Occupational contact dermatitis

The dermatologist should be aware of the many facets of occupational skin diseases, which can be caused by physical, chemical, and biological insults. The most common manifestation of occupational skin diseases is contact dermatitis (both irritant and allergic). Three factors point out the importance of occupational skin diseases as diseases that have a public health impact: 1) occupational skin diseases are common; 2) they often have a poor prognosis; and 3) they result in a noteworthy economic impact for society and for an individual. They are also diseases amenable to public health interventions. Specific industries and exposures may put a worker at risk of occupational contact dermatitis. The accuracy of the diagnosis of occupational contact dermatitis is related to the skill level, experience, and knowledge of the medical professional who makes the diagnosis and confirms the relationship with a workplace exposure. Prevention of occupational contact dermatitis is important, and a variety of prevention strategies are available.     

Occupational airborne contact dermatitis from omeprazole

Tixocortol pivalate (TP) is a good marker for hydrocortisone allergy. The concentration of TP to be included in the standard series for patch testing has been the subject of debate. The objective of this study was to investigate the right concentration of TP to be included in the standard series for patch testing. 3747 consecutive patients with dermatitis were patch tested simultaneously with TP 1% and 0.1% in petrolatum at 9 centres in the UK from August 2004 to December 2005. Statistical analysis of the results was performed using STATISTICA, version 6 software. 41 patients had positive reactions of current or past relevance. 20 were positive for both concentrations, 13 positive only for TP 1% concentration, and 8 positive only for 0.1% concentration. Statistical analysis, using a two-tailed difference in proportions test, did not show a significant difference between the 2 concentrations (P=0.21). There was no statistically significant difference between the 2 concentrations of TP. The number of allergens that can be included in the standard series is limited for practical considerations. When testing for screening purposes, TP 1% is recommended.     

Occupational pigmented contact dermatitis from azo-dyes

A 51-year-old man had been working in a dye factory for 25 years and had noticed itching and pigmentation on the extremities for the past 5 years. Patch testing showed positive reactions to Sudan I and Vacanceine Red, among the azo dyes which he had been handling. After he changed his work, he became free from erythematous lesions with itching. The pigmentation almost disappeared 10 months later.     

Occupational airborne allergic contact dermatitis from azithromycin

The Dutch government has recently taken initiatives to improve the protection of labourers against diseases which are related to their work, and most especially, to reduce the rapidly increasing number of patients who have to definitely stop working and who, eventually, end up being dependent on social welfare. Firstly, a number of new laws have been adopted which define the responsibilities of both the employers and the employees. Secondly the cooperation is stimulated between the Dermatologist and the Occupational Health Physician of the patient. The latter is (according to law) employed by the employer of the patient and regularly visits the place of work. We now had the opportunity to treat and study both the social, medical and occupational aspects of a patient's case simultaneously.
We decided to eliminate the existing hesitation of consulting or referring, as well as the barriers created by matters of procedure, bureaucracy and waiting lists. In our paper we discuss the above‐mentioned laws and regulations, and the way in which cooperation takes place between the doctors. We will present figures showing the effects of this approach on sickleave.