Keratolysis exfoliativa-like eruption induced by ranolazione

Dermatoses affecting palms may represent a dermatologic challenge from both the diagnostic, and therapeutic point of view. Patients with supposedly occupational dermatitis can spend months or even years in a frustrating attempt to avoid contact with possible irritants or allergens. To underline the importance of a thorough unbiased analysis of the patient’s history and clinical features, we present the iconic case of a bricklayer affected by a chronic, disabling desquamation of palms which in the end was classified as keratolysis exfoliativa (KE) attributed to ranolazine-intake, an antianginal drug. To the best of our knowledge, this specific adverse effect of drug-induced KE of palms has never been reported before in association with ranolazine.

HUBUNGAN HIGIENE PERORANGAN DAN PENGGUNAAN ALAT PELINDUNG DIRI DENGAN KSEJADIAN DERMATITIS KONTAK AKIBAT KERJA PADA PEKERJA PENGANGKUT SAMPAH DI DLHK KOTA DENPASAR TAHUN 2020

ABSTRAK Tingginya angka kejadian dermatitis kontak pada pekerja pengangkut sampah dikarenakan petugas pengangkut sampah setiap harinya mengalami kontak langsung dengan sampah sebagai agen yang meningkatkan risiko terjadinya dermatitis kontak akibat kerja. Tujuan penelitian ini untuk mengetahui hubungan antara higiene perorangan dan penggunaan alat pelindung diri dengan dermatitis kontak akibat kerja pada pekerja pengangkut sampah di Dinas Lingkungan Hidup dan Kebersihan Kota Denpasar. Penelitian ini bersifat kuantitatif dengan rancangan cross sectional. Sampel penelitian adalah pekerja pengangkut sampah di DLHK Kota Denpasar dengan jumlah sampel minimal 84 responden. Teknik pemilihan sampel dengan simple random sampling. Penelitian dilakukan pada Bulan Maret-Juni tahun 2020. Data dianalisis untuk meneliti hubungan antar variabel yang diuji dengan analisis bivariat. Hasil penelitian menunjukkan terdapat 26,19% pekerja mengalami dermatitis kontak akibat kerja. Terdapat hubungan yang signifikan antara masa kerja, jam kerja, kebersihan kulit, kebersihan rambut dan kulit kepala, kebersihan kuku, tangan, dan kaki, penggunaan sarung tangan, penggunaan baju dan celana panjang, penggunaan sepatu boot dengan kejadian dermatitis kontak akibat kerja. Sedangkan pada variabel umur, tingkat pendidikan, dan penggunaan topi tidak berhubungan. Disarankan kepada Dinas Lingkungan Hidup dan Kebersihan Kota Denpasar tetap mendukung penyediaan APD serta kepatuhan para pekerja untuk memelihara higiene perorangan dan menggunakan APD yang lengkap. Kata Kunci: Dermatitis, Higiene Perorangan, APD ABSTRACT The high incidence of dermatitis due to garbage transport workers because they have a direct contact with garbage as an agent that increases the risk of occupational dermatitis. The aims of this study was to determine the association of personal hygiene and the use of PPE with the incidence of occupational dermatitis in garbage transport workers at Denpasar City Environment and Sanitation Office. This research is a quantitative study with cross sectional design. Respondents were 84 garbage transport workers in Denpasar City Environment and Sanitation Office which selected by simple random sampling. The study was conducted in March-June 2020. Data were statistically analyzed by bivariately to examine the association between variables tested. The results of this study showed the 26.19% workers had occupational dermatitis. There were association between work period, hours of work, hygiene of skin, hair and scalp, nails, hands and feet, use of gloves, clothing and trousers, and boots with occupational dermatitis. While the variables of age, education level, and hat usage did not have association with occupational dermatitis. It is necessary for support of facilities and infrastructure from the government and the need for awareness of workers to maintain personal hygiene and use the complete PPE. Keywords: Dermatitis, Personal Hygiene, PPE

The successful introduction of a hand dermatitis clinic to reduce occupational dermatoses during the covid-19 pandemic

BackgroundThe SARS-Co-V pandemic has necessitated strict hand hygiene practices in healthcare settings. An increased incidence of staff presentations of occupational dermatitis in our institutions prompted the establishment of a drop-in access daily hand dermatitis clinic.Objectiveto document the incidence and severity of cases of occupational dermatitis arising in healthcare workers during the first wave of the pandemic, and to reduce the impact of this with early assessment and treatment.Methodsan open-access daily staff clinic run by dermatologists was established, and demographic and clinical data collected from each clinical encounter.Results532 staff attended the clinic over a 6 week period. This compared to 7 staff presenting to occupational health over the same period in 2019. The majority were females 81%,and ward based 51%. ITU and A&E staff represented 15%. The prevalence of occupational hand dermatitis was 88%. 52% were classed as mild, 26% as moderate 26% and 9% severe/very severe.Conclusionsthe pandemic and associated hand hygiene practices have led to a substantial increase in presentations of occupational hand dermatitis. A drop-in clinic proved an effective way of allowing staff to access treatment in a timely fashion.

Modified Plasma Cytokine Profile in Occupational Dermatitis

Background: Despite significant progress in the diagnosis of contact dermatitis, the identification by specific tests or biomarkers remains an unsolved issue, particularly when needed for the confirmation of the occupational origin of the disease. Objective: To characterize the plasma proteome profile in occupational dermatitis in workers of paint industry. Methods: The study has a case-control design, comparing exposed workers with and without occupational contact dermatitis, matched for age, gender, occupational history, and comorbidities. An immunological assay (Human XL Cytokine Array Kit – ARY022B, R&D Systems) was used to measure the plasma levels of 105 cytokines and chemokines in a pooled sample of the cases and a pooled sample of the controls. Results: A 1.5-fold increase was noticed for interleukin 3, interleukin 10, and leptin in cases, as compared to controls. Fibroblast growth factor-7 and growth/differentiation factor-15 showed a 1.4-fold increase, while interleukin 19, interleukin 31, and macrophage inflammatory protein 3a.had only a 1.3- fold increase. The leukemia inhibitory factor was the only plasma cytokine that showed a 1.3-fold decrease. All other cytokines had a variation of less than 1.2-fold between cases and controls. Conclusion: The recognition of the molecular signatures is very important for an accurate and indisputable diagnosis of occupational contact dermatitis. In workers from the paint industry, plasma levels of interleukins 3, 10, 13 and 19, fibroblast growth factor-7, and growth/differentiation factor-15, together with leukemia inducible factor, may differentiate subjects with contact dermatitis from those without skin lesions.