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Acute irritant contact dermatitis with erythema, papules, and scaling after 2 weeks of application of a cream containing tretinoin and urea for follicular hyperkeratosis. Patch testing was negative
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Irritant contact dermatitis (ICD) is more common than allergic contact dermatitis (ACD). It ranges from acute irritant reactions
to chronic forms, often morphologically indistinguishable from ACD. Numerous exogenous and endogenous factors are involved
in the pathogenesis. Major irritants are water, detergents, acidic and alkaline substances of vari...
Context in source publication
Context 1
... clinical appearance of acute irritant contact dermatitis is very variable and it may even be indistinguishable from the allergic type. There are numerous reports in the literature of even experienced dermatologists being misled into an initial assumption of allergic contact dermatitis, which later, after a careful work-up, turned out to be “only irritation.” ( Fig. 15). Most instructive is the report by Malten et al. [145] on hexanediol diacrylate. A UV-cured paint used in a door factory contained hexanediol diacrylate, which caused an epidemic of papular and burning, rather than itching, dermatitis among the workers. Retro- spectively, it is clear that the irritant contact dermatitis did not show the typical polymorphic picture of contact allergy, with the synchronous presence of macules, papules, and vesicles. These lesions developed one after another over the course of a few days (metachronic polymorphism). Malten et al. used the term “delayed irritation” for this type of cutaneous irritancy. In the meantime it has also been reported with other diacrylates [158] and various other substances [143]. Delayed irritation may be more common than so far generally thought. Further substances causing it are listed in Table 3. Irritant patch test reactions to benzalkonium chloride may be papular and increase in intensity with time [20, 30, 35]. On the normal skin surrounding psoriatic plaques, dithranol causes red- ness and edema, which may become very severe on the legs with venous stasis. Calcipotriol frequently causes delayed irritation after several applications. Although redness and edema dominate, papules and vesicles may develop and mimic contact allergy. The latter has been verified only in rare cases, requiring patch testing with serial dilutions, repeated open application and, if possible, repeat of those procedures at a later stage [79]. Diclofenac gel is now widely used for the treatment of solar keratoses. In patients with sensitive skin a severe irritant dermatitis may develop within a few days, clinically indistinguishable from allergic contact dermatitis (Fig. 16). Recently, a series of cases with chemical burns due to bromide was reported [120]. Small vesicles and bullae, or erythematous patches followed by hyperpigmentation, developed 2–5 days after exposure to bromine in the face and neck region of workers exposed to bromine vapors or liquids [120]. Bromine is used for gasoline additives, agricultural chemicals, flame retardants, dyes, photographic and pharmaceutical chemicals, bleaching of pulp and paper, etc. The model irritants sodium lauryl sulfate (SLS) and nonanoic acid have been used in many patch test studies as a “positive control.” Using detailed visual scoring, and particularly with bioengineering methods (transepidermal water loss, skin blood flow, skin surface contour), it can be demonstrated that the intensity of reaction may increase over time (48 h ver- sus 96 h), at least within a certain low concentration range [4, 176]. Furthermore, data from right to left comparisons showed good reproducibility. The tra- ditional view in patch testing that reactions that fade after 48 h are necessarily irritant, rather than allergic, has to be discarded. Irritation due to tretinoin develops usually after a few days and is characterized by mild to fiery redness, followed by large flakes of stratum corneum. The dermatitis is burning rather than itching. The skin becomes sensitive to touch and to water (Fig. 17). Acute irritant contact dermatitis includes other well-known entities such as irritation from adhesive tapes (Fig. 18), diaper dermatitis [10], perianal der- matitis, and airborne irritant contact dermatitis due to dusts and vapors (Table 4, Fig. 19). A long list of airborne irritants that caused a dermatitis, which initially was often thought to be allergic, has been com- piled and recently updated (Table 5) [52, 102]. Cosmetics are not infrequently the cause of mild irritant contact dermatitis on the face, particularly the eyelids, where contact allergy has to be excluded by appropriate patch and use testing. Reaction to prostheses of the limbs (Fig. 20) or hearing aids are often not allergic but irritant. Perianal dermatitis is primarily due to fecal enzymes, but in patients taking pancreatic enzymes as supple- ments this may provoke a severe spreading dermatitis, even with vulvodynia [144]. It has also been described in patients taking danthron laxatives, con- verted in the colon to the well-known irritant ...
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About 20% of the general population is contact-sensitized to common haptens such as fragrances, preservatives, and metals. Many also develop allergic contact dermatitis (ACD), the clinical manifestation of contact sensitization. ACD represents a common health issue and is also one of the most important occupational diseases. Although this inflammat...
Citations
... Irritant contact dermatitis ICD is the most common type of contact dermatitis. It is basically an eczematous (English, 2004) [6] and non-allergic (Frosch and John, 2011) [8] skin disorder (English, 2004) [6] . It is caused by physiological, chemical and biological toxins (Eberting et al., 2014;Woolfson, 2008) [4,25] . ...
... Irritant contact dermatitis ICD is the most common type of contact dermatitis. It is basically an eczematous (English, 2004) [6] and non-allergic (Frosch and John, 2011) [8] skin disorder (English, 2004) [6] . It is caused by physiological, chemical and biological toxins (Eberting et al., 2014;Woolfson, 2008) [4,25] . ...
Skin is the largest organ of our body when it is exposed to exogenous irritants and allergens in 24hours, these noxious agents' cause immunotoxicity, and Contact dermatitis (CD) is one of them. Here in this review we had checked its types, main causes, Action mechanisms of irritants and allergens, Clinical aspects and its management: diagnostic tests, preventions and treatments of this contagion. There are two types of CD: first is the Irritant contact dermatitis (ICD) and second one is Allergic contact dermatitis (ACD). ICD is exposure of skin by physiological, biological, and chemical toxins resulting into rupturing of stratum corneum and release of cytokines which show inflammatory response. ACD is the interaction of xenobiotics with immune system. It is basically the immunotoxicity by chemicals which is developed by two phases (1) induction and (2) elicitation. Phototoxic and photo allergic CD is developed when CD is due to sunlight exposure. Management of CD is including (1) primary prevention: by avoidance or preventions at different levels (2) secondary prevention: when skin is affected by chemicals then diagnoses is very necessary by Patch test and photo Patch test(3)Tertiary prevention: treatment should be done as soon as possible by steroids and other products. Introduction The word "Dermatitis" means the skin inflammation which may be due to exogenous or endogenous agents but the term contact dermatitis (CD) is applied when any external or noxious agent gets in touch with skin and cause some irritation and/or allergic response. It is estimated that 5 to 9 percent men and 13 to 15 percent women are affected by dermatitis (English, 2004) [6]. It is responsible of 10% visit to hospital. Dermatitis is very common skin disorder with great socioeconomic influence. Skin is the largest organ of our body and due to large size to volume ratio it separates human body from external environment and greatly exposed by number of physical and chemical factors of the environment (Saint-mezard et al., 2004; Martins and Reis, 2011) [18, 14] It act as a first line immune defense against the internal and external irritants (Chu et al.,2011) [3] and Here, our main concern is exogenous irritants or exogenous dermatitis.The exogenous substances may have effect on skin directly ICD (irritant contact dermatitis) or due to some allergic chemicals when hypersensitivity of immune reaction delayed ACD (allergic contact dermatitis) (English, 2004) [6]. A Study is conducted in 2006 in which 210 patients were studied for five years and it is investigated that 58.5% have ACD and 41.4% have ICD and results of 5 patients are unclear. Results shows both are very common skin disorders (Racheva, 2006) [17] .
... Skin lesions can vary according to the type of exposure, body region, and individual vulnerability. 6 Improper skin cleansing is a major cause of occupational irritant contact dermatitis. Therefore, handwashing methods and facilities need to be reviewed if in the workplace there are one or more cases of work-related irritant contact dermatitis. ...
Background: Skin disorders or abnormalities occur in more than 35% of all occupational disorders. Contact dermatitis is the most recognized occupational disease in many countries (with irritant contact dermatitis accounting for 80% of the cases), yet these cases are often not reported. One of the causes of irritant contact dermatitis is Cyclohexanone, a chemical recognized as an oxidizing agent that can irritate the skin. This evidence-based case report aims to gather evidence about the effect of cyclohexanone exposure on the incidence of irritant contact dermatitis.Method: The case in this study is about a 37-year-old woman who worked as a logo printing operator in a shoe manufacturing company that is exposed to cyclohexanone and was diagnosed with irritant contact dermatitis. A literature search was conducted through PubMed, Scopus, and ProQuest and performed with the hand searching method. The inclusion criteria included systematic review study, cohort study, case-control study, cross-sectional study, irritant contact dermatitis, cyclohexanone, and occupational. Then, critically appraised using relevant criteria by the Oxford Center for Evidence-Based Medicine. Result: Three relevant cross-sectional studies were found through literature searching and are critically appraised. The estimate’s magnitude and precision regarding the association between the exposure and outcome in the first study cannot be assessed; the study only stated no statistically significant p-value in the prevalence of occupational skin dermatitis between departments and the examination between departments. The second study showed that workers with solvent chemical mixture exposure, including cyclohexane, are correlated with skin symptoms, dry or itchy skin on the hands or arms, POR 1.46 (95% CI 1.06-2.01), and redness on hands or arms, POR 1.50 (95% CI 1.09-2.70). In comparison, the third study showed that workers with a high dermal single exposure to cyclohexane have a higher risk for the incidence of hand dermatitis OR 2.15 (95% CI 0.59-7.95) without any statistical significance.Conclusion: The available evidence from cross-sectional studies did not prove an association between cyclohexanone exposure and irritant contact dermatitis in workers; only one study shows a significant association statistically. However, it is recommended to provide tools to prevent direct contact with the chemical; workers should also wear appropriate protective gloves to avoid occupational irritant contact dermatitis. A better study design such as cohort or case-control is needed to provide substantial evidence that cyclohexanone exposure can cause irritant contact dermatitis in workers.
... This may lead to misdiagnosis as ACD. Clinical symptoms are similar to acute ICD with the skin becoming sensitive to touch and water [59]. ...
... Irritant reaction is a subclinical type of ICD that typically affects individuals exposed to wet work. Clinical features are monomorphic, characterized by erythema, scaling, vesicles, pustules, and erosions [59]. It often begins on fingers under occlusive jewelry such as rings and spreads to involve the hands and forearms. ...
Purpose of Review
Irritant contact dermatitis is the most common form of contact dermatitis and the most common occupational skin disease. This review provides a comprehensive summary of the endogenous and exogenous factors that play a role in the pathogenesis of irritant contact dermatitis.
Recent Findings
In conjunction with avoidance of irritants, barrier protection, and regular application of moisturizers, management now emphasizes the importance of primary prevention through educational initiatives in high-risk workplaces.
Summary
The diagnosis of irritant contact dermatitis is often difficult, as there is no confirmatory test, and it is often a default diagnosis after allergic contact dermatitis has been excluded. Early recognition, prevention, and treatment are vital in management, especially in the occupational setting.
... Their amphiphilic nature makes them suitable for applications such as detergency and washing. An excessive use of detergents is, however, causing major problems for the environment [2][3][4] and humans [5][6][7][8][9][10][11]. More than 60 % of the total surfactant production enters the aquatic environment resulting in water and environmental pollution. ...
... More than 60 % of the total surfactant production enters the aquatic environment resulting in water and environmental pollution. After a cleaning procedure, 2.5 % of detergent remains on the clothes, causing skin irritation, inflammation and allergic reactions [6]. ...
... Analysis of Eqs. (4)- (6) shows that both repulsive and attractive components of energy grow with the particle size, but the general trend of increasing stability upon decrease of salt content exists independently of the particle size. This demonstrates that the charge stabilization of colloidal particles can be very efficient if very pure water is used as a dispersion medium. ...
Hypothesis
Detergents used in everyday life for cleaning and washing are a source of water pollution and can have a negative effect on human health and the environment. To reduce their negative impact, a new trend of using only purified water for washing and cleaning applications is emerging. A scientific basis of this method needs to be established, as its mechanisms and the efficiency should be better understood.
Experiments
In this work, we investigate the effect of water purity on the removal of hydrophobic films from solid surfaces using quartz crystal microbalance with dissipation monitoring (QCM-D) and gravimetric experiments. We compared the cleaning efficiency of TAP water, two grades of purified water, NaCl solution and SDS solution.
Findings
The QCM-D results show that both grades of purified water remove more than 90% of Vaseline deposited of the surface while tap water only 75%. SDS solution fully removes the deposited layer. Gravimetric experiments with removal of olive oil from hydrophilic and hydrophobic surfaces also indicate higher efficiency of purified water grades. Contact angle experiments show that pure water facilitates roll-up mechanism of cleaning. We suggest that due to lower ionic strength, purified water increases electrostatic repulsion and promotes the cleaning process.
... Norstictic (CAS: 571-67-5) and usnic (CAS: 7562-61-0) acids, which are lichen secondary metabolites, have also shown efficiency and low toxicity on various microorganisms as cyanobacteria (Chroococcus minutus) and fungi (Coniosporium perforans, Phaeococcomyces chersonesos) ( Table 1) (Fidanza and Caneva, 2019;Gazzano et al., 2013) However, there are few available studies on these compounds, and more research is needed to confirm these preliminary observations. As with QACs (especially BACs), pelargonic acid causes slow onset irritancy, erythema and is an irritant compound (Frosch and John, 2011). Other families of acids are employed and commercialized to prevent biodeterioration like lactic acid (CAS: 50-21-5) as MossKade® supplied by HortiPro. ...
... Other families of acids are employed and commercialized to prevent biodeterioration like lactic acid (CAS: 50-21-5) as MossKade® supplied by HortiPro. However, some studies have also highlighted the effects of lactic acid on human health, which has been shown to be responsible for erythema and stinging when used at 5% in water (Frosch and John, 2011). For this reason, the supplier recommends that customers wear gloves and eye protection to avoid its potential hazards (Hortipro B.V., 2014). ...
... (Table 1) (Rosado et al., 2017). However, as the other biocides, they are also mentioned as an irritant if not used with personal protection gear (Frosch and John, 2011), and in 2019 government of Canada has assessed pchlorocresol as posing a risk to human health and has recommended a reduction in its usage (Government of Canada, 2019). ...
All types of building materials are rapidly colonized by microorganisms, initially through an invisible and then later a visible biofilm that leads to their biodeterioration. Over centuries, this natural phenomenon has been managed using mechanical procedures, oils, or even wax. In modern history, many treatments such as high-pressure cleaners, biocides (mainly isothiazolinones and quaternary ammonium compounds) are commercially available, as well as preventive ones, such as the use of water-repellent coatings in the fabrication process. While all these cleaning techniques offer excellent cost-benefit ratios, their limitations are numerous. Indeed, building materials are often quickly recolonized after application, and microorganisms are increasingly reported as resistant to chemical treatments. Furthermore, many antifouling compounds are ecotoxic, harmful to human health and the environment, and new regulations tend to limit their use and constrain their commercialization. The current state-of-the-art highlights an urgent need to develop innovative antifouling strategies and the widespread use of safe and eco-friendly solutions to biodeterioration. Interestingly, innovative approaches and compounds have recently been identified, including the use of photocatalysts or natural compounds such as essential oils or quorum sensing inhibitors. Most of these solutions developed in laboratory settings appear very promising, although their efficiency and ecotoxicological features remain to be further tested before being widely marketed. This review highlights the complexity of choosing the adequate antifouling compounds when fighting biodeterioration and proposes developing case-to-case innovative strategies to raise this challenge, relying on integrative and multidisciplinary approaches.
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... Dermatitis is a disease that can occur due to exposure to the skin. Dermatitis is inflammation of the skin in the epidermis and dermis in response to the influence of exogenous and endogenous factors that cause clinical abnormalities in the form of polymorphic efflorescence (erythema, edema, papules, vesicles, squama, and lichenification) and itching complaints [3]. The cause of this dermatitis can come from outside the body (exogenous), for example, chemicals detergents, acids, bases, oil, cement), physical (light, temperature), microorganisms (bacteria, fungi), or from the body (endogenous), for example, atopic dermatitis [4]. ...
BACKGROUND: Many factors can influence the occurrence of dermatitis; this factor is divided into two, namely exogenous and endogenous factors. Fishermen are jobs that are susceptible to disease in dermatitis, especially contact dermatitis in the small island. AIM: This study aimed to determine the factors associated with the incidence of contact dermatitis in fishermen on the Spermonde islands. METHODS: This study was an observational analytic study using a cross-sectional design study. This research was conducted on Lae-Lae, Barrang Lompo, and Lumu-Lumu Island in 2019. Samples in this study were 110 fishermen obtained using Accidental sampling techniques. Data collection is using research instruments. RESULTS: Data analysis performed was univariate and bivariate analysis with a Chi-square test. Based on the results of the study, the research variables related to factors affecting contact dermatitis in fishermen in the Spermonde Islands were a history of skin diseases (p = 0.000), use of PPE (p = 0.000), personal hygiene (p = 0.000), and working period (p = 0.003) while unrelated factors are age (p = 0.373). CONCLUSION: Fishermen should pay more attention to four factors, namely the history of skin diseases, the use of PPE, hygiene, and work period, to avoid contact dermatitis.
... Irritant skin is a common inflammatory skin condition resulted from a single or repetitive exposure to natural products or chemical agents with irritant properties. 55 Topically, the effect of pure limonene oil and limonene based microemulsion system on the skin of mice over seven consecutive days was studied. According to the Draize scale, physical appearance of the mice ears showed slight irritant effect with no significant difference (p > 0.05) as summarized in Table 3. ...
Purpose:
Microemulsion (ME) achieved progressing consequences on both the research and industry levels due to their distinctive properties. ME based-limonene system is considered as a surrogate to the traditional microemulsion composed of conventional oils. Thus, a novel microemulsion based on D-limonene and Gelucire® 44/12 had been designed and evaluated with assessing the factors affecting its physicochemical characteristics and in vivo skin irritation.
Methods:
The impact of microemulsion components and ratios on the isotropic region of the pseudo-ternary phase diagram was investigated. The optimal formula was evaluated in terms of percentage transmittance, average globule size, size distribution, zeta potential, microscopical morphology, stability under different storage conditions and its effect on the mice ear skin.
Results:
The results demonstrated that Labrasol® and Labrafil® M 1944 CS had been selected as surfactant and co-surfactant, respectively, due to their emulsifying abilities. The largest isotropic area in the pseudo-ternary phase diagram was at a weight ratio of 4:1 for Labrasol® and Labrafil® M 1944 CS. The optimized microemulsion with 25% w/w of the lipid phase and 58.3% w/w of the aqueous phase displayed an optical transparency of 96.5±0.88 %, average globule size of 125±0.123 nm, polydispersity index of 0.272±0.009, zeta potential of -18.9± 2.79 mV with rounded globules morphology and high stability. The in vivo skin irritation and the histopathological evaluation of microemulsion elucidated its safety profile when applied on the skin.
Conclusion:
The formulated microemulsion is a prospective aid for an essential oil to minimize its volatility, enhance its stability, and mask its dermal irritant.
... Edukasi pencegahan terjadinya DKI mudah untuk diaplikasikan, sebab seringnya kerjadian dermatitis kontak iritan ini pada tangan (Wijaya et al., 2016) atau bagian tubuh yang tidak terlindungai oleh APD (Frosch & John, 2011). ...
Dermatitis kontak iritan merupakan peradangan kulit yang terjadi sebagai respon non-spesifik kulit terhadap zat kimia melalui pelepasan mediator inflamasi dari sel-sel epidermis. Tujuan penelitian ini adalah untuk mengetahui hubungan penggunaan alat pelindung diri yaitu sarung tangan terhadap kejadian dermatitis kontak iritan pada petani rumput laut di Desa Bawalipu Kecamatan Wotu. Penelitian ini menggunakan desain deskriptif analitik dengan rancangan cross sectional pada responden sebanyak 47 orang. Dari hasil kajian menggunakan uji chisquare didapatkan nilai p = 0,05 sehingga dapat disimpulkan bahwa penggunaan sarung tangan memiliki hubungan dengan kejadian dermatitis kontak iritan pada petani rumput laut khusunya yang berada di Desa Bawalipu Kecamatan Wotu, sehingga diharapkan kepada pemerintah Desa untuk mensosialisasikan manfaat penggunaan sarung tangan yang salah satunya melalui kerja sama dengan pusat pelayanan kesehatan.
... Organic solvents can likewise irritate the respiratory system such as upper respiratory tract symptoms, cough, dyspnea, chronic bronchitis, and bronchial asthma. Benzene, toluene, xylene, ethyl benzene, butyl acetate, gasoline, kerosene, turpentine, Stoddard solvent, hexane, trichloroethane, tetrachloroethane, trichloroethylene, carbon tetrachloride, methylene chloride, methyl alcohol, ethyl alcohol, glycidyl ethers, and dimethyl sulfoxide are some of the examples of common irritants in the workplaces [17,31]. In the updated version of OAsJEM, there are 30 specific asthmagens and irritants; some of these, including organic solvents and MWFs, are also common causes of OCD [62]. ...
... Examples of metals related to occupational allergic diseases[17,[24][25][26][27]31] Occupational contact dermatitis (OCD), occupational asthma (OA), occupational rhinitis (OR) ...
Purpose of review:
Occupational allergic diseases (OAD) such as occupational contact dermatitis (OCD), occupational asthma (OA), and occupational rhinitis (OR) are the most prevalent occupational diseases in industrialized countries. The purpose of this review is to provide an update about the main occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field.
Recent findings:
Currently for over 400 causative agents for OA and OCD, several hundreds of agents for OR have been identified. Although many studies have reported an overall decline in OAD related to known agents after implementation of efficient and effective workplace preventive measures, the constant development of new products continuously introduces to the market potential unknown respiratory hazards. Workplace allergens are often high molecular weight (HMW) agents that are > 10 kDa molecular weight and capable of eliciting IgE sensitization. Sensitizing low molecular weight (LMW) agents are often reactive chemicals. Metals and solvents are two large causative agent groups related to OADs that mainly behave as LMW (< 10 kDa) sensitizers and/or irritants. Avoidance of causative exposures through control strategies is the primary prevention approach for OADs. These strategies must be applied and covered for all known and newly defined causative agents. This review aims to summarize current status of known occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field.
... Occupational dermatitis is classified internationally as the second largest occupational disease group after musculoskeletal disorders (Frosch & John, 2011). Epidemiological data show that contact dermatitis comprises 90 to 95% of all occupational dermatitis. ...
Background: Occupational skin diseases are the most common occupational diseases in many countries. Dermatitis has become one of the top 10 occupational diseases (PAK) based on the potential incidence, severity, and prevention ability. Fishermen are one of the oldest occupations and have a high risk of occupational accidents or occupational diseases, which one of the risks is dermatitis due to the exposure to sea water containing salt which is high enough to absorb the water from the skin.Objective: This study aims to determine the incidence of dermatitis, working duration, duration of exposure, history of skin diseases, use of personal protective equipment, and personal hygiene in the fishing communities in North Bontang.Methods: This study is an analytic observational study with a cross sectional study design. The population in this study was the fishing community in Loktuan Urban-Village, North Bontang. The samples were taken with the purposive sampling and a sample of 154 fishermen was obtained. The data were collected with a questionnaire that has been tested for the validity. The statistical analysis was conducted by Chi Square test with a significance level of 0.05.Results: The results showed that the history of skin diseases, the duration of exposure are related to the incidence of dermatitis in fishermen.Conclusion: Further research is needed to find out other risk factors that can cause dermatitis in fishermen.
