Occupational skin diseases

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

Occupational dermatoses include skin diseases that first appeared in industrial conditions. If the disease appeared before work at the production site, and under the influence of industrial factors it worsens and recurs, such a disease is not occupational.

Production factors

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

Clinical forms

1. Professional simple (contact) dermatitis is no different from simple contact non-professional dermatitis, but occurs in industrial conditions.
2. Occupational allergic dermatitis is no different from non-occupational allergic dermatitis, but occurs in industrial settings.
3. Professional photodermatoses are photosensitization that occurs in industrial conditions under the influence of photodynamic substances (asphalt, tar, pitch, creosote oil).
4. Occupational eczema is no different from normal eczema, but the allergen is associated with the production process.
5. Professional folliculitis occurs when working with tar, pitch, oils, kerosene. Oils and kerosene cause skin irritation and the appearance of inflammatory folliculitis - red papules around the hair. Tar and pitch cause proliferation of cellular epithelium and the appearance of horny folliculitis - these are dense epidermal papules around the hair, horny, dark red in color. Localization - most often the shin, less often the forearm, sometimes the torso.
6. Professional ulcers are observed in contact with acids, alkalis (soda), cyanide compounds. Localization - the back of the hands, palms in places of damage to the epidermis. The ulcers are small, shallow, shallow, slightly painful. Sometimes there may be a larger number of ulcers covered with dark crusts - the "bird's eye" symptom.
7. Professional hyperkeratosis and papillomatosis occur with prolonged contact with products that contain carcinogenic substances. These are coal tar, synthetic resins, tar, etc. Localization - upper and lower extremities. The disease occurs 10-15 years after contact with these substances.

Skin manifestations

• Flat wart-type lesions are epidermal papules formed as a result of proliferation of cellular epithelium;
• rashes similar to vulgar warts - due to the proliferation of cellular epithelium and the growth of dermal papillae with the formation of a primary element - epidermal-dermal papules. Clinically, large vulgar warts up to the size of a cherry are detected, leaving behind scars;

Differential diagnosis

Epidermodysplasia verruciformis - affects only exposed areas, is inherited in an autosomal recessive manner. Clinically, warts-papules, yellow-brown plaques are determined. The age of patients is up to 25 years and younger.

Papillomas are characterized by rapid growth, are painful, ulcerate and often degenerate into epitheliomas.

Milkmaids' nodes - occur in milkmaids, livestock technicians, veterinarians when in contact with sick cows affected by cowpox. Localization - fingers, back of hands, palms, wrists, forearms. Clinically determined dense papules the size of a pea with a depression in the center, painless, rounded, after 1-2 months spontaneously disappear.

Professional candidiasis - develops between the fingers of confectioners and workers in vegetable storage facilities (overripe vegetables and fruits, the effect of malic, citric and lactic acids on the skin).

Criteria for correct diagnosis

1. Establishing a connection with a specific production factor.
2. Localization on open areas of the body.
3. Positive skin tests to suspected irritants.
4. The presence of a similar disease in other workers in the same conditions.

Treatment of occupational skin diseases

Treatment of professional dermatoses is no different from treatment of similar skin diseases.

Prevention of occupational skin diseases

1. Protecting skin from harmful substances.
2. Mechanization, automation, sealing of production.
3. Sanitary and technical conditions of ventilation, special clothing, washbasins, showers, etc.
4. Health education work.
5. Use of protective equipment (ointments, pastes, creams that are applied to skin areas before work):
   1. when in contact with aqueous solutions, use silicone cream, which protects hands from the harmful effects of water;
   2. when in contact with organic solvents, use biological gloves or a casein solution (casein dissolved in alcohol);
   3. When in contact with epoxy glue or resin, use 96° alcohol to remove them.
6. Professional selection of workers should include skin testing techniques.

If the harmful substance cannot be replaced, the technical process cannot be mechanized, and protective equipment does not help, a professional selection is carried out. For this, a person entering the work is given skin tests with an industrial irritant. If the skin test is negative, the worker is accepted to this production.

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