Upload
damian-welch
View
225
Download
3
Embed Size (px)
Citation preview
Eczema – dermatitis Eczema – dermatitis Occupationals Occupationals
dermatosisdermatosisLibuše MardešićováLibuše Mardešićová
Dpt. Of Dermatovenerology FNKV Dpt. Of Dermatovenerology FNKV and 3.LF UK and 3.LF UK
Eczema - dermatitisEczema - dermatitis
most frequent skin disease (1/4)most frequent skin disease (1/4)
a group of skin diseases with a group of skin diseases with complicated, different and sometimes complicated, different and sometimes unknown unknown pathogenesispathogenesis
but with the identical clinical picturebut with the identical clinical picture
Eczema - dermatitisEczema - dermatitis
DefinitionDefinition: superfitial non-infectious inflamation of skin : superfitial non-infectious inflamation of skin frequently of allergic origin which is provoked by different frequently of allergic origin which is provoked by different external and internal factors external and internal factors
Histopathological marks are located in epidermis and upper Histopathological marks are located in epidermis and upper coriumcorium
Healing of acute forms without scars Healing of acute forms without scars ( red macules, hypo- or ( red macules, hypo- or hyperpigmentations), healing of chronical form sometimes hyperpigmentations), healing of chronical form sometimes with lichenificationwith lichenification
provoking factors are usually unknownprovoking factors are usually unknown
Eczema - dermatitisEczema - dermatitis
Different typesDifferent types - atopic eczema or dermatitis- atopic eczema or dermatitis - seborrhoic eczema or dermatitis- seborrhoic eczema or dermatitis - microbic eczema- microbic eczema - contact alergic eczema- contact alergic eczema -contact irritant dermatitis-contact irritant dermatitis
The unique morfology is typical!!!The unique morfology is typical!!!
Clinical picture ofClinical picture ofeczema -dermatitiseczema -dermatitis
Acute stadiumAcute stadium red papules(grouped)red papules(grouped) edematous swellingedematous swelling small vesiclessmall vesicles weeping of moistureweeping of moisture crustingcrusting scalingscaling
Chronical diseaseChronical disease thickening of skinthickening of skin rough skinrough skin creation of fissurescreation of fissures
Different treatment!!!
PredilectionPredilection
Eczema can be Eczema can be located at any place located at any place of the body of the body
but some of them but some of them are more often are more often presentpresent
HandsHands FaceFace
Eczema acutumEczema acutum
“ekdzein“= to spring to the surface
Eczema chronicumEczema chronicum
Eczema atopicumEczema atopicum
White dermografism, pruritus, capricious course
Seborrhoic eczemaSeborrhoic eczema
Microbic eczemaMicrobic eczema
Main differences between contact Main differences between contact dermatitis and eczemadermatitis and eczema
dermatitis dermatitis cause: cause: irritantirritant occures in all individuals occures in all individuals
contacting irritant contacting irritant burning sensations, painburning sensations, pain symptoms are symptoms are restrictedrestricted
just on the place of just on the place of contactcontact
toxical provo factorstoxical provo factors
eczemaeczema cause: cause: alergenalergen a patient is only a patient is only
genetically predisposed genetically predisposed personperson
itchingitching spreadingspreading from the from the
place of contactplace of contact
alergyalergy of the VIth type of the VIth type
Irritant contact dermatitisIrritant contact dermatitis
- due to a nonspecific reaction- due to a nonspecific reaction - contact with irritans for a sufficient - contact with irritans for a sufficient
lenght of timelenght of time - irritant in sufficient high concentration -- irritant in sufficient high concentration -
Main irritantsMain irritants
Defatting, degreasing agents, damage of Defatting, degreasing agents, damage of the skin by cytotoxic actionthe skin by cytotoxic action
- detergents- detergents - solvents- solvents - cleaners- cleaners (- strong acids and alkalis –acute severe (- strong acids and alkalis –acute severe
dermatitis)dermatitis)
Acute contact allergic eczemaAcute contact allergic eczema
Acute contact irritant dermatitisAcute contact irritant dermatitis
Chronical dermatitis Chronical dermatitis xx chronical chronical eczema eczema
dryness, some fissuring, thickening
Most frequent allergensMost frequent allergens
MetalsMetals (Ni, Co, Hg, Cr, Pt….) (Ni, Co, Hg, Cr, Pt….) RubberRubber (additives) (additives) CosmeticsCosmetics (emulgators, antimicrobials, perfumes) (emulgators, antimicrobials, perfumes) Organic dyesOrganic dyes FormaldehydeFormaldehyde Parabens and lanolinParabens and lanolin Plastics and resinsPlastics and resins (epoxy resin, acrylates) (epoxy resin, acrylates) Topically used medicamentsTopically used medicaments Plants Plants (needles, tulips, chrysantems, poisson ivy..)(needles, tulips, chrysantems, poisson ivy..)
Epi- testsEpi- tests
Alergy of the IV th Alergy of the IV th typetype
Preparation of the Preparation of the patientpatient
AnamnesisAnamnesis Concentration of Concentration of
allergenallergen VehicleVehicle
Occupational skin diseasesOccupational skin diseases
List of occupational diseasesList of occupational diseases-law-law 60-80%60-80% the the rulesrules for reporting are strictly done for reporting are strictly done specialised dpts. - assessmentspecialised dpts. - assessment reporting reporting of occupational diseases of occupational diseases legal consequenceslegal consequences: retraining, financial profit: retraining, financial profit eczema contactum allergicum, dermatitis eczema contactum allergicum, dermatitis
contacta irritativa, occupational acne (picea, contacta irritativa, occupational acne (picea, oleosa, chlorina), skin tumors, skin infections oleosa, chlorina), skin tumors, skin infections (medicals, farmers, ! teachers x sisters)(medicals, farmers, ! teachers x sisters)
Chronical contact irritative Chronical contact irritative dermatitisdermatitis
(„house wife dermatitis“)(„house wife dermatitis“) Detergents,soaps, Detergents,soaps,
cleansers, frequent cleansers, frequent washing, polishes, washing, polishes, waxes, bleacheswaxes, bleaches
weak acidsweak acids cementcement dezinficientsdezinficients organic solventsorganic solvents
(petrol, turpentyne...)(petrol, turpentyne...)
Allergy -Chromium in leather Allergy -Chromium in leather glovesgloves
Typical protective necessity among workers
Occupationals skin infectionsOccupationals skin infections
farmers (no tinea pedum)farmers (no tinea pedum) forrest workers (borreliosis)forrest workers (borreliosis) medicals (scabies x teachers –pedikulosis) + medicals (scabies x teachers –pedikulosis) +
tbc cutis verrucosatbc cutis verrucosa poultry farms (candidiasis)poultry farms (candidiasis) flesh processing (butchers, cookers)-erysipeloidflesh processing (butchers, cookers)-erysipeloid
Occupational skin infectionsOccupational skin infections
Acne venenataAcne venenata
„„venenatio“, -onis f. venenatio“, -onis f. l.l. poisoning poisoning
Acne contacta
Acne chlorinaAcne chlorina
rarerare
occupational or non-occupational or non-
through skin, ingescion, inhalationthrough skin, ingescion, inhalation
Chlorated hydrocarbons (importance of Chlorated hydrocarbons (importance of position of Cl in the molecule)position of Cl in the molecule)
Chlorated hydrocarbonsChlorated hydrocarbons
Polychlorated naftalensPolychlorated naftalens Polychlorated difenyls (PCB)Polychlorated difenyls (PCB) Polychlorated dibenzofurans (PCDF)Polychlorated dibenzofurans (PCDF) Polychlorated dibenzodioxinsPolychlorated dibenzodioxins Azobenzens a azoxybenzensAzobenzens a azoxybenzens
Chemical industry, halowax, herbicids…Prevention, accidents
Toxicity Toxicity
hepatotoxichepatotoxic: hepatitis - cirrhosis: hepatitis - cirrhosis
neurotoxicneurotoxic
kancerogenickancerogenic teratogenicteratogenic
Clinical picture of acne Clinical picture of acne chlorinachlorina
commedons – small cysts with black commedons – small cysts with black centres, centres, cysts, cysts, scaringscaring
predilection: all places with skin folliculs predilection: all places with skin folliculs (face except nose, axils, scrotum, (face except nose, axils, scrotum, penis…) penis…)
Acne oleosaAcne oleosa
Products made from crude oil- petroleumProducts made from crude oil- petroleum Other oilsOther oils (from plants) (from plants)
Metall working fluidsMetall working fluids– mineral oils, grease, – mineral oils, grease, technological fluids, oils, diesel…technological fluids, oils, diesel…
Acne oleosaAcne oleosa
Personaly dispositionPersonaly disposition Clinical picture is polymorph: a picture of Clinical picture is polymorph: a picture of
keratosis pilaris keratosis pilaris comedons comedons papules papules pustules pustules absces. Never cysts. absces. Never cysts.
Predilection: dorsal part of fingers, Predilection: dorsal part of fingers, forearms, thighs, abdomen, back, face forearms, thighs, abdomen, back, face (among young patients)(among young patients)
Prevention of acne oleosaPrevention of acne oleosa
Cleanliness of dressCleanliness of dress Cleanliness of skin during work and after it Cleanliness of skin during work and after it
(warm! Water, soaps)(warm! Water, soaps)
Cleanliness is next to godliness
Acne piceaAcne picea
asfalts, bitumens (mede f.i. from coal)asfalts, bitumens (mede f.i. from coal) many professions (contact with asfalt – many professions (contact with asfalt –
construction of roads, industry of construction of roads, industry of petroleum…)petroleum…)
Clinical pictureClinical picture: open commedons, without : open commedons, without inflammation of surrounded skin, inflammation of surrounded skin, whenever on the skin (also on the face) whenever on the skin (also on the face) + hyperpigmentations + hyperpigmentations
Prevention of acne piceaPrevention of acne picea
Ventilation in workroomsVentilation in workrooms Personaly hygienic habitsPersonaly hygienic habits Persons with seborrhoic type of skinPersons with seborrhoic type of skin (fotoprotection)(fotoprotection)
Occupationals tumors
Spinalioma
- fingers of physicians (x-rays)