27: Occupational Skin Diseases Flashcards
1
Q
What are the primary categories of exposures that can lead to Occupational Skin Diseases (OSDs)?
A
OSDs can be classified by the following exposures:
- Chemical: organic and inorganic compounds, elemental substances
- Mechanical: friction, pressure, vibration
- Physical: ionizing and nonionizing radiation, thermal stress
- Biologic: bacteria, viruses, fungi, parasites, insects, plants, animals
2
Q
What percentage of Occupational Skin Diseases (OSDs) is comprised of Occupational Contact Dermatitis (OCD)?
A
Occupational Contact Dermatitis (OCD) comprises 90% to 95% of OSDs.
3
Q
What are the two main types of Occupational Contact Dermatitis (OCD) and how are they differentiated?
A
The two main types of Occupational Contact Dermatitis (OCD) are:
-
Irritant Contact Dermatitis (ICD)
- Nonimmunologic reaction to a chemical, physical, or mechanical irritation.
- Caused by direct cytotoxic effects from an agent.
- No prior sensitization is required.
-
Allergic Contact Dermatitis (ACD)
- Reaction to a substance via a type IV, delayed hypersensitivity reaction.
- Requires prior sensitization to an allergen.
4
Q
What are the common causes of Irritant Contact Dermatitis (ICD)?
A
Common causes of Irritant Contact Dermatitis (ICD) include:
- Wet work tasks (most common occupational exposure)
- Exposure to soaps
- Petroleum products
- Cutting oils
- Coolants
- Solvents
5
Q
What are the clinical presentations of Irritant Contact Dermatitis (ICD)?
A
ICD presentations may be categorized as follows:
- Acute
- Irritant reaction
- Cumulative
- Traumatic
- Asteatotic dermatitis
- Pustular and acneiform
- Subjective
6
Q
What is the decrescendo phenomenon in Acute Irritant Contact Dermatitis?
A
The decrescendo phenomenon refers to an irritant reaction that quickly reaches a peak and then starts to heal. This occurs shortly after exposure, typically within minutes to hours, allowing for a clear association between exposure and skin symptoms, which aids in diagnosis.
7
Q
What phenomenon is observed when a worker develops a transient increase in symptom intensity despite removal of an allergen?
A
This is the crescendo phenomenon, observed in acute irritant contact dermatitis (ICD).
8
Q
What is the likely diagnosis for a worker who develops a chronic condition with lichenification and fissuring of the skin?
A
The likely diagnosis is chronic irritant contact dermatitis (ICD).
9
Q
What are the primary factors that contribute to Occupational Skin Diseases (OSDs)?
A
Occupational Skin Diseases (OSDs) are primarily caused or aggravated by workplace factors, which can be classified into four main exposure types:
- Chemical: organic and inorganic compounds, elemental substances
- Mechanical: friction, pressure, vibration
- Physical: ionizing and nonionizing radiation, thermal stress
- Biologic: bacteria, viruses, fungi, parasites, insects, plants, animals
Most OSDs are attributed to chemical agents, and multiple concurrent exposures can occur.
10
Q
What distinguishes irritant contact dermatitis (ICD) from allergic contact dermatitis (ACD)?
A
Irritant contact dermatitis (ICD) is a nonimmunologic reaction that occurs when the skin’s normal barrier is disrupted by an irritant, with effects visible within minutes to hours and no prior exposure necessary. In contrast, allergic contact dermatitis (ACD) is a type IV hypersensitivity reaction that requires prior sensitization to an allergen, typically a low-molecular weight chemical acting as a hapten.
11
Q
What are the clinical presentations of irritant contact dermatitis (ICD)?
A
Irritant contact dermatitis (ICD) can present in various forms, categorized as follows:
- Acute
- Irritant reaction
- Cumulative
- Traumatic
- Asteatotic dermatitis
- Pustular and acneiform
- Subjective
The clinical picture is dependent on the time-effect and dose relationship, with symptoms ranging from immediate irritation to chronic conditions such as lichenification and fissuring.
12
Q
What is the significance of the decrescendo and crescendo phenomena in acute irritant contact dermatitis?
A
In acute irritant contact dermatitis, the decrescendo phenomenon refers to the irritant reaction quickly reaching a peak and then starting to heal, typically within a short lag time after exposure. This allows for a clear association between exposure and skin symptoms, facilitating diagnosis. Conversely, the crescendo phenomenon describes a transient increase in symptom intensity despite the removal of the irritant, indicating a more complex reaction that may complicate diagnosis and management.
13
Q
What are the common symptoms of irritant contact dermatitis?
A
Common symptoms include:
- Burning
- Soreness
- Stinging of the skin
- Lesions restricted to areas where the irritant damages the skin, resulting in erythema, edema, bullae, or necrosis with sharply demarcated borders.
14
Q
What is cumulative irritant contact dermatitis and how does it develop?
A
Cumulative irritant contact dermatitis is:
- A consequence of multiple subthreshold insults to the skin with insufficient time between insults for restoration of skin barrier function.
- Often results from the frequent repetition of one agitating factor or a variety of stimuli.
- Symptoms develop when damage exceeds an individually determined manifestation threshold.
- Sensitive skin may have a decreased irritant threshold or prolonged restoration time, leading to earlier development of cumulative ICD.
15
Q
What characterizes traumatic irritant contact dermatitis?
A
Traumatic irritant contact dermatitis is characterized by:
- Occurrence after acute skin trauma (e.g., lacerations, burns).
- Frequent appearance after using harsh cleansers.
- Eczematous lesions and delayed healing.
- Full resolution may take months after discontinuation of exposure.
16
Q
What is asteatotic dermatitis and who is most commonly affected?
A
Asteatotic dermatitis is:
- Also known as exsiccation eczematid ICD, asteatotic eczema, or winter dermatitis.
- A unique variant predominantly seen in elderly individuals with a history of extensive soap and cleansing product usage.
- Leads to dry-appearing skin with ichthyosiform scaling and intense pruritus, often occurring in low-humidity winter months.
17
Q
What are the specific irritants associated with pustular and acneiform irritant contact dermatitis?
A
Pustular and acneiform irritant contact dermatitis can result from exposure to specific irritants such as:
- Croton oil
- Mineral oils
- Tars
- Greases
- Naphthalenes
This syndrome should be considered when acneiform lesions develop in postadolescent patients who have never had teenage acne; the pustules are sterile and transient.
18
Q
What is the likely diagnosis for a worker who develops erythema and scaling under rings on their hands?
A
The likely diagnosis is irritant reaction contact dermatitis.
19
Q
What is the condition for a worker who develops erythema and scaling on their hands after exposure to weak irritants over time?
A
The condition is cumulative irritant contact dermatitis, caused by multiple subthreshold insults to the skin with insufficient recovery time.
20
Q
What is the likely diagnosis for a worker who develops pustular acneiform lesions after exposure to mineral oils?
A
The likely diagnosis is pustular and acneiform irritant contact dermatitis.
21
Q
What are the characteristics and symptoms of Irritant Reaction Contact Dermatitis in workers with excessively wet hands?
A
- Subclinical irritant dermatitis occurs in workers like hairdressers and bartenders.
- Symptoms include scaling and erythema, first identified under rings before spreading.
- Thinner skin on the dorsum of the hand is usually affected.
- Can cause vesiculation resembling pompholyx.
- Heals spontaneously but may progress to cumulative irritant dermatitis.
22
Q
How does Cumulative Irritant Contact Dermatitis develop and what factors contribute to its onset?
A
- Develops from multiple subthreshold insults to the skin without sufficient recovery time.
- Often results from repeated exposure to various stimuli.
- Symptoms appear when damage exceeds an individual’s manifestation threshold.
- Sensitive skin has a decreased irritant threshold or prolonged restoration time, leading to earlier development of cumulative ICD.
23
Q
What are the clinical implications of Traumatic Irritant Contact Dermatitis and its management?
A
- Arises after acute skin trauma (e.g., lacerations, burns).
- Characterized by eczematous lesions and delayed healing, often seen after harsh cleanser use.
- Full resolution may take months after exposure cessation.
- Management includes replacing harsh soaps with appropriate, effective alternatives.
24
Q
What distinguishes Asteatotic Dermatitis from other forms of irritant contact dermatitis?
A
- Also known as exsiccation eczematid ICD, primarily affects elderly individuals.
- Associated with extensive soap and cleansing product use.
- Leads to dry skin with ichthyosiform scaling and intense pruritus, especially in low-humidity winter months.
25
What are the common symptoms of Allergic Contact Dermatitis (ACD)?
Common symptoms of ACD include:
- **Pruritus** (itching)
- **Pain**
- **Erythema** (redness)
- **Swelling**
- **Xerosis** (dry skin)
- Formation of **wheals or blisters**
- **Lichenification** (thickening of the skin)
These symptoms can manifest as an acute, subacute, or chronic condition.
26
What distinguishes Nonimmunologic Contact Urticaria (NICU) from Immunologic Contact Urticaria (ICU)?
The distinctions between NICU and ICU are as follows:
| Feature | Nonimmunologic Contact Urticaria (NICU) | Immunologic Contact Urticaria (ICU) |
|-------------------------------|-----------------------------------------|-------------------------------------|
| **Cause** | Caused by a wide array of agents without previous sensitization | Type I hypersensitivity reaction mediated by IgE |
| **Severity** | Less severe than ICU reactions | More severe reactions possible |
| **Reactions** | Not inhibited by H-1 antihistamines; NSAIDs are effective | Can spread beyond localized contact |
| **Common Triggers** | Various chemicals and proteins | Latex gloves, certain foods |
27
What is the role of natural rubber latex (NRL) in Immunologic Contact Urticaria (ICU)?
Natural rubber latex (NRL) plays a significant role in ICU as it can cause:
- **Type I hypersensitivity reactions** in individuals previously exposed to latex.
- **Contact urticaria** from latex gloves is a prototypical example of ICU.
- A high prevalence of ICU among health care workers and others who frequently use latex products.
- A type IV hypersensitivity reaction (Allergic Contact Dermatitis) in response to NRL, accounting for the majority of allergic reactions (>80%) to NRL.
28
What type of occupational skin disease is characterized by erythema and pruritus after exposure to lactic acid in a cosmetic product?
This is subjective irritant contact dermatitis, characterized by sensory irritation without visible cutaneous signs.
29
What is the condition for a worker who develops a type IV hypersensitivity reaction to formaldehyde?
The condition is allergic contact dermatitis (ACD), caused by a delayed hypersensitivity reaction to formaldehyde.
30
What is the condition for a worker who develops a transient wheal and flare reaction after exposure to a protein agent?
The condition is contact urticaria, which can be nonimmunologic (NICU) or immunologic (ICU).
31
What is the condition for a worker who develops a type I hypersensitivity reaction to latex gloves?
The condition is immunologic contact urticaria (ICU), caused by a type I hypersensitivity reaction mediated by IgE.
32
What is the condition for a worker who develops erythema and pruritus after exposure to ammonium persulfate?
The condition is contact urticaria of uncertain mechanism, characterized by a histamine-type reaction.
33
What type of occupational skin disease is characterized by a transient wheal and flare reaction within minutes of wearing latex gloves?
This is immunologic contact urticaria (ICU), a type I hypersensitivity reaction mediated by allergen-specific IgE.
34
What type of contact urticaria is characterized by erythema, edema, and severe pruritus after exposure to ammonium persulfate?
This is contact urticaria of uncertain mechanism, characterized by a histamine-type reaction without a direct or immunologic basis.
35
What type of occupational skin disease is characterized by a delayed hypersensitivity reaction to glutaraldehyde?
This is allergic contact dermatitis (ACD), a type IV delayed hypersensitivity reaction.
36
What type of contact urticaria is developed from exposure to ammonium persulfate in hair bleaching products?
This is contact urticaria of uncertain mechanism, characterized by a histamine-type reaction without a direct or immunologic basis.
37
What type of occupational skin disease does a healthcare worker develop due to a delayed hypersensitivity reaction to glutaraldehyde?
This is allergic contact dermatitis (ACD), a type IV delayed hypersensitivity reaction.
38
What are the common clinical signs associated with Allergic Contact Dermatitis (ACD)?
Common clinical signs of ACD include:
- **Pruritus**
- **Pain**
- **Erythema**
- **Swelling**
- **Xerosis**
- **Formation of wheals or blisters**
- **Lichenification**
These symptoms can manifest as an acute, subacute, or chronic condition.
39
What distinguishes Nonimmunologic Contact Urticaria (NICU) from Immunologic Contact Urticaria (ICU)?
The distinctions between NICU and ICU are:
| Feature | NICU (Nonimmunologic) | ICU (Immunologic) |
|-------------------------------|-------------------------------------------|-------------------------------------------|
| **Sensitization** | No previous sensitization required | Requires previous exposure to the allergen |
| **Severity** | Less severe reactions | More severe reactions |
| **Reactions** | Not inhibited by H-1 antihistamines | Mediated by allergen-specific IgE (Type I) |
| **Onset of lesions** | Appears within minutes to an hour | Can spread beyond localized contact point |
40
What are the potential occupational exposures that can lead to Immunologic Contact Urticaria (ICU)?
Occupational exposures that can lead to ICU include:
- **Natural rubber latex (NRL)**
- **Food**
- **Other allergens**
These include preservatives, fragrances, disinfectants, antibiotics, topical medicaments, epoxy resin hardeners, formaldehyde in clothing, several woods, and birch pollen.
41
What skin condition can machinists develop due to exposure to industrial or cutting oils?
Machinists can develop **oil acne**, which occurs not only in oil-soaked clothing regions but also in other areas exposed to potential airborne oil mists.
42
What are the characteristics of chloracne associated with chemical exposures?
Chloracne is characterized by multiple **closed comedones** and **straw-colored cysts**, primarily over the malar crescents and retroauricular folds, and may also involve the neck, trunk, extremities, buttocks, scrotum, and penis.
43
What types of injuries can result from mechanical exposures to the skin?
Mechanical exposures can lead to injuries such as:
1. **Calluses**
2. **Blisters**
3. **Myositis**
4. **Tenosynovitis**
5. **Osseous injury**
6. **Nerve damage**
7. **Lacerations**
8. **Shearing of tissue**
9. **Abrasions**
These injuries may pave the way for secondary infections by bacteria, fungi, parasites, or viruses.
44
What skin condition can develop in workers exposed to hot environments?
Workers in hot environments may develop **miliaria**, which is characterized by pruritus, papule formation, and a small risk of heat exhaustion.
45
What is Erythema ab igne and when is it typically seen?
**Erythema ab igne** is seen in repeated, prolonged exposure to heat, particularly in individuals using laptops on their laps for extensive periods of time.
46
What is the likely exposure for a worker who develops chloracne characterized by multiple closed comedones and straw-colored cysts?
The likely exposure is to dioxins, naphthalenes, biphenyls, dibenzofurans, azobenzenes, or azoxybenzenes.
47
What is the likely cause of comedonal acne in a worker in a coal tar plant?
The likely cause is exposure to coal tar oils, creosote, and pitch, which can lead to comedonal acne. These compounds also contain polycyclic aromatic hydrocarbons (PAH), which are carcinogenic.
48
What is the condition of a worker in a hot environment who develops pruritic papules in areas of chronic rubbing with clothing?
The condition is miliaria, and if left untreated, there is a small risk of heat exhaustion.
49
What type of occupational skin disease does a musician develop due to chronic rubbing from playing their instrument?
This is a mechanical exposure-related occupational skin disease caused by friction and pressure.
50
What are the occupational risk factors for frostbite in a construction worker?
Occupational risk factors include working in cold environments, such as those faced by firemen, construction workers, postal workers, and military personnel.
51
What is the cause of erythema ab igne in a worker in a tanning salon?
The cause is repeated, prolonged exposure to heat, such as from laptops or other heat sources.
52
What is the likely cause of a pruritic eruption resembling scabies in a worker in a fiberglass factory?
The likely cause is mechanical irritation from fiberglass penetration into the skin.
53
What skin condition can machinists develop due to exposure to industrial oils?
Machinists may develop **oil acne**, characterized by comedones and acne lesions in areas exposed to industrial or cutting oils, particularly in oil-soaked clothing regions and other areas exposed to airborne oil mists.
54
How does prolonged exposure to heat affect workers, and what skin condition can develop as a result?
Workers in hot environments may develop **miliaria**, which is characterized by pruritus and papule formation due to chronic rubbing with clothing, and they are at risk for heat exhaustion.
55
What skin condition is associated with exposure to chloracne-inducing chemicals, and what are its characteristics?
**Chloracne** is associated with exposure to certain dioxins and is characterized by multiple closed comedones and straw-colored cysts, primarily over the malar crescents and retroauricular folds, and may also involve the neck, trunk, and other areas.
56
What are the effects of mechanical exposures on the skin, particularly for athletes and musicians?
Mechanical exposures can lead to repetitive trauma resulting in conditions such as **blisters**, **jogger's toe**, and lesions in musicians due to chronic rubbing specific to the instrument being played. These effects are influenced by factors like age, gender, and preexisting skin conditions.
57
What are the potential consequences of cold exposure on the skin?
Cold exposure can lead to **Raynaud phenomenon**, which is characterized by reduced blood flow to extremities, and can also result in **frostbite**, affecting areas such as the nose, ears, fingers, and toes, particularly in workers exposed to cold environments.
58
What is the most important cause of skin cancer and how can it be prevented?
**Ultraviolet radiation (UV)** is the most important cause for all types of skin cancer, including melanoma, squamous cell carcinoma, and basal cell carcinoma. Avoiding UV exposure could prevent more than 3 million cases of skin cancer each year.
59
What are the primary measures for preventing skin cancer in outdoor workers?
The primary measures for preventing skin cancer in outdoor workers include:
1. Regular use of **sunscreen**.
2. Protection from direct UV radiation by suitable **clothing**.
3. Changes in behavior with awareness of health and diseases resulting from exposure to UV radiation.
60
How does UV radiation exposure differ for airline crews compared to the general population?
Meta-analysis identified that pilots and cabin crew have twice the rate of melanoma compared to the general population. UV radiation exposure increases by 10% to 12% for every 1000 m in elevation, leading to potential UV exposure that is 2 to 3 times greater at cruising altitude.
61
What are the characteristics of radiation dermatitis?
**Radiation dermatitis** is characterized by high levels of acute exposure leading to:
- **Erythema**
- **Itching**
- **Cutaneous inflammation**
62
What are the common bacterial infections associated with occupational exposure?
Common bacterial infections associated with occupational exposure include:
| Infection | Description | Occupations at Risk |
|-----------|-------------|---------------------|
| Staphylococcus and Streptococcus | Contaminate minor lacerations, burns, puncture wounds, leading to impetigo, cellulitis, furuncles, and abscesses. | Meat packers, construction workers, farm workers |
| Anthrax | Predominantly a cutaneous infection found in occupations handling imported goat hair, wool, and hides contaminated with Bacillus anthracis spores. | Wool handlers |
| Fish Tank Granuloma | Caused by Mycobacterium marinum, resulting in a warty nodule or plaque at a point of trauma. | Fish handlers |
| Erysipeloid | Caused by Erysipelothrix rhusiopathiae, associated with handling decaying animal products. | Fish and poultry handlers |
| Pitted Keratolysis | Caused by Corynebacterium species, leading to localized skin infections. | Various occupations |
63
What is the likely diagnosis and causative agent for a worker who develops a warty nodule at a point of trauma six weeks after exposure to fish tank water?
The likely diagnosis is fish tank granuloma, caused by Mycobacterium marinum.
64
What is the condition and causative agent for a worker who develops a localized bright red infection after handling fish?
The condition is erysipeloid, caused by Erysipelothrix rhusiopathiae.
65
What is the condition and causative agent for a worker in a laboratory handling Bacillus anthracis who develops a cutaneous infection?
The condition is anthrax, and occupational risk factors include handling imported goat hair, wool, and hides contaminated with Bacillus anthracis spores.
66
What is the likely diagnosis for a farmer handling decaying animal products who develops a localized bright red infection on their hand?
The likely diagnosis is erysipeloid (Fish-Handler Disease), caused by the gram-positive bacterium Erysipelothrix rhusiopathiae.
67
What are the primary measures for preventing skin cancer in outdoor workers exposed to UV radiation?
The primary measures for preventing skin cancer in outdoor workers include:
1. Regular use of **sunscreen**.
2. Protection from direct UV radiation by **suitable clothing**.
3. Changes in behavior with awareness of health and diseases resulting from exposure to UV radiation.
68
What is Fish Tank Granuloma, and what occupational exposure is it associated with?
Fish Tank Granuloma is caused by **Mycobacterium marinum**, an acid-fast, nontuberculous mycobacterium. It is associated with occupational exposure to contaminated water, particularly in individuals who handle fish tanks or swimming pools, leading to a warty nodule or plaque at the site of trauma, typically appearing about 6 weeks after exposure.
69
What are the clinical features and occupational associations of Erysipeloid (Fish-Handler Disease)?
Erysipeloid, caused by the gram-positive bacterium **Erysipelothrix rhusiopathiae**, is almost always an occupational disease associated with handling decaying animal products such as fish, shellfish, mammals, and poultry. Clinical features include a sharply demarcated bright red to violaceous infection, often involving the hands, which occurs after a predisposing insult to the skin, such as an abrasion or cut.
70
What are the potential health risks associated with exposure to Staphylococcus and Streptococcus in occupational settings?
Exposure to **Staphylococcus** and **Streptococcus** in occupational settings can lead to contamination of minor lacerations, burns, puncture wounds, or abrasions, resulting in conditions such as impetigo, cellulitis, furuncles, and abscesses. This risk is particularly prevalent among meat packers, construction workers, farm workers, and those in close contact with infected individuals.
71
What is the primary cause of Tinea pedis and which workers are at greater risk of infection?
Tinea pedis is primarily caused by fungal infections, particularly in humid, occlusive footwear. Workers at greater risk include miners, military personnel, athletes, and laborers.
72
What are the common sources of Brucellosis infection in humans?
Common sources of Brucellosis infection in humans include inhalation of contaminated aerosols, contact with conjunctival mucosa, entry of bacteria through cuts in the skin, and ingestion of infected milk or milk products. Occupational exposure is prevalent among slaughterhouse workers, farmers, veterinarians, and laboratory workers.
73
What is the most common presentation of Tularemia and who is at risk?
The most common presentation of Tularemia is the ulceroglandular form, characterized by an ulcer at the site of inoculation and regional lymphadenopathy. Those at risk include laboratory workers, farmers, veterinarians, sheep workers, hunters, cooks, and meat handlers.
74
Which zoophilic dermatophytes are associated with Tinea pedis and what occupations are at risk?
The zoophilic dermatophytes associated with Tinea pedis include Trichophyton verrucosum, Trichophyton mentagrophytes, Microsporum canis, and Microsporum nanum. Occupations at risk include slaughterhouse workers, veterinarians, farmers, and pet shop workers.
75
What preventive measures can be taken to avoid Candida skin infections among food handlers?
Preventive measures for avoiding Candida skin infections among food handlers include proper drying of the skin and wearing protective gloves to minimize moisture and maceration near the nails and between the digits.
76
How can Herpes Simplex Virus be transmitted in healthcare settings?
Herpes Simplex Virus can be transmitted in healthcare settings through direct (lip) or indirect (finger) contact, especially when a lesion is present in the patient, posing a particular risk in dental practices.
77
What is the condition and causative agent for a worker who develops a localized infection with malodor and hyperhidrosis of the plantar skin?
The condition is pitted keratolysis, caused by gram-positive bacteria, usually Corynebacterium species.
78
What is the primary mode of transmission for Tularemia?
Tularemia is primarily transmitted by ticks, fleas, deerflies, ingestion, inhalation, or direct contact with infected tissues.
79
Which occupational groups are at higher risk for Tularemia?
Occupational groups at higher risk include laboratory workers, farmers, veterinarians, sheep workers, hunters, cooks, and meat handlers.
80
What are the common occupational exposures that can lead to Brucellosis?
Common occupational exposures to Brucellosis include inhalation of contaminated aerosols, contact with conjunctival mucosa, and entry of bacteria through cuts in the skin.
81
What are the typical symptoms associated with Brucellosis?
Typical symptoms include fevers, night sweats, myalgia, weight loss, arthralgia, and infrequent skin manifestations such as disseminated papular and nodular eruptions, extensive purpura, and chronic ulcerations.
82
What is the condition and causative agent for a localized infection with malodor and hyperhidrosis of the plantar skin?
The condition is pitted keratolysis, caused by gram-positive bacteria, usually Corynebacterium species.
83
Which occupational groups are at increased risk for Tinea pedis?
Occupational groups at increased risk for Tinea pedis include miners, military personnel, athletes, and laborers.
84
What factors contribute to the risk of Tinea pedis?
Factors contributing to this risk include humid and occlusive footwear and prolonged exposure to warm, moist environments.
85
What preventive measures can bartenders and food handlers take to reduce the risk of Candida skin infections?
To reduce the risk of Candida skin infections, bartenders and food handlers should properly dry their skin after washing, wear protective gloves during wet work, and maintain good hand hygiene.
86
What are the implications of Herpes Simplex Virus exposure for health care workers?
Herpes Simplex Virus poses significant implications for health care workers due to the ease of transmission through direct or indirect contact, especially when lesions are present in patients.
87
What is Orf (Ecthyma Contagiosum) and who is at risk?
Orf is a zoonotic infection caused by a parapoxvirus that infects sheep and goats, transmitted to humans through contact with infected animals or fomites. Those at risk include veterinarians, sheep herders, farmers, and children visiting petting zoos.
88
What are the characteristics and prevention methods for Pseudocowpox (Milker Nodule)?
Pseudocowpox is transmitted by direct contact from infected cows' udders to farmers, veterinarians, and fresh meat handlers, causing painful nodules. Prevention includes treating cows' mastitis and using gloves, soap, water, and disinfectants.
89
What are the bloodborne pathogens that pose a threat to healthcare workers?
The three bloodborne viruses that pose a serious occupational threat to healthcare workers are Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human Immunodeficiency Virus (HIV).
90
What is the gold standard for diagnosing Allergic Contact Dermatitis (ACD)?
The gold standard for diagnosing ACD is patch testing, which is pivotal in determining the etiology of Occupational Skin Diseases when assessing contact dermatitis.
91
What is the purpose of skin prick testing in contact urticaria?
Skin prick testing is used to identify IgE-mediated immediate hypersensitivity reactions, introducing a small amount of allergen into the epidermis to elicit a localized response.
92
What is the Radioallergosorbent test (RAST) and its current status?
The Radioallergosorbent test (RAST) measures serum-specific IgE but has been outdated and replaced with more sensitive ELISA tests.
93
What are the primary preventive measures for Orf in at-risk populations?
Preventive measures for Orf include using gloves when handling infected animals, washing hands with soap and water after contact, disinfecting surfaces, and avoiding contact with infected animals.
94
How does the transmission of Pseudocowpox occur?
Pseudocowpox is transmitted by direct contact from infected cows’ udders to farmers, veterinarians, and fresh meat handlers.
95
What is the significance of patch testing in diagnosing allergic contact dermatitis in occupational skin diseases?
Patch testing identifies specific allergens responsible for skin reactions and helps determine the etiology of occupational skin diseases.
96
What role does skin prick testing play in diagnosing contact urticaria?
Skin prick testing identifies IgE-mediated immediate hypersensitivity reactions by introducing allergens into the epidermis.
97
What are the implications of bloodborne pathogens for healthcare workers?
Bloodborne pathogens pose serious risks, including exposure to HBV, HCV, and HIV, with potential skin manifestations and systemic dysfunctions.
98
What are the four main components of health risk assessment in occupational skin diseases?
The four main components are Hazard Identification, Dose-Response Relationship, Exposure Assessment, and Risk Characterization.
99
How can older individuals be affected by irritants in occupational skin diseases?
Older individuals have reduced reactivity to irritants, making them more susceptible to conditions like irritant contact dermatitis.
100
What role does the filaggrin gene play in occupational skin diseases?
Mutations in the filaggrin gene can affect skin barrier functions, contributing to the development of atopic dermatitis and increasing susceptibility to contact dermatitis.
101
What are some methods to reduce exposure to hazards in the workplace?
Methods include Elimination or Substitution, Engineering Controls, Administrative Controls, and Personal Protective Equipment (PPE).
102
What is the significance of the dose-response relationship in occupational contact dermatitis?
The dose-response relationship helps delineate the threshold concentrations of exposure that result in adverse health effects.
103
What factors should be considered during exposure assessment for occupational skin diseases?
Factors include potential routes of exposure, duration and frequency of work tasks, and monitoring for compliance with legal permissible exposure limits.
104
What recommendations might be included in risk characterization for occupational skin diseases?
Recommendations may include substitution of hazardous chemicals, changes in ventilation, addition of local exhaust systems, alterations in work cycles, and use of PPE.
105
What is the likely diagnosis for a worker developing erythema and scaling on their hands after exposure to soaps?
The likely diagnosis is irritant contact dermatitis (ICD).
106
What is the likely diagnosis for a healthcare worker developing pruritus and scaling on their hands after frequent handwashing?
The likely diagnosis is irritant contact dermatitis (ICD), caused by excessive hygiene measures and use of soaps.
107
How do older individuals and females differ in their susceptibility to irritant contact dermatitis?
Older individuals generally have reduced reactivity to irritants, making them more susceptible to ICD, while ICD is seen more commonly in females.
108
What are the implications of using personal protective equipment (PPE) in preventing occupational skin diseases?
PPE can limit hazardous exposures but may also increase permeation of irritants, directly irritate the skin, or lead to excessive hygiene measures.
109
What factors should be considered in exposure assessment for occupational contact dermatitis?
Factors include potential routes of exposure, work task duration and frequency, and monitoring for compliance with permissible exposure limits.
