Dermatosis Flashcards
What is the general term for dermatosis?
skin disease
What is the history of dermatosis?
some of the earliest recognized occupational diseases
What is the statistic for dermatosis today?
-second highest reportable illness
What is the issue with looking at numbers? What is better? example?
Numbers- raw data, do not have a standard comparison. Rate- gives a standard comparison, so much better.
Ex) raw data shows that service industry of highest concern for dermatosis, but when looking at rate, agriculture, forestry, and fishing is actually the highest and services one of lowest (so larger number working in service industry and more agricultural workers getting sick with less workers)
Do percentage breakdowns accurately show data?
NO- need rates to compare data
What host factors affect risk of dermatosis?
- race
- age
- gender
- texture
- perspiration
- cleanliness
- atopy
- other skin diseases
What is atopy?
Allergic disposition
Why is age an important host factor?
older people have skin with less elasticity and oils
What are the common locations of atopic skin wounds in adults?
Face, neck, visible skin folds, hands/ feet, arms and legs
relating to or affecting the skin
cutaneous
through the skin –> systemic effects
percutaneous absorption
What is the difference between cutaneous and percutaneous?
Cutaneous- relating to the skin
percutaneous absorption- absorbed through the skin and distributed to cause systemic effects
Why is skin a concern?
it is the largest organ with the largest surface area (increased opportunity for contact and absorption)
How much skin do we have total? Breakdown?
18k cm^2
1/3 lower limbs
1/3 torso
1/3 upper limbs, head, and neck
What are the functions of the skin?
1) regulates temperature
2) UV light barrier
3) permeability barrier
What are the three layers of the skin?
Epidermis
Dermis
Subcutaneous
tough layer of the epidermis that offers the most protection
stratum corneum
What cells are in the epidermis that respond to UV light?
Melanocytes- more are produced when exposed to UV light
Are pores and hair a concern as a route of entry?
No
What substances are able to penetrate the stratum corneum?
alkali
What is dermatosis?
abnormal conditions of the skin
Layer that flakes off
Stratum corneum in epidermis
What are some abnormal conditions of the skin?
1) mild redness
2) itching
3) scaling
4) acneiform
5) eczema
6) pigmentary
7) ulcers
8) granuloma
9) neoplasms
Skin abnormalities resulting from or aggravated by the work environment
occupational dermatosis
What are the 5 categories of occupational dermatosis agents?
1) Physical
2) Mechanical
3) Biological
4) Botanical
5) Chemical
term for irritation of the skin
Dermatitis
What is the difference between dermatosis and dermatitis?
Dermatosis- abnormal skin conditions
dermatitis- irritation of the skin
What is the most common occupational illness in the U.S.?
contact dermatitis
What is the most prevalent form on dermatitis? how can it occur?
irritant contact dermatitis- when a compound comes into direct contact with the skin, often more than once
Who can get primary irritation
anyone
Give example of some agents that can cause primary irritation
alkali, fibrous glass, acids, solvents
What are two occupations that come into contact with alkali?
Concrete workers and blueberry harvesters
What are irritant reactions caused by?
Contact with acids, alkaline materials, solvents, or other chemicals
What can increase the risk of dermatitis?
- moisture
- dirt
- detergent
- chemicals
with enough exposure to a chemical. ___ can develop a reaction
anyone
What characterizes dermatitis?
erythema and unilocular bullae resulting from epithelial necrosiss
What does the dermatitis reaction usually resemble?
Burns
Describe allergic contact dermatitist
Less prevalent, requires sensitization of the immune system.
What is the most common form of allergic contact dermatitis via plant
poison ivy/ poison oak
What is unilocular bullae?
blister with one opening
will everyone develope allergies?
no
what is a microvesicle?
little blister
Describe allergic reactions
- Immune system must be sensitized to a chemical or material prior to reacting
- Not everyone will have the same reaction
- skin reaction takes over 24 hours to develop and can last for weeks
- characterized by microvesicles
- skin inflammation varies from mild irritation and redness to open sores
Describe the process of an allergic reaction
exposure –> immune system –> reaction when exposed later
What is another term for allergy?
hypersensitivity
What is the oily toxic part of the poison ivy plant that causes rash, itch, and blisters?
urushiol
What is a major concern with Poison Ivy/ Oak?
resistant to herbicides so growers are exposed
What is the treatment for poison ivy/ oak?
immediately cleanse exposed skin with rubbing alcohol and water, then shower with soap and water. Wipe all tools, clothes, shoes, and items that contact urushiol with alochol
What is the proper way to prevent future dermatitis cases?
- determine and eliminate the source
How long does it typically take to recover from dermatitis?
Uncomplicated cases: 3-7 days, vulnerable for 3 weeks
Severe: months
What are the two types of dermatitis that result from extreme temperatures?
- burns (1st, 2nd, and 3rd degree)
- frostbite in extremities
What is acne?
inflammation of the sebaceous gland opening
Type of acne with inflamed follicle “black heads” and excess oil
folliculitis
What is chloracne caused by?
chlorinated hydrocarbons
What is the term for reactions to light?
photoreactions
What is the difference between photosensitization, photoallegy, and phototoxicity?
photoallergy- first exposure, immune system trigger, tends to be an allergic reaction to drugs and sunlight
Photosensitivitization- allergic reaction, chemical is impacted by the light, which causes a reaction
Phototoxicity- most severe, not an allergic reaction and UV light causes reaction from the chemical
What aggravates occupational acne?
heat and friction
What is commonly triggered by drugs + sunlight
photoallergy
What is commonly triggered by chemicals + light? Ex?
Photosensitivity- field workers (outside) and pharmaceutical workers
What is commonly triggered by drugs, chemicals and sunlight, not an allergic reaction but the sunlight alters toxicity. Ex?
Phototoxicity-ex) dyes
What are examples of dermatoses that cause growths/ holes?
- keratin stimulants
- callus
- ulcers
- tumors, cancer
What is cancer?
abnormal and uncontrolled growth
What are the two types of skin cancer in the epidermis?
basal and squamous
What is skin cancer of the mesoderma?
Squamous
What are the most dangerous skin cancers?
melanoma
What agents can cause skin cancer?
radiation
arsenic
PAH
What puts someone at an increased risk for skin cancer?
frostbite and skin trauma
What should you look for in moles when checking for skin cancer?
asymmetry, size, color, border
Prickly heat
miliaria
patchy hair loss
alopecia
reabsorption of distal phylanges due to death of skin cells on fingers
acroosteolysis
What is a potential dermatosis from data entry?
nail trauma / nail disorders
Loss of pigmentation
vitiligo
What determines the amount of percutaneous absorption?
1) Stratum corneum (barrier)
2) function of agent
3) skin integrity
4) amount transferred
5) skin moisture
Important factors for percutaneous absorption
1) concentration and chemical type
2) surface area affected and where
3) type of skin (ie dry versus oily)
4) Intact skin?
5) Clean?
6) Solvents or surfactants
7) Follicles and ducts (minor role)
8) Frequency of application
Other routes of entry are influenced by ___
contaminated hands
What else can influence exposure to dermatosis agents?
Contaminated surfaces
Poor air quality
What can exacerbate occupational dermatosis issues?
combining work exposure with after work exposure
Chemical agentsthat cause dermatosis
- corrosives
- heavy metals
- organic solvents
- complex organics
- chlorinated organics
- rhus genus chemicals
- epoxides, isocyanates
- sensitizers
Examples of mechanical agents that cause dermatosis
1) Trama (lacerations, punctures, tears from single or repeated events)
2) Friction (blisters, calluses) ie fiberglass
Examples of physical agents that cause dermatosis
1) heat
2) cold
3) ultraviolet
4) ionizng radiation
5) vibration
6) combination with chemical
Example of biological agents that cause dermatosis
1) bacteria
2) viruses
3) fungi
4) parasites
IE dust mite dropping
Example of Botanical agents that cause dermatosis
plant products: irritants, allergens, photosensitizers
How do you evaluate the workplace for occupational dermatosis agents?
- mostly based on SDS
- Biological monitoring
- wipe testing
- vaccuum testing
- surfaces of people
- air sampling
What is BDT?
Breakthrough Time or breakthrough detection time- time in minutes from initial exposure of a chemical to the gloves outer surface to the time the chemical can first be detected on the gloves interior
What is the permeation rate?
the rate of a chemical in ug/ min permeating an area (cm2) of glove material
What are considered better breakthrough times and permeation rates?
BDT- high duration
PR- low rate
What are the controls for skin?
select PPE based on the agent (lab coats, gloves)
Barrier cream (needs to be reapplied)
Emergency wash stations
Give an example of an occupation where vacuum testing would be used?
home of an agricultural worker- vacuum evaluation of carpet for pesticides
What agents can be detected during air sampling that would cause dermatosis?
mold spores, biological agents
What are some different types of gloves?
to the wrist/ emergent
