常见环境接触因素在手部皮炎发病中的作用

通过问卷调查及斑贴试验对常见环境接触因素在48例手部皮炎患者发病中的作用进行了研究。结果确诊接触性皮炎7例(14．6％),其中5例为职业性接触性皮炎;其余41例为可疑接触性皮炎。手部皮炎患者斑贴阳性率偏低(51％);洗涤剂引起或加重患者病情的占41．7%。水引起或加重患者病情的占39．6％;说明刺激因素在手部皮炎中也很重要。可疑接触性皮炎患者斑贴阳性率为46．3％,接触过敏因素在这部分患者发病中的作用仍不能忽视。明确斑贴试验阳性结果与疾病的联系是进一步必须研究的课题。     

62例面部皮炎患者斑贴试验分析

目的：探讨面部皮炎的致敏原及其特点。方法：采用欧洲标准筛选变应原对62例面部皮炎患者进行斑贴试验。结果：列前10位的常见致敏原分别是芳香混合物，对苯二胺、重铬酸钾、松香、硫酸镍。结论：斑贴试验是面部皮炎患者寻找致敏原的有效方法。     

495例面部皮炎的斑贴试验分析及临床意义

目的:研究面部皮炎患者斑贴试验的结果及临床意义。方法:对本科门诊确诊的495例面部皮炎患者进行斑贴试验,并对结果作统计学处理。结果:斑贴试验总阳性率89.49%,其中老年组患者阳性率明显低于青年组和中年组,性别差别无统计学意义。阳性率居前5位的变应原依次为:重铬酸钾、硫酸镍、芳香混合物、甲醛和卡巴混合物,其中卡巴混合物的阳性率男性明显高于女性,硫酸镍阳性率女性明显高于男性。58.47%的病例同时存在3种及以上的阳性变应原。结论:重铬酸钾、硫酸镍、芳香混合物、甲醛和卡巴混合物是本地区面部皮炎的常见变应原,男女患者对卡巴混合物和硫酸镍的反应存在差异,斑贴试验对面部皮炎寻找致敏原及防治具有重要的参考价值。     

武汉某高校大学生面部皮炎患病情况及影响因素分析

目的 分析探讨某高校大学生常见面部皮炎发病情况与相关影响因素。方法 参与研究的面部皮炎患者以体格检查和调查问卷方式获得详细病史,部分患者行斑贴试验。结果 入选病例174人,男女比例为1∶4.44,平均年龄(20±19.22)岁。分类诊断为接触性皮炎(29.9%)、激素依赖性皮炎(21.3%)、特应性皮炎(12.1%)、季节性皮炎(14.4%)、脂溢性皮炎(8.0%)、日光性皮炎(4.6%)、其他类型皮炎(9.8%)。其中激素依赖性皮炎、特应性皮炎患者性别分布与总样本的比较差异有统计学意义(χ²=10.590,P=0.001;χ²=6.178,P=0.030)。患者皮肤油型最多(42.2%),皮损以红斑丘疹为主(87.1%),瘙痒症状最明显(84.2%)。睡眠时间、心理因素与面部皮炎的发病无关(P均>0.05)。斑贴试验总阳性率为72.4%,性别间阳性率差异无统计学意义(χ²=2.882,P=0.089)。十二醇硫酸钠(20.09%)、脂肪酸硫酸钠(18.13%)、香料混合物(11.85%)是最常见的变应原。结论 某...     

720例皮炎湿疹类皮肤病接触性致病因素探讨

为了探索皮炎湿疹类皮肤病接触性致病因素，应用ＧＢ７８０４－８７中规定的２３种标准抗原对７２０例皮炎湿疹类皮肤病患者进行皮肤斑贴试验。对１种以上被试物呈阳性反应的有３７６例，总阳性率５２．２％。其中阳性率较高的抗原依次为：硫酸钴（１１８例，１６．４％）、重铬酸钾（１１５例，１６．０％）、氯化镍（１０８例，１５．０％）、升汞（１０６例，１４．７％）、北海洗衣粉（６３例，８．８％）、对苯二胺（５０例，６．９％）。阳性率在１％以上者有１８种抗原。斑试阳性结果与病史中临床接触史符合者１１３例，占７３．９％。表明抗原标准系列在探索皮炎湿疹类皮肤病接触性致病因素中起重要作用。     

斑贴试验在诊断接触性皮炎中的应用及体会

统计分析56例接触性皮炎患者的致敏原斑贴试验结果。致敏原分别是硫酸镍、甲醛、香料、对苯二胺、重铬酸钾、松香、橡胶、乙二胺和环氧树脂。斑贴试验不仅有助于确定接触性皮炎患者的致敏原,还有助于确定职业性皮炎的致病原因。     

158例芒果皮炎临床分析

1999年 4月至 2 0 0 0年 9月 ,厦门市中山医院皮肤科门诊收治接触芒果过敏者 15 8例 ,现将资料进行分析报告如下 :1　临床资料1.1　一般资料　接触芒果过敏者 15 8例 ,其中男 4 5例 ,女 113例 ,年龄 2～ 5 2岁 ;第 1次发病 119例 ,发病 2次以上 39例 ,发病前均有接触芒果。发病人群中以女性多于男性 ,年龄 6～ 35岁居多 ,过敏高峰期 4～ 7月 ;患者中 5 0例 (31.7% )既往有油漆过敏。对患者就诊后按接触方式的不同 ,皮损的分布、特征及再次接触后的症状进行详细记录 ,并作血常规检查及皮炎消除后的斑贴试验研究。1.2　临床表现　所有患者皮损…     

180例皮炎湿疹类患者斑贴试验结果分析

目的探讨溧水地区常见变应原种类,以更好地预防和治疗过敏性皮肤病。方法应用"瑞敏"牌斑贴试剂盒对180例(面部皮炎106例,手部湿疹47例,外阴湿疹27例)过敏性皮肤病患者进行皮肤斑贴试验,并以36例健康者为对照。结果过敏组斑贴试验阳性率74.44%,高于对照组(2.78%)(χ2=66.58,P0.01),3组病例间差别无统计学意义。常见过敏原依次为硫酸镍(23.89%)、卡巴混合物(20.00%)、芳香混合物(19.44%)、重铬酸钾(17.22%)、对苯二胺基质(13.89%);3组病例中均有超过半数的病例存在2种及以上的阳性变应原;男女性患者斑贴试验阳性率差异有统计学意义的变应原,分别为卡巴混合物(33.33%,13.82%)、芳香混合物(12.28%,22.76%)。结论硫酸镍、卡巴混合物、芳香混合物、重铬酸钾、对苯二胺基质是引起溧水地区皮炎湿疹类患者的主要变应原。     

182例接触性皮炎及湿疹患者斑帖试验结果分析

目的　探讨成都地区接触性皮炎及湿疹病因及规律。方法　用IQ标准系列斑贴试验试剂盒对患者进行检测。结果　 182例患者中阳性者 12 2例 ,阳性率为 6 7 0 3% ,其中接触性皮炎组斑试阳性率为 79/ 10 1(78 2 % ) ,湿疹组斑试阳性率为 4 3/ 81(5 3 1% ) ,差异有统计学意义 (χ2 =12 84 ,P <0 0 1)。结论　斑贴试验对了解接触性皮炎、湿疹的病因及指导工作有一定的意义 ,对临床上原因不明的过敏反应可做斑试 ,以排除过敏的可能     

45例皮炎湿疹类皮肤病斑贴试验结果分析

目的分析皮炎湿疹类皮肤病患者的致敏源,探讨常见的致病因素,以期对皮炎、湿疹类皮肤病有更好的治疗和诊断。方法对2012年2月—2013年2月在我院皮肤门诊确诊的45例皮炎湿疹类皮肤病患者进行诊断性斑贴试验,并对不同组之间的试验结果进行比较和分析。结果选用20种标准抗原对45例患者进行试验,有37例患者对其中的17种抗原出现了1种或多种阳性抗原反应,总的阳性率高达82.22%,且其中硫酸镍的阳性率为35.13%,重铬酸钾的阳性率为29.72%,卡巴混合物的阳性率为27.02%,其余为芳香混合物、硫柳汞、氯化钴的混合物。且接触性皮炎的阳性率为80.23%,湿疹的阳性率为73.33%,过敏性皮炎的阳性率为71.25%,复发性皮炎的阳性率为75%,脂溢性皮炎的阳性率为50%。结论硫酸镍、卡巴混合物、重铬酸钾是引发患者皮肤病的主要致病因素,接触性的过敏原是引发皮炎湿疹类皮肤病的一个主要原因,斑贴试验可以有效的诊断皮炎湿疹类皮肤病。     

Occupational issues of irritant contact dermatitis

Occupational irritant contact dermatitis (ICD), a non-immunological cutaneous inflammatory response to a workplace substance, comprises a major portion of occupational dermatoses in industrialized societies, resulting in considerable social and economic implications. The sheer morphological variety of ICD presents a diagnostic and classification challenge; ideotypes identified to date include acute, chronic and cumulative irritant dermatitis, delayed acute irritant dermatitis, irritant reaction, pustular irritant dermatitis, suberythematous irritation, sensory irritation, friction dermatitis and airborne dermatitis. Hand dermatitis is the most frequent manifestation of occupational ICD. This article reviews the various types of ICD, the epidemiological data available to date, risk factors, pathophysiology, diagnosis and management of ICD, emphasizing occupational issues.Paper presented at the Occupational Skin Care Management State-of-the-Art Conference, 1–3 September 2000, Zurich     

Occupational contact dermatitis in a gender perspective: North East Italian data 1996-2016

Background:Occupational contact dermatitis (OCD) ranks high among occupational diseases in Europe, but little is known as regards OCD and jobs in a gender perspective.Objectives:To evaluate sex prevalence of OCD according to occupational sectors and agents involved. 27381 patients (1996–2016) with suspected irritant/allergic contact dermatitis (ICD-ACD) were evaluated in North-Eastern Italy. Each patient underwent: a standardized questionnaire, a dermatologist/occupational physician evaluation and a patch test.Results:Females were younger at diagnosis (35.2 ± 11.6 years vs 37.7 ± 12.6 in males, p< 0.001) and had a lower ICD prevalence (OR 0.58, C.I. 95% 0.51 - 0.66, p < 0.001). Job categories most involved differed between sexes, with highest rank for healthcare professionals in females and machinery mechanics and filters for males. In females ACD percentage was higher in all job categories.Conclusions:OCD characteristics differ between sexes, according to intrinsic and extrinsic factors. Use of personal care products, housekeeping products and outdoor work activities may account for different sensitization profiles.     

镍接触性皮炎的斑贴试验及其组织病理学特征

目的 探讨斑贴试验在金属过敏等环境与职业性皮炎中的诊断价值,了解镍接触性皮炎的组织病理学特征。方法 应用欧洲标准抗原系列斑贴试验检测110例疑诊为接触性皮炎患者,并对13例硫酸镍(5％)斑贴试验不同时段阳性反应皮肤进行活检。结果 39例接触性皮炎患者对硫酸镍敏感(占35．5％),其中阳性反应皮肤组织学特征为：24h时表皮轻度海绵变性和灶状空泡变性,少许嗜酸性粒细胞外渗;48-72h时表皮和真皮炎症达高峰,主要是CD45RO^ T细胞和CD68^ 巨噬细胞分布于炎症表皮及真皮血管周围。916h-5d时表皮轻度增生,不同细胞成分参与修复过程。结论 硫酸镍是引起湿疹皮炎类疾病的主要接触变应原,镍皮炎病理学改变符合变应性接触性皮炎的特征。     

护肤品对皮肤不良反应的研究

本实验受试物５０２７营养霜在短期内集中推销后出现多例皮肤不良反应（接触性皮炎）《毒理实验结果急性皮肤刺激试验无刺激性（皮肤反应积分家兔０．１２５，豚鼠０．１００），多次皮肤刺激试验无明显刺激性（刺激指数１１．６，病理积分３．８）；皮肤变态反应训度致敏物（致敏率４０％）。实验研究表明不能排除其对人体的致敏作用，提示对新的原料、成分或产品上市前应做好必要的安全性评价工作。     

Occupational protein contact dermatitis with type I allergy to different kinds of meat and vegetables

Objective: Even though occupational protein contact dermatitis is not an uncommon finding in occupational dermatology, reports about multiple sensitizations are rare. High-molecular-weight substances such as proteins can pass the epidermis only if it is damaged and cause a sensitization. In a high percentage of cases, atopic dermatitis might be the cause of this damage but cannot be regarded as the only cause. An interesting case is presented that was carefully worked up. Methods: Scratch, intracutaneous, and prick or prick-to-prick tests with native occupational allergens were performed as single tests. The patient was patch-tested with the European Standard Series. The determination of allergen-specific IgE was performed by ImmunoCAP. The results were subdivided into six classes. In addition, oral provocations with relevant allergens were performed. Results: The skin tests showed positive type I allergies to beef, lamb, horse, and pork meat, to pork and horse blood as well as to rye and wheat flour, raw potato, and pasta. Weak positive reactions could be found for fowl, duck, goose, and turkey in intracutaneous testing. The ImmunoCAP showed elevated specific IgE values for pork meat, raw potato, and rye and wheat flour. The oral provocation did not show any systemic or skin change. Conclusions: This case report demonstrates how an initial case of contact urticaria turns into protein contact dermatitis. It shows that the diagnosis can be made by means of scratch or prick tests with native occupational allergens. The determination of allergen-specific IgE by ImmunoCAP might be helpful, but a negative result does not exclude protein contact dermatitis. Received: 26 August 1997 / Accepted: 14 November 1997     

The Environmental Impact on Occupational Therapy Interventions

The purpose of this study was to investigate how the environment influenced the intervention choices occupational therapists made for patients recovering from a stroke in an inpatient rehabilitation hospital. Three occupational therapists were observed providing intervention for six patients over a 16-month period. Treatment spaces included a therapy gym, gym with kitchen combination, and a home-like space. Furniture was added to the therapy gym to be more home-like midway through the study. Observations included therapist selection of treatment location and interventions, and observational data of the environment and interactions among therapists and patients. This study found that inpatient rehabilitation environments did influence interventions. The occupational therapists provided therapy in the standard therapy gym environment most often, whether it was enhanced to be more home-like or not, and predominately used preparatory methods.     

Variability in transepidermal water loss of the skin: evaluation of a method to assess susceptibility to contact dermatitis in epidemiological studies

Summary Transepidermal water loss (TEWL) has been suggested to be a measure which can be used to identify subjects at risk for the development of contact dermatitis. Transepidermal water loss is high when the barrier function of the skin is impaired. It is assumed that subjects with a high TEWL have skin which is more permeable to substances causing contact dermatitis. The inter-individual and intra-individual variability of simultaneous TEWL measurements and TEWL measurements over a period of three weeks were estimated in healthy individuals. The intra-individual coefficient of variation (CV) of simultaneous measurements was 13.5%. The intra-individual coefficient of variation of the measurements on consecutive days was somewhat higher (15.1%). The intra-individual coefficients of variation were low compared to the inter-individual coefficients of variation. The results indicate that transepidermal water loss is a stable personal characteristic, which can be studied as a risk factor in epidemiologie studies on contact dermatitis.