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Car heater dermatitis in a salesman due to frequent long car driving. The hot air stream came from the center of the car and induced redness and scaling only on the directly exposed right leg 

Car heater dermatitis in a salesman due to frequent long car driving. The hot air stream came from the center of the car and induced redness and scaling only on the directly exposed right leg 

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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...

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... outdoor temperatures and low humidity may cause dryness and scaling on the hands and face, and later on also on other body regions. Erythema is usually absent but may be prominent in more severe conditions with fissures or nummular eczema-like lesions (“eczema craquelée”). Living or working in overheated dry rooms will further aggravate the process, which has also been termed “low-humidity der- matosis” [186]. Office workers and outdoor occupations of various types are predisposed. Atopics are more easily affected than nonatopics. In a retrospective analysis of 29,000 patients who attended a contact dermatitis clinic in London, a diagnosis of physical irritant contact dermatitis was made in 1.15% of all patients. The most common cause was low humidity due to air-conditioning, which caused dermatitis of face and neck in office workers due to drying out of the skin [156]. Meteorological factors (dry and cold weather) can contribute to the pathogenesis of irritant hand dermatitis in wet work professions [209]. Some authors found increased irritability to standard irritants such as SLS, even of skin not directly exposed to weather conditions during the winter season in bioengineering studies [2, 15, 141]. Thus, it is no surprise that there is also a seasonal variation in allergy patch test results: the likelihood of weak, i.e.,“false-positive” reactions is increased. This will particularly be the case for those allergens that are also marginal irritants [34, 86, 211–213]. Thermal injury can be very subtle and lead to an itchy eczematous plaque on the lower legs of car driv- ers in the winter (“car heater dermatitis”, Fig. 25, [218]. Shoes, helmets, and other garments or carried equip- ment can lead to circumscribed lesions that may mimic allergic contact dermatitis. This is primarily seen in patients with a past or present atopic dermatitis or psoriasis ( Köbner phenomenon ) [155]. Typical cases are shown in Figs. 26–28. Friction, heat, and occlusion are triggering factors for manifestation of the endogenous disease in previously nonaffected regions. The sharp demarcation often suggests an allergic contact dermatitis, which must always be excluded by adequate testing. On the hand, psoriasis can be due to contact allergy to rubber gloves [101] but may also result solely from irritation, particularly in hospital personnel wearing gloves frequently [84, 175]. Several studies have shown that gloves impair skin barrier function and can further damage primarily irritated skin [175, 243]. A recent review summarizes the effects of occlusion on irritant and allergic contact dermatitis [250]: barrier function is decreased; the effect of irritants and contact allergens is increased, particularly on compromised skin; hydro- colloid patches that absorb water can decrease the irritant reaction caused by the occlusive agent itself; and occlusion does not significantly delay barrier repair in humans. The ubiquitous usage of the computer mouse has led to reports of low-grade frictional irritant dermatitis and formation of calluses [117, 203]. Contact allergy to plastic materials present in the mouse or in the pad has also been observed [37]. In view of the high numbers of users worldwide these side-effects are apparently very rare. Hard data on the incidence of irritant contact dermatitis are still very limited. In many studies on contact dermatitis no clear distinction is made between irritant and allergic types. The source population is also often either ill-defined or highly selected (patients attending a contact dermatitis clinic, for example), and cases of slight cutaneous irritation where medical attention is not sought are therefore missed. Recent data are presented and discussed in detail in Chap. 10. Some studies are, however, worthy of note in this context. In Denmark, the compensation paid for occupational skin diseases was analyzed by Halkier- Sørensen [95]. Skin diseases represented 36% of all compensated cases and were closely followed by musculoskeletal disorders. For irritant eczema (59%) a total of DKr 102,671,567 was paid in comparison to allergic eczema (41%), DKr 71,147,070. In a large multicenter prospective study on reactions caused by cosmetics, Eiermann et al. [55] found irritancy to account for 16% of 487 cases of contact dermatitis due to cosmetics. Over a time period of 40 months, approximately 179 800 patients were seen by 11 dermatologists and 8,093 patients were tested for contact dermatitis. In all, 487 cases (6%) were caused by cosmetics, the majority of them (407) being due to contact allergy. The authors pointed out that during the course of the study irritation was more frequently diagnosed once the physicians had been mentally “sensitized” to this type of reaction. When the adverse effects of 253 cosmetics and toiletries as reported to the Swedish Medical Products Agency were analyzed, 90% were eczematous reactions. Of these, 70% were classified as allergic and 30% as irritant [29]. The number of reports for the years of 1989–1994 appears to be small and can be explained by underreporting. In Heidelberg, Germany, a retrospective study of 190 cases of hand dermatitis revealed the following distribution of diagnoses: atopic dermatitis 40%, chronic irritant contact dermatitis 27%, allergic contact dermatitis 23%, and various other diseases 10% [127]. The 50 patients with chronic irritant hand dermatitis (without clinical or laboratory signs of atopy) came from typical high-risk occupations: housework, nursing, hairdressing, and cleaning. Bäurle and co-workers [22, 23] studied 683 patients with hand eczema in Erlangen, Germany. They considered 24.2% to suffer from chronic irritant contact dermatitis, 15.8% from allergic contact dermatitis and 38.5% from atopic hand dermatitis. Meding [150] made an extensive study of hand eczema in Gothenburg, an industrial city in southern Sweden.When a questionnaire was sent out to 20,000 inhabitants, the point prevalence of hand eczema was determined to be 5.4% (1-year period prevalence 11%). Females outnumbered males by 2:1. The distribution of the three main diagnoses in her panel of 1,585 patients who were investigated further was: 35% irritant contact dermatitis, 22% atopic hand dermatitis, and 19% allergic contact dermatitis. The author pointed out that, due to careful clinical examination, a considerable number of mild cases of irritant con- tact dermatitis were recognized, hence the relatively high figure for irritant contact dermatitis. In this study, the most harmful exposures turned out to be to “unspecified chemicals,” water, detergents, dust, and dry ...

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... 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] . ...
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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. ...
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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. ...
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... 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]. ...
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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). ...
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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]. ...
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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). ...
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... 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) ...
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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. ...
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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.