27 - Occupational Skin Disease Flashcards
Exposure classification of occupational skin diseases
- Chemical
- Mechanical
- Physical
- Biologic
Vast majority of occupational skin diseases are attributed to _____ agents
Chemical
Occupational contact dermatitis comprises _____% of occupational skin diseases
90-95
Highest total skin disease cases found in
Education and health services
Highest incidence rate of skin diseases found in
Natural resources and mining industries
Vast proportion of occupational skin diseases occur on the
Hands (80%)
Most common occupational exposure leading to contact dermatitis
Wet work tasks
ICD presentations
Acute Irritant reaction Cumulative Traumatic Asteatotic dermatitis Pustular and acneiform Subjective
Manifests when the skin is exposed to a potent irritant or caustic chemical
Acute ICD
Decrescendo vs crescendo: ICD or ACD
Decrescendo: ICD
Crescendo: ACD
Most frequent potent culprits giving rise to acute ICD
Acids and alkaline
Scaling and erythema are first identified under rings before spreading over fingers to hands and forearms
Irritant reaction contact dermatitis
Irritant reaction contact dermatitis usually affects the
Dorsum of the hand
Consequence of multiple subthreshold insults to the skin with insufficient time between insults to allow complete restoration of the skin barrier function
Cumulative ICD
In cumulative ICD, clinical symptoms develop only when the damage exceeds an individually determined
Manifestation threshold
Associated with weak irritants rather than potent irritants
Cumulative ICD
May arise after acute skin trauma
Traumatic ICD
Seen predominantly in elderly individuals with a history of extensive usage of soaps and cleansing products
Asteatotic dermatitis
Should always be considered when acneiform lesions develop in postadolescent patients who never had teenage acne
Pustular and acneiform ICD
Y/N: Pustules are sterile and transient in pustular and acneiform ICD.
Yes
Result from exposure to specific irritants such as croton oil, mineral ouls, tars, greases and naphthalenes
Pustular and acneiform ICD
Lack of objective clinical signs as individuals complain of a sensation of burning or stinging
Subjective ICD
Subjective ICD has been observed with chemicals such as
Lactic acid
Most common type of contact urticaria
Nonimmunologic contact urticaria
Nonimmunologic vs immunologic contact urticaria
Nonimmunologic: remains localized, less severe, not inhibited by H-1 antihistamines
Y/N: Oral or topical nonsteroidal anti-inflammatory medications are effective for nonimmunologic contact urticaria.
Yes
Prototypical example of immunologic contact urticaria
Contact urticaria from latex gloves
Immunologic contact urticaria stage: localized urticaria, dermatitis, or nonspecific symptoms
Stage 1
Immunologic contact urticaria stage: generalized urticaria
Stage 2
Immunologic contact urticaria stage: Urticaria and rhinoconjunctivitis, asthma, or GI symptoms
Stage 3
Immunologic contact urticaria stage: anaphylaxis
Stage 4
Majority of natural rubber latex allergy caused a type _____ hypersensitivity reaction
IV
Second most common cause of immunologic contact urticaria
Food
Contact urticaria of uncertain mechanism is most commonly caused by
Ammonium persulfate in bleaching hair boosters
Exposure to certain dioxins, naphthalenes, biphenyls, dibenzofurans, azobenzenes, and azoxybenzens have been associated with
Chloracne
Subclinical irritant dermatitis
Irritation reaction contact dermatitis
Harpist’s
Finger
Fiddler’s
Neck
Guitar
Nipple
Cellist’s
Chest
Flautist’s
Chin
Jogger’s
Toe
Black heel or
Talon noir
Mousing
Callus
Computer
Palms
Use of vibration-producing tools can induce painful vascular spasms in the fingers and hands known as
White finger or vibration-induced white finger
White finger or vibration-induced white finger is a secondary type of
Raynaud’s phenomenon
Vibration frequencies between _____ Hz ate most strongly associated with vibration-induced white finger
30 and 300
Risk factor for vibration-induced white finger
Smoking
Highest incidence rates for all burn injuries
Welders
Outdoor workers are loosely defined as individuals who work outdoors for _____ or more hours
3
UV radiation is recognized to increase by _____% for every 1000 m in elevation
10-12
Pilots and cabin crew flying for approximately _____ minutes at cruising altitude receive the same amount of UVA as that from a 20-minute tanning bed session
56
Responsible for fish tank or swimming pool granuloma
Mycobacterium marinum
Responsible for the acute infection of erysipeloid
Erysipelothrix rhusiopathiae
Also known as fish-handler disease
Erysipeloid
Pitted keratolysis is usually caused by
Corynebacterium species
Caused by gram-negative bacterium that is primarily a disease of animals in which humans are an accidental host
Brucellosis
Tularemia is caused by
Francisella tularensis
Most common presentation of tularemia
Ulceroglandular form
Most severe though less common form of tularemia
Pneumonic form
Trichophyton verrucosum is associated with
Cattle, farm buildings, straw
Trichophyton mentagrophytes is associated with
Cattle and domestic animals
Microsporum canis is associated with
Domestic animals especially cats
Microsporum nanum is associated with
Pigs
Zoonotic infection caused by a parapox virus that commonly infected sheep and goats
Orf or ecthyma contagiosum
Also know as milker nodule
Pseudocowpox
Transmitted by direct contact from infected cows’ udders
Orf or ecthyma contagiosum
(High/Low) HPV transmission risk of oral and nasal HPV
Low
Butcher wart virus
HPV-7
Open test: (immunologic/nomimmunologic contract urticaria) usually presents earlier (15-20 min), whereas (immunologic/nomimmunologic contract urticaria) may be delayed (45-60 min) after application
Immunologic
Nonimmunologic
Exposure to arsenic can be detected in
Blood
Hair
Nails
Urine
Most reliable indicator of exposure to arsenic
Urine
When measuring arsenic in urine, it is important to requesr
Speciation to determine the specific amounts of organic versus inorganic arsenic
Toxic forms of arsenic
Inorganic arsenic
Elemental arsenic
Arsine gas
Organjc arsenic can be found in
Seafood
Significantly elevate total arsenic levels up to _____ hours after ingesting a seafood meal
72
In the occupational setting, beryllium sensitization can be detected throug
Beryllium lymphocyte proliferation test
Permanent and potentially progressive granulomatous restrictive lung disease
Chronic beryllium disease
Y/N: Older individuals have increased reactivity to irritants
No - increased reactivity
Hierarchy of controls for mitigating hazards from most to least protective
Elimination Substitution Engineering Administrative PPE
_____ skin may be more reactive and _____ skin less reactive than white skin
Asian
Black
Atopic dermatitis is known to increase the susceptibility of skin to (irritants/allergens) but not to (irritants/allergens)
Irritants
Allergens
Wet work conditions are defined as
Exposure of skin to liquid for more than 2 hours per day or
Use of occlusive gloves for more than 2 hours per day or
Frequent handwashing
Characterized by multiple closed comedones and straw-colored cysts primarily over the malar crescents and retroauricular folds
Chloracne