The Health Status of Hispanic Agricultural Workers in Georgia and Florida

To examine the health status of Hispanic agricultural workers in Florida and Georgia. Health data from agricultural workers in the Farm Worker Family Health Program (June 2019) and research studies in Florida (May 2015 and May 2019) were examined. Data from 728 agricultural workers were collected through sociodemographic questionnaire and clinical data. In the Florida sample, 83% were overweight or obese, 70% elevated blood pressure, 60% met the definition of prediabetes. In Georgia, 64% were overweight or obese and 67% had elevated blood pressure. Weak correlations were observed between BMI and systolic blood pressure (unadjusted r?=?0.20), diastolic blood pressure (unadjusted r?=?0.19), and glucose (unadjusted r?=?0.14). Adjusting for age and gender did not show statistically significant correlation between BMI and systolic and diastolic blood pressure or glucose. While BMI has been shown to be strongly associated with high blood pressure and impaired glucose, we found a weak correlation among agricultural workers. Given the common and high use of pesticides and elevated rates of hypertension, impaired glucose, and adiposity in agricultural workers, the public health impact of this relationship may require and lead to occupational reform that protects the health of agricultural workers. Future studies should assess occupational and environmental factors and lifestyle differences between agricultural workers and the general population to better understand these discrepancies in health status.

     

Tick-borne dermatologic diseases

Inquiries regarding tick exposure can be important in dermatologic diagnosis and treatment since ticks can be vectors of a diversity of infectious diseases. The classic teaching is that ticks are best removed with nail polish, solvents, petrolatum, mineral oil, or a hot match. However, a recent evaluation of tick removal revealed that mechanical removal with forceps preceded and followed by disinfection is the most effective method. In most cases, should the characteristic dermatologic lesion or systemic symptoms appear, appropriate treatment should be initiated for presumptive diseases.     

Dermatologic manifestations of fluoride exposure

The dermatologic manifestations of fluoride/fluorine exposure have not been established definitively. There is no evidence of allergic dermatologic reactions to fluorides, and the most reproducible toxic reactions are those to inorganic gaseous fluorines and solutions of hydrogen fluoride, which produce burns. Anecdotal associations have included papulondular and pustular eruptions secondary to topical fluoride-containing preparations, telangiectases and Chizzola maculae in the setting of airborne inorganic fluorides. Carefully controlled studies are needed to identify fluoride as the primary cause of these dermatoses, as well as to correlate the gross pathology, specific histopathology, and plasma levels of fluorine.     

Capsaicin as an in vitro inhibitor of benzo(a)pyrene metabolism and its DNA binding in human and murine keratinocytes

Capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide), the active principle of capsicum fruits, such as hot peppers, is a known inhibitor of substance P. This substance was also found to be a potent in vitro inhibitor of human and murine epidermal metabolism of benzo(a)pyrene (BP) and the enzyme-mediated binding of BP metabolites to DNA. In both untreated and 3-methylcholanthrene-treated neonatal rat epidermal microsomes, capsaicin resulted in a dose-dependent inhibition of aryl hydrocarbon hydroxylase activity with an I50 value of 3.0 X 10(-4)-3.6 X 10(-4) M. A Lineweaver-Burk plot of the inhibition of aryl hydrocarbon hydroxylase activity suggested that the inhibition is of the noncompetitive type with Ki value of 50 microM. Capsaicin also inhibited BP metabolism and the binding of 3H-BP to DNA in BALB/c mouse and human keratinocytes. The formation of BP-7,8-diol was also substantially diminished in both systems in the presence of capsaicin (180-300 microM). Our results indicate that the substance P inhibitor, capsaicin, is also an inhibitor of epidermal BP metabolism and DNA binding of its metabolites. Therefore, in addition to its neurological effects, capsaicin may represent a new category of compound with anti-carcinogenic effects.     

Evaluation of alopecia: a new algorithm

The clinical evaluation of alopecia is becoming less precise as more histopathologic correlations become available. According to the classic approach, the clinician should initially differentiate between scarring and nonscarring alopecia. Because several case reports in the past ten years have demonstrated that the definition of "scarring alopecia" is ambiguous, the use of the traditional schema--scarring versus nonscarring--may well be outmoded. Therefore, we propose a new algorithm for the evaluation of alopecia that emphasizes the importance of both clinical and histologic findings.     

Metastatic malignant melanoma arising from a common blue nevus in a patient with subacute cutaneous lupus erythematosus

We describe a 66-year-old black male who first presented with subacute cutaneous lupus erythematosus (SCLE) and was later found to have malignant melanoma adjacent to a common blue nevus. The melanoma was located on the left buttock and in several left inguinal lymph nodes. Following complete resection and lymph node dissection the patient developed widespread leukoderma. To our knowledge this is the first report of malignant melanoma arising in a common blue nevus. The literature on SCLE and leukoderma in the setting of melanoma is reviewed.