DOCSLIB.ORG

Occupational Skin Disease W.F

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Occupational Skin Disease W.F Occupational Skin Disease W.F. PEATE, M.D., M.P.H., University of Arizona College of Medicine, Tucson, Arizona Contact dermatitis, the most common occupational skin disease, is characterized by clearly demarcated areas of rash at sites of exposure. The rash improves on removal of O A patient informa- the offending agent. In allergic contact dermatitis, even minute exposures to antigenic tion handout on work-related skin substances can lead to a skin rash. Common sensitizing agents include nickel and mem- problems, written by bers of the Rhus genus (e.g., poison ivy, poison oak). Severe skin irritants tend to cause the author of this immediate red blisters or burns, whereas weaker irritants produce eczematous skin article, is provided on changes over time. An occupational cause should be suspected when rash occurs in page 1039. areas that are in contact with oil, grease, or other substances. Direct skin testing (patch or scratch) or radioallergosorbent testing may help to identify a specific trigger. Skin cancer can have an occupational link in workers with prolonged exposure to sunlight and certain chemicals, although it can take decades for lesions to develop. In workers with occupational skin disease, workplace changes and protective measures are impor- tant to prevent future exposure. (Am Fam Physician 2002;66:1025-32,1039-40. Copy- right© 2002 American Academy of Family Physicians.) ork-related skin diseases relationship between the skin condition (i.e., account for approximately onset, improvement, and recurrence) and the 50 percent of occupa- work exposure, including the effects of time off tional illnesses and are and return to work. An in-depth occupational responsible for an esti- history should cover the following points: Wmated 25 percent of all lost workdays. These 1. General work conditions (e.g., heat, dermatoses are often underreported because humidity) and specific activities in the their association with the workplace is not patient’s present job that involve skin contact recognized.1 with potential hazards. Note that Material Occupational skin diseases affect workers of Safety Data Sheets are more informative for all ages in a wide variety of work settings. large acute exposures than for the low-level Industries in which workers are at highest risk chronic exposures that are so common with include manufacturing, food production, skin conditions. construction, machine tool operation, print- 2. Physical, chemical, and biologic agents ing, metal plating, leather work, engine ser- (chemical and trade names) to which the vice, and forestry.2,3 patient is or may be exposed. 3. Presence of skin diseases in fellow workers. General Principles of Diagnosis 4. Control measures to minimize or prevent Because of the prevalence of occupational exposure in the workplace, including personal exposures that can cause or exacerbate skin and occupational hygiene (e.g., handwashing disorders, it is advisable to screen all patients instructions and facilities, showers, laundry with skin disease for a work-related cause. If service) and the availability of gloves, aprons, occupational skin disease is suspected, ques- shields, and enclosures. tions should be asked about the exact time 5. Compensation the patient received for skin disease in a previous job. 6. Other exposures, including soaps, deter- Work-related skin diseases account for approximately gents, household cleaning agents, materials used in hobbies (e.g., resins, paints, solvents), 50 percent of occupational illnesses and are responsible and topical medications, especially those con- for an estimated 25 percent of all lost workdays. taining sensitizing agents such as neomycin (e.g., Neosporin). SEPTEMBER 15, 2002 / VOLUME 66, NUMBER 6 www.aafp.org/afp AMERICAN FAMILY PHYSICIAN 1025 The depth of questioning should reflect sures can almost always provide some relief, the morphologic presentation of the skin but cure depends on identification of the disorder. The physician should look for offending agent and cessation of exposure. eczema, hives, asthma, hay fever, clothing or food allergy, psoriasis, acne, oily skin, mil- ACUTE DERMATITIS iaria (i.e., “prickly heat,”with many tiny vesi- Wet Dressings. Absorbent material (e.g., cot- cles near openings of sweat and sebaceous ton dressings) moistened with cool water or glands), contact allergies (e.g., reactions to Burow’s solution (aluminum acetate diluted metal objects, cosmetics, home cleansers), 1:40 in water) should be applied to the fungal infections (e.g., athlete’s foot, ring- affected area four to six times a day. The effects worm), family history of atopy or psoriasis, of this treatment include bacteriostasis, gentle and systematic diseases that may have skin debridement, debris removal, and evaporative manifestations (e.g., diabetes mellitus, cooling (which lessens pruritus). peripheral vascular disease). Steroids. Topical steroids have no effect on The history of the illness and the occupa- acute vesicular reactions, but they may be tional history may reveal a close association applied once vesicles have resolved. Systematic between the skin condition and a specific steroid therapy is indicated when lesions are work exposure known to produce such skin widespread, vesicular, and edematous or bul- effects. The appearance of the condition may lous. Short courses of prednisone, in a dosage also suggest the cause. For example, a glove- of 40 to 60 mg per day for five to seven days, pattern distribution of vesicular lesions on the are usually satisfactory and do not require hands strongly indicates a contact dermatitis. tapering. Secondary infections should be It is not unusual to discover an underlying treated. Systemic steroids should be used cau- skin disease that is exacerbated by work tiously in patients with diabetes mellitus, psy- exposures. However, multiple occupational chotic disorders, uncontrolled hypertension, and nonoccupational exposures may be or infections such as tuberculosis or herpes. identified, no clear time relationship between Systemic Antihistamines. Diphenhydramine the skin lesions and the work history may be (e.g., Benadryl), in a dosage of 25 to 50 mg found, or the skin lesions may be difficult to three or four times daily, or hydroxyzine classify. hydrochloride (Atarax), in a dosage of 25 mg three or four times daily, provides an antipru- General Principles of Treatment ritic effect. Because of the sedating effects of For therapeutic purposes, contact dermati- these drugs, patients should be advised against tis can be classified as acute (weepy, edema- operating machinery or vehicles. Doxepin tous, vesicular, blistered) or chronic (dry, (Sinequan), in a dosage of one to three 10-mg cracked, scaly, thickened). Therapeutic mea- capsules taken at night as needed, is effective, but patients should be monitored for anti- cholinergic effects. A 5 percent doxepin cream (Zonalon) is also effective. Topical antihista- The Author mines should be avoided because of their W.F. PEATE, M.D., M.P.H., is associate professor of clinical family and community med- potential sensitizing action. icine and director of occupational health/campus health at the University of Arizona College of Medicine, Tucson. Dr. Peate graduated from Dartmouth Medical School, CHRONIC DERMATITIS Hanover, N.H., and completed a master of public health degree at Harvard University, Boston. Emollients. Topical agents such as petrola- tum (Vaseline) provide an occlusive film over Address correspondence to W.F. Peate, M.D., M.P.H., University of Arizona College of Medicine, Department of Family and Community Medicine, 1435 N. Fremont, Tucson, inflamed skin, decrease fissuring, and reduce AZ 85719 (e-mail: [email protected]). Reprints are not available from the author. evaporation. Emollients are most effective 1026 AMERICAN FAMILY PHYSICIAN www.aafp.org/afp VOLUME 66, NUMBER 6 / SEPTEMBER 15, 2002 Occupational Skin Disease when they are applied after skin has been soaked or washed in water. In acute contact dermatitis, the skin is usually blistered Topical Steroids. These agents reduce inflam- and weepy. Chronic dermatitis typically leads to dry, scaly, mation and associated pruritus. Topical thickened skin. steroids should be applied no more than twice a day; more frequent use provides no advantage and may induce tachyphylaxis. Treatment with higher potency fluorinated steroids, such as CONTROL MEASURES 0.05 percent fluocinonide (Lidex), in contrast As long as proper protective measures are in to mid-potency 0.1 percent triamcinolone ace- place, workers with irritant or even allergic tonide (Kenalog), is indicated in patients with contact dermatitis often can remain on the job. more persistent dermatitis or chronic dermati- However, ordinary protective measures may be tis affecting the hands. Occlusion with plastic inadequate for some workers with allergic con- wrap or plastic gloves enhances absorption. tact dermatitis. It may be necessary to recom- Fluorinated steroids should not be used around mend that these persons be given a different the eyes, on the face, or in the groin area job or moved to another workstation. because of their long-term effects, which Many dermatoses can be prevented by include the development of striae. improved worker and workplace cleanliness. Workers should be counseled about personal General Principles of Prevention hygiene, and management personnel should and Control be advised about proper handwashing agents. Most occupational skin diseases can be Contact with organic solvents (e.g., mineral prevented.
Load more

Recommended publications
  • Copyrighted Material
    1 Index Note: Page numbers in italics refer to figures, those in bold refer to tables and boxes. References are to pages within chapters, thus 58.10 is page 10 of Chapter 58. A definition 87.2 congenital ichthyoses 65.38–9 differential diagnosis 90.62 A fibres 85.1, 85.2 dermatomyositis association 88.21 discoid lupus erythematosus occupational 90.56–9 α-adrenoceptor agonists 106.8 differential diagnosis 87.5 treatment 89.41 chemical origin 130.10–12 abacavir disease course 87.5 hand eczema treatment 39.18 clinical features 90.58 drug eruptions 31.18 drug-induced 87.4 hidradenitis suppurativa management definition 90.56 HLA allele association 12.5 endocrine disorder skin signs 149.10, 92.10 differential diagnosis 90.57 hypersensitivity 119.6 149.11 keratitis–ichthyosis–deafness syndrome epidemiology 90.58 pharmacological hypersensitivity 31.10– epidemiology 87.3 treatment 65.32 investigations 90.58–9 11 familial 87.4 keratoacanthoma treatment 142.36 management 90.59 ABCA12 gene mutations 65.7 familial partial lipodystrophy neutral lipid storage disease with papular elastorrhexis differential ABCC6 gene mutations 72.27, 72.30 association 74.2 ichthyosis treatment 65.33 diagnosis 96.30 ABCC11 gene mutations 94.16 generalized 87.4 pityriasis rubra pilaris treatment 36.5, penile 111.19 abdominal wall, lymphoedema 105.20–1 genital 111.27 36.6 photodynamic therapy 22.7 ABHD5 gene mutations 65.32 HIV infection 31.12 psoriasis pomade 90.17 abrasions, sports injuries 123.16 investigations 87.5 generalized pustular 35.37 prepubertal 90.59–64 Abrikossoff
    [Show full text]
  • BODY LOTIONS/CREAMS and HOMOEOPATHY © Dr
    BODY LOTIONS/CREAMS AND HOMOEOPATHY © Dr. Rajneesh Kumar Sharma M.D. (Homoeopathy) Homoeo Cure & Research Centre P. Ltd. NH 74, Moradabad Road, Kashipur (Uttaranchal) INDIA, Pin- 244713 Ph. 05947- 260327, 9897618594 [email protected], [email protected] Definition There are two types of body lotions and creams- 1- Moisturizers, lubricants or softening ones. 2- Cleansing ones. 1- Body lotions and creams are the cosmetic emollient substances, which when applied to skin, protect it from loss of moisture, lubricating and softening dead keratin, thereby lowering the rate at which water evaporates from the skin surface, acting similarly to the natural sebum, secreted by sebaceous glands of the skin. 2- Cleansing creams and lotions are detergent-based or emulsified oil systems that are designed primarily for the removal of surface oil, pollutants, or cellular debris along with makeup. History Perfumed oils About 3100–2907 BC, during the First empire of Egypt, men and women used perfumed oils, stored in unguent jars made of alabaster and marble, to maintain soft, supple, and unwrinkled skin. Face pack By the middle of the first century AD, Romans used a face pack of barley-bean flour, egg, and mashed narcissus bulbs to promote smooth skin. Cold cream A Greek physician of the second century AD invented cold cream containing water, beeswax, and olive oil. When rubbed on the face, the water evaporated, cooling the skin. (Cold cream formulations of the 1920s were of similar composition.) Oiled packs By 1700, smooth skin was in fashion and women applied oiled cloths on their foreheads and wore gloves in bed to prevent wrinkles.
    [Show full text]
  • EL 04-85-GC1 a Study to Define a Set of Requirements for Cleansing Agents for Use in the Space Station Whole Body Shower
    FINAL REPORT NAS 9-17428 - EL 04-85-GC1 A Study To Define A Set of Requirements For Cleansing Agents For Use in the Space Station Whole Body Shower. October 29, 1985 _ , MT.X \t> )> C ^ ^>'- N86-16903 S final Unclas 05 ml HC A05/WF A01 ECONOMICS LABORATORY. INC. Osborn Building St. Paul, Minnesota 55102 INDEX CONTENTS PAGE Introduction Final Report 1-26 Table #1 - Foam Test Results Table #2 - Shampoo Ingredient Comparisons Appendix A - Database References Appendix B - Dermal Sensitization Study Appendix C - Eye Irritation Study Appendix D - Protocol For Comparing Shampoos Appendix E - Detergent Filming Build Up Study Figure 1 - Whole Body Portable Shower Head Unit Page 2 October 25, 1985 NAS 9-17428 - EL 04-85-GC1 INTRODUCTION The purpose of this contract is to assist NASA engineers in defining a set of requirements for a whole body cleansing agent to be used in the Space Station Whole Body Shower System. In addition, cleansing agent candidates are to be identified that are likely to satisfy requirements defined in the first part of the study. It is understood that the main reason for having a Whole Body Shower is to satisfy the physiological, psychological and social needs of the crew throughout the duration of duty in ^ the Space Station. The cleansing agent must also be compatible with the vortex water/gas separator and the water reclamation system. To accomplish these goals the study was divided into six tasks. These tasks are as follows: 1. Task One: Survey literature and unpublished information to ascertain state-of-the-art in Whole Body Shower cleansing and the potential impacts of extended use of WBS cleansing agents in a mic'rogravity environment.
    [Show full text]
  • Dermatological Conditions
    18 Dermatological Conditions JAMES E. LESSENGER Key words: predisposing factors, patch testing, wood’s light, urticarian, dermatitis Skin problems in worldwide agricultural workers are very common. Among California grape and tomato harvesters, pustular eruptions such as acne and fol- liculitis were present in 30% of studied workers. Irritant or allergic contact der- matitis was present in 2%. In Iowa, 9.6% of male farmers and 14.4% of wives of farmers reported dermatitis during the previous 12-month period. In Washington State, researchers studied 7445 claims for occupational skin disorders filed over a 5-year period. Medical bills totaled $1.22 million, and lost time payments were $1.23 million. The highest rates of occupational skin disorder claims were seen in agriculture with 2.8 claims per 10,000 full-time equivalent employee years. Most of these skin disorders were due to chemical and vegetation exposures (1–4). Among northern Ecuadorian potato farm workers, high rates of dermatitis and pigmentation disorders were attributable to the use of pesticides and fungi- cides. Among California farm workers, skin disease rates were found in tomato workers (6.2%), citrus (10.8%), and vineyard workers (21.0%). Factors found to contribute to dermatitis in farm workers included the specific type of crop cul- tivated, specific job activity, use of personal protective measures, field and home sanitation, environmental conditions of heat and humidity, personal hygiene, allergic history (including atopy), and ethnicity. Several pesticides were shown to cause irritant and allergic contact dermatitis. Causes were found to include pes- ticides, naturally occurring plant substances, heat, sunlight and humidity, atopy, and infectious fungal and bacterial agents (5,6).
    [Show full text]
  • 15 Occupational Irritant Dermatitis – Metal Workers
    137 15 Occupational Irritant Dermatitis – Metal Workers Undine Berndt, Peter Elsner Contents tates the skin by denaturating keratin, defatting and dehydrating the stratum corneum [6, 7]. In addition, References . 138 frequent wetting and drying cycles contribute to the skin-damaging effect. An above-average incidence of irritant contact dermatitis in those machinists who work at machines with short running periods and do Although computerized tooling operations are in- mechanical work in between has been observed [8]. creasing, the metalworking industry is a trade that Within the phase of manual work, the cutting fluid continues to have a great deal of work done by hand. that the workers are exposed to during machine oper- Consequently, the parts of the body which are pre- ating dries on the skin surface, thus reaching a higher, dominantly affected by occupational skin disease are and thus, irritant concentration. the hands and forearms. Among the frequently ob- served cases of hand dermatitis in metalworkers, the vast majority is of irritant origin [1, 2] (Fig. 1). This condition is closely related to exposure to metalwork- ing fluids. These liquids are sprayed or flow over the Number of case work piece that is being shaped by different mechani- cal means, such as turning, drilling, grinding, or plan- ing. Thus, cutting fluids carry away the produced heat and decrease its production by lubricating the area Observation period (years) between the tool and the metal so as to minimize fric- Fig. 1. Cumulative incidence of irritant hand dermatitis dur- tion. Secondly, they wash away metal chips, reduce ing the observation of 201 trainee metal workers over a period strain hardening, and protect the workpiece against of 2.5 years [9] rusting [3,4].
    [Show full text]
  • Skin Notation (SK) Profile Pentachlorophenol (PCP) [CAS No
    Skin Notation (SK) Profile Pentachlorophenol (PCP) [CAS No. 87-86-5] Department of Health and Human Services Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Disclaimer Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health (NIOSH). In addition, citations to Web sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these Web sites. Ordering Information To receive this document or information about other occupational safety and health topics, contact NIOSH: Telephone: 1-800-CDC-INFO (1-800-232-4636) TTY: 1-888-232-6348 E-mail: [email protected] Or visit the NIOSH Web site: www.cdc.gov/niosh For a monthly update on news at NIOSH, subscribe to NIOSH eNews by visiting www.cdc.gov/niosh/eNews. Suggested Citation NIOSH [20XX]. NIOSH skin notation profile: Pentachlorophenol (PCP). By Hudson NL, Dotson GS. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. XXX DHHS (NIOSH) Publication No. XXX ii This information is distributed solely for the purpose of pre-dissemination peer review under applicable information quality guidelines. It has not been formally disseminated by the National Institute for Occupational Safety and Health. It does not represent and should not be construed to represent any agency determination or policy. Foreword As the largest organ of the body, the skin performs multiple critical functions, such as serving as the primary barrier to the external environment.
    [Show full text]
  • Journal of the Society of Cosmetic Chemists 1976 Volume.27 No.3
    Voi. 27 No. 3 March 1976 Journal of the Society of Cosmetic Chemists■ C o n te n ts Page REVIEW PAPER The nature of dandruff Albert M. Kligman, Kenneth J. McGinley, and James J. Leyden ................................................................................ Ill ORIGINAL PAPER Neue insektenabwehrmittel-am Stickstoff disubstituierte /3-alaninderivate (New insect repellent derivatives of N-diubstituted /3-alanine) Manfred Klier and Friedrich Kuhlow ........ ..................................... 141 DEPARTMENTS Synposes fo r c a rd in d e x e s ......................................................................................... XIX In d e x to a d v e rtis e r s ...................................................................................................... XXI Ü* jb. ' ' ' M JJ** La Gronda Sphinx, Asia Minor, 4th Century B.C What sets man apart from all other forms of life is creativity. And it is creativity that sets Givaudan apart. QVAUDAN ïttdeSÉeiïceiif* « < # creativity Givaudan Corporation, 100 Delawanna Avenue,Clifton, N.J.07014. In Canada Givaudan Limited. 60 Overlea Boulevard. Toronto. Ontario Also Argentina • Australia • Brazil • Columbia • England • France • West Germany • Hong Kong • Italy • Japan • Mexico • Republic of South For cold wave lotions and depilatories use Evans Thioglycol made from uniform and high quality vacuum di THIOGLYCOLIC ACID. EVANS THIOGLYCOLATES can help you three important advantages for your cold perman wave and depilatory formulations: (1) uniformity, (2) purity, (3) high quality. Get additional information from EVANS technical service specialists in the field of hair chemistry. EVANS SPECIALIZES IN COMPOUNDS FOR COLD WAVE LOTIONS (PERMS) Emulsifier K-700— a lanolin clouding agent with four ounces of water will produce a for PERMS containing wetting agents and viscous on-the-rod neutralizer. conditioning oils. 4. High Speed Neutralizer containing sodium PERM Neutralizers perborate monohydrate as the active in­ gredient is available either in foil enve­ 1.
    [Show full text]
  • Environmental Health Criteria 242
    INTERNATIONAL PROGRAMME ON CHEMICAL SAFETY Environmental Health Criteria 242 DERMAL EXPOSURE IOMC INTER-ORGANIZATION PROGRAMME FOR THE SOUND MANAGEMENT OF CHEMICALS A cooperative agreement among FAO, ILO, UNDP, UNEP, UNIDO, UNITAR, WHO, World Bank and OECD This report contains the collective views of an international group of experts and does not necessarily represent the decisions or the stated policy of the World Health Organization The International Programme on Chemical Safety (IPCS) was established in 1980. The overall objec- tives of the IPCS are to establish the scientific basis for assessment of the risk to human health and the environment from exposure to chemicals, through international peer review processes, as a prerequi- site for the promotion of chemical safety, and to provide technical assistance in strengthening national capacities for the sound management of chemicals. This publication was developed in the IOMC context. The contents do not necessarily reflect the views or stated policies of individual IOMC Participating Organizations. The Inter-Organization Programme for the Sound Management of Chemicals (IOMC) was established in 1995 following recommendations made by the 1992 UN Conference on Environment and Development to strengthen cooperation and increase international coordination in the field of chemical safety. The Participating Organizations are: FAO, ILO, UNDP, UNEP, UNIDO, UNITAR, WHO, World Bank and OECD. The purpose of the IOMC is to promote coordination of the policies and activities pursued by the Participating Organizations, jointly or separately, to achieve the sound management of chemicals in relation to human health and the environment. WHO Library Cataloguing-in-Publication Data Dermal exposure. (Environmental health criteria ; 242) 1.Hazardous Substances - poisoning.
    [Show full text]
  • 21 Atopic Dermatitis (Atopic Eczema, Disseminated Neurodermatitis, Besnier’S Prurigo)
    21 Atopic Dermatitis (Atopic Eczema, Disseminated Neurodermatitis, Besnier’s Prurigo) INTRODUCTION Atopic dermatitis is the cutaneous component of a complex hereditary predisposition that also includes a tendency toward bronchial asthma and immediate type I allergy to a range of environmental antigens manifest by allergic conjunctivitis. The linkage among the three is poorly understood but with careful history taking, 75 to 80% of patients are found to have a positive family history. Atopic dermatitis is a multifaceted problem and exhibits diverse physiological defects, which continue to lead investigators in many different directions. Among the more prominent features, there is evidence of a functioning, but disordered, immune system that overreacts through humoral mechanisms to common environmental antigens (pollen, danders, foods, house dust), while responses of the delayed or cellular immune system to certain antigens (toxicodendron, candida, tuberculin, and some viruses) are depressed. This defect of immune modulation is clinically manifest by abnormal handling of certain otherwise minor infections. Other features include inherently dry skin, altered vasomotor responses, and disturbed sweating with sweat retention. It is beyond the scope of this book to discuss the complex interactions in atopic der- matitis, but the practitioner must be aware of their existence, as they can be important in the recognition and treatment of certain cases. CLINICAL APPLICATION QUESTIONS A 68-year-old retired bank executive seeks your help regarding a progressively dis- abling and intensely pruritic rash that has generalized over the past 6 months. Examination reveals a widespread inflammatory dermatitis with excoriations and impetiginization. Heavily involved areas include the face, neck, upper back, scalp, and the dorsum of the hands.
    [Show full text]
  • 12.2% 116000 125M Top 1% 154 4300
    We are IntechOpen, the world’s leading publisher of Open Access books Built by scientists, for scientists 4,300 116,000 125M Open access books available International authors and editors Downloads Our authors are among the 154 TOP 1% 12.2% Countries delivered to most cited scientists Contributors from top 500 universities Selection of our books indexed in the Book Citation Index in Web of Science™ Core Collection (BKCI) Interested in publishing with us? Contact [email protected] Numbers displayed above are based on latest data collected. For more information visit www.intechopen.com ProvisionalChapter chapter 4 Occupational Acne Occupational Acne Betul Demir and Demet Cicek Betul Demir and Demet Cicek Additional information is available at the end of the chapter Additional information is available at the end of the chapter http://dx.doi.org/10.5772/64905 Abstract Occupational and environmental acne is a dermatological disorder associated with industrial exposure. Polyhalogenated hydrocarbons, coal tar and products, petrol, and other physical, chemical, and environmental agents are suggested to play a role in the etiology of occupational acne. The people working in the field of machine, chemistry, and electrical industry are at high risk. The various occupational acne includes chloracne, coal tar, and oil acne. The most common type in clinic is the comedones, and it is also seen as papule, pustule, and cystic lesions. Histopathological examination shows epidermal hyperplasia, while follicular and sebaceous glands are replaced by keratinized epidermal cells. Topical or oral retinoic acids and oral antibiotics could be used in treatment. The improvement in working conditions, taking preventive measures, and education of the workers could eliminate occupational acne as a problem.
    [Show full text]
  • Tissue Liver X-Receptor Alpha (Lxrα) Level in Acne Vulgaris
    TISSUE LIVER X-RECEPTOR ALPHA (LXRα) LEVEL IN ACNE VULGARIS Thesis Submitted for the fulfillment of Master Degree in Dermatology and Venereology BY Eman Abdelhamed Aly Nada (M.B.B.Ch) Supervisors Dr. Shereen Osama Tawfic Assistant prof.of Dermatology Faculty of Medicine Cairo University Dr. Marwa Ahmed Ezzat Lecturer of Dermatology Faculty of Medicine Cairo University Dr. Olfat Gamil Shaker Professor of Medical Biochemistry Faculty of Medicine Cairo University Faculty of Medicine Cairo University 2012 1 Acknowledgment First and foremost, I am thankful to God, for without his help I could not finish this work. I would like to express my sincere gratitude and appreciation to Dr. Shereen Osama Tawfic, Assistant Professor of Dermatology, Faculty of Medicine, Cairo University, for giving me the honor for working under her supervision and for her great support and stimulating views. Special thanks and deepest gratitude to Dr. Marwa Ahmed Ezzat, Lecturer of Dermatology, Faculty of Medicine, Cairo University, for her advice, support and encouragement all the time for a better performance. I am deeply thankful to Prof. Dr. Olfat Gamil Shaker, Professor of Medical Biochemistry, Faculty of Medicine, Cairo University for her sincere scientific and moral help in accomplishing the practical part of this study. I would like to extend my warmest gratitude to Prof. Dr. Manal Abdelwahed Bosseila, Professor of Dermatology, Faculty of Medicine, Cairo University, whose hard and faithful efforts have helped me to do this work. Furthermore, I would like to thank my family who stood behind me to finish this work and for their great support to me.
    [Show full text]
  • Management of Acne
    Review CMAJ Management of acne John Kraft MD, Anatoli Freiman MD cne vulgaris has a substantial impact on a patient’s Key points quality of life, affecting both self-esteem and psychoso- cial development.1 Patients and physicians are faced • Effective therapies for acne target one or more pathways A in the pathogenesis of acne, and combination therapy with many over-the-counter and prescription acne treatments, gives better results than monotherapy. and choosing the most effective therapy can be confusing. • Topical therapies are the standard of care for mild to In this article, we outline a practical approach to managing moderate acne. acne. We focus on the assessment of acne, use of topical • Systemic therapies are usually reserved for moderate or treatments and the role of systemic therapy in treating acne. severe acne, with a response to oral antibiotics taking up Acne is an inflammatory disorder of pilosebaceous units to six weeks. and is prevalent in adolescence. The characteristic lesions are • Hormonal therapies provide effective second-line open (black) and closed (white) comedones, inflammatory treatment in women with acne, regardless of the presence papules, pustules, nodules and cysts, which may lead to scar- or absence of androgen excess. ring and pigmentary changes (Figures 1 to 4). The pathogene- sis of acne is multifactorial and includes abnormal follicular keratinization, increased production of sebum secondary to ing and follicle-stimulating hormone levels.5 Pelvic ultra- hyperandrogenism, proliferation of Propionibacterium acnes sonography may show the presence of polycystic ovaries.5 In and inflammation.2,3 prepubertal children with acne, signs of hyperandrogenism Lesions occur primarily on the face, neck, upper back and include early-onset accelerated growth, pubic or axillary hair, chest.4 When assessing the severity of the acne, one needs to body odour, genital maturation and advanced bone age.
    [Show full text]