Professional Skin Diseases

Professional dermatoses account for up to 80% of occupational pathology and arise as a result of the harmful effects of various production factors.

Occupational diseases include skin diseases, which first arose in production conditions. If the disease appeared before work in the workplace, and under the influence of production factors is aggravated and recurs, this disease is not professional.

Production factors

1. Chemical irritants (basic) - acids, alkalis, turpentine, synthetic and epoxy resins, fiberglass, synthetic paints and varnishes, compounds of nickel, chlorine, mercury, cement, formalin, pesticides, streptomycin and novocaine.
2. Physical factors are radioactive isotopes, X-ray beams, ultraviolet rays, mechanical and thermal factors.
3. Some infections are cowpox virus, Candida fungi.

Clinical forms

1. Professional simple contact dermatitis is no different from simple contact non-occupational dermatitis, but occurs in production conditions.
2. Professional allergic dermatitis is no different from non-professional allergic dermatitis, but occurs in production conditions.
3. Professional photodermatoses - photosensitization, which appeared in production conditions under the influence of photodynamic substances (asphalt, tar, tar, creosote oil).
4. Professional eczema does not differ from ordinary eczema, but the effect of an allergen is related to the production process.
5. Professional folliculitis occur when working with tar, tar, oils, kerosene. Oils and kerosene cause skin irritation and the appearance of inflammatory folliculitis - the red papules around the hair. Tar and tar cause the proliferation of cellular epithelium and the appearance of horny folliculitis - a dense epidermal papules around the hair, horny, dark red. Localization - more often the lower leg, less frequently the forearm, sometimes the trunk.
6. Professional ulceration is noted on contact with acids, alkalis (soda), cyanide compounds. Localization - the dorsal surface of the hands, palms in places of damage to the epidermis. Ulcers small, small, shallow, not very painful. Sometimes there may be more ulcers covered with dark crusts - a symptom of the "bird's eye".
7. Professional hyperkeratosis and papillomatosis occur with prolonged contact with products that contain carcinogenic substances. This is coal tar, synthetic resins, tar, etc. Localization - upper and lower extremities. The disease occurs 10-15 years after contact with these substances.

Cutaneous manifestations

• Eruptions by the type of flat warts are epidermal papules formed as a result of the proliferation of cellular epithelium;
• rashes on the type of vulgar warts - due to the proliferation of cellular epithelium and the growth of the papillae of the dermis with the formation of the primary element - epidermal-dermal papules. Clinically identified large vulgar warts the size of cherries, leaving behind a ribs;

Differential diagnosis

Verruxiform epidermodysplasia - only open areas are affected, inherited by autosomal recessive type. Clinically defined warts-papules, plaques of yellow-brown color. The age of patients is 25 years or less.

Papillomas - characterized by rapid growth, painful, ulcerated and often degenerate into epitheliomas.

Nodules of milking - arise from milkmaids, livestock specialists, veterinarians in contact with sick cows, which are affected by cowpox. Localization - fingers, rear of hands, palms, wrist joints, forearms. Clinically defined dense papules the size of a pea with a westernization in the center, painless, rounded, after 1-2 months spontaneously disappear.

Professional candidiasis - develops between the fingers of the hands of confectioners, workers of vegetable stores (overripe vegetables and fruits, the effect on the skin of apple, lemon and lactic acid).

Criteria for correct diagnosis

1. Establishing a connection with a certain production factor.
2. Localization in open areas of the body.
3. Positive skin tests with suspected irritants.
4. The presence of such a disease in other workers who are in the same conditions.

Treatment of occupational skin diseases

Treatment of profdermatosis is not different from the treatment of similar skin diseases.

Prophylaxis of occupational skin diseases

1. Protection of the skin from harmful substances.
2. Mechanization, automation, production sealing.
3. Sanitary and technical conditions of ventilation, special. Clothes, wash basins, showers, etc.
4. Sanitary-educational work.
5. The use of protective agents (ointments, pastes, creams, which are applied to the skin before work):
   1. when in contact with aqueous solutions use a silicone cream that protects hands from the harmful effects of water;
   2. When contacting with organic solvents, use biological gloves or a casein solution (casein dissolved in alcohol);
   3. on contact with epoxy glue, the resin is used to remove 96 ° alcohol.
6. Professional selection of workers should include a method of skin tests.

If the harmful substance can not be replaced, the technical process can not be mechanized, and protective measures do not help, professional selection is carried out. For this, a person entering the work is put skin tests with a production stimulus. If the skin test is negative, the worker is accepted for this production.

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