel and Fowler 1995). 

Primary prevention should be practised by identifying individuals with the propensity to develop occupational contact psoriasis during the course of work. Once identified, these individuals should be counselled accordingly before embarking on their careers. 

Fisher AA (1979) Occupational palmar psoriasis due to safety prescription caps. Contact Dermatitis 5 56 Kanerva L, Talvi A, Estlander T (1998) Occupational contact psoriasis. Eur J Dermatol 8 217-218 Melski JW, Bernhard JD, Stern RS (1983) The Koebner (isomorphic) response in psoriasis. Arch Dermatol 119 655-659 Moroni P, Cazzaniga R, Pierini F, Panella V, Zerboni R (1988) Occupational contact psoriasis. Dermatosen 36 163-164 Rietschel RL, Fowler JF (1995) Fisher s contact dermatitis, 4th edn. Williams and Wilkins, Baltimore, pp 92-113... 

Most people are exposed to very low levels of coal tar. In the general population, exposure is most likely through products that contain coal tar or similar materials to improve a health problem such as eczema or psoriasis. Occupational exposure to coal tar could occur through contact with the skin or by inhalation exposure to volatile fractions when coal tar is heated. 

Mathias (1988) reported 13 similar cases which he termed post-traumatic eczema. The injuries were mainly of occupational origin. Eczema started within a few weeks after the trauma, and the individual lesions recurred for up to 8 years. Post-traumatic eczema has to be differentiated from other eczematous and non-eczematous disorders, such as trauma-induced psoriasis, foreign-body reaction and recurrent herpes simplex precipitated by trauma. Superimposed allergic contact dermatitis from topical preparations used to treat the eczematous skin must be excluded. 

Rudzki E, Rebandel P (1990) Dermatitis from methyl 2,3 epoxy-3-(4-methoxyphenyl)propionate. Contact Dermatitis 23 382 Rycroft RJG (1980) Atypical psoriasis following epoxy resin sensitization. J Soc Occup Med 30 132-134 Sasseville D (1998) Contact urticaria from epoxy resin and reactive diluents. Contact Dermatitis 38 57-58 Savla M (1977) Epoxy resin adhesives. In Skeist I (ed) Handbook of adhesives, 2nd edn. Van Nostrand Reinhold Co, New York, pp 434-464... 

A double-blind, placebo-controlled allergenicity study using aniseed in spice industry workers found positive results in skin prick, and nasal and oral challenge tests. Other case reports of occupational allergic reactions to anise include a psoriasis-Uke allergic contact dermatitis from exposure to the seed oil and allergic asthma from exposure to the seed dust. ... 

---