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Occupational Skin Allergies: Testing and Treatment (The Case of Occupational Allergic Contact Dermatitis)

  • OCCUPATIONAL ALLERGIES (JA POOLE, SECTION EDITOR)
  • Published:
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Abstract

Occupational contact dermatitis, including occupational allergic contact dermatitis, is one of the most common occupational diseases. Making a timely and accurate diagnosis is important to improving the outcome. Taking a work history and patch testing are essential elements in the diagnostic process. Management, based on an accurate diagnosis, must include both medical treatment to address the disease and workplace modifications as appropriate to reduce exposure the causative agents.

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References

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  1. Diepgen TL, Kanverva L. Occupational skin diseases. Eur J Dermatol. 2006;16:324–30.

    CAS  PubMed  Google Scholar 

  2. Cahill J, Keegel T, Nixon R. The prognosis of occupational contact dermatitis. Contact Dermatitis. 2004;51:219–26.

    Article  PubMed  Google Scholar 

  3. Lau MY, Burgess JA, Nixon R, Dharmage SC, Matheson MC. A review of the impact of occupational contact dermatitis on quality of life. J Allergy. 2011;2011:964509.

    Article  Google Scholar 

  4. Holness DL. Workers with occupational contact dermatitis: work outcomes and return to work process in the first six months following diagnosis. J Allergy. 2011;2011:170693.

    Article  Google Scholar 

  5. Holness DL, Harniman E, DeKoven J, Skotnicki Grant S, Beaton D, Nixon R, et al. Hand function in workers with hand dermatitis. Dermatitis. 2013;24:131–6.

    PubMed  Google Scholar 

  6. Diepgen TL. The costs of skin disease. Eur J Dermatol. 2006;16:456–60.

    CAS  PubMed  Google Scholar 

  7. Keegel T, Moyle M, Dharmage S, Frowen K, Nixon R. The epidemiology of occupational contact dermatitis (1990-2007): a systematic review. Int J Dermatol. 2009;48:571–8.

    Article  PubMed  Google Scholar 

  8. Ibler KS, Jemec GBE, Flyvholm M-A, et al. Hand eczema: prevalence and risk factors of hand eczema in a population of 2274 healthcare workers. Contact Dermatitis. 2012;67:200–7. up to date information on prevalence of and risk factors for hand eczema in health care workers.

    Article  PubMed  Google Scholar 

  9. Luk N-MT, Lee H-CS, Luk C-KD, et al. Hand eczema among Hong Kong nurses: a self-report questionnaire survey conducted in a regional hospital. Contact Dermatitis. 2011;65(6):329–35.

    Article  PubMed  Google Scholar 

  10. Lysdal SH, Sosted H, Johansen JD. Do hairdressers in Denmark have their hand eczema reported as an occupational disease? Results from a register-based questionnaire study. Contact Dermatitis. 2012;66:72–8. up to date information on prevalence of hand eczema in hairdressers and information on reporting.

    Article  PubMed  Google Scholar 

  11. Schnuch A, Geier J, Lessman R, et al. Surveillance of contact allergies: methods and results of the Information Network of Departments of Dermatology (IVDK). Allergy. 2012;67:847–67. demonstrates use of group data to follow trends.

    Article  CAS  PubMed  Google Scholar 

  12. Geier J, Krautheim A, Uter W, et al. Occupational contact allergy in the building trade in Germany: influence of preventive measures and changing exposure. Int Arch Occup Environ Health. 2011;84:403–11. demonstrates use of group data to follow trends and specifically changes in the building trades.

    Article  CAS  PubMed  Google Scholar 

  13. Uter W, Gefeller O, Geier J, Schnuch A. Methylchloroisothiazolinone/methylisothiazolinone contact sensitization: diverging trends in subgroups of IVDK patients in a period of 19 years. Contact Dermatitis. 2012;67:125–9. demonstrates use of group data to follow trends and documents the increase in positive reactions to methylisothiazoline.

    Article  CAS  PubMed  Google Scholar 

  14. Arrandale VH, Liss GM, Tarlo SM, et al. Occupational contact allergens. Are they also associated with occupational asthma? Am J Ind Med. 2012;55:353–60.

    Article  CAS  PubMed  Google Scholar 

  15. Nicholson PJ, Llewellyn D, English JS. Evidence-based guidelines for the prevention, identification and management of occupational contact dermatitis and urticaria. Contact Dermatitis. 2010;63:177–86.

    Article  PubMed  Google Scholar 

  16. Smedley J. on behalf of the OHCEU and BOHRF Dermatitis guideline development groups. Concise guidance: diagnosis, management and prevention of occupational contact dermatitis. Clin Med. 2010;5:487–90.

    Article  Google Scholar 

  17. Adisesh A, Robinson E, Nicholson PJ, Sen S, Wilkinson M, on behalf of the standards of Care Working Group. U.K. standards of care for occupational contact dermatitis and contact urticaria. Br J Dermatol. 2013;168:1167–75. current standards of care of occupational contact dermatitis.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Bourke J, Coulson I, English J. Guidelines for the management of contact dermatitis: an update. Br J Dermatol. 2009;160:946–54.

    Article  CAS  PubMed  Google Scholar 

  19. Holness DL. Health care services used by workers with work-related contact dermatitis. Dermatitis. 2004;15:18–24.

    Article  PubMed  Google Scholar 

  20. Adisesh A, Meyer JD, Cherry NM. Prognosis and work absence due to contact dermatitis. Contact Dermatitis. 2002;46:273–9.

    Article  CAS  PubMed  Google Scholar 

  21. Cahill J, Keegel T, Dharmage S, Nugriaty D, Nixon R. Prognosis of contact dermatitis in epoxy resin workers. Contact Dermatitis. 2005;52:147–53.

    Article  CAS  PubMed  Google Scholar 

  22. Johnansen JD, Hald M, Andersen BL, et al. Classification of hand eczema: clinical and aetiological types. Based on the guidelines of the Danish Contact Dermatitis Group. Contact Dermatitis. 2011;65(1):13–21.

    Article  Google Scholar 

  23. Goulden V, Wilkinson SM. Evaluation of a contact allergy clinic. Clin Exp Dermatol. 2000;25:67–70.

    Article  CAS  PubMed  Google Scholar 

  24. Wilkinson DS, Fregert S, Magnusson B, et al. Terminology of contact dermatitis. Acta Derm Venereol (Stockh). 1970;50:287–92.

    CAS  Google Scholar 

  25. Lachapelle J-M, Maibach HI. Patch testing and prick testing. A practical guide. Official publication of te ICDRG. 3rd ed. Heidelberg: Springer; 2012. a good short book about patch testing.

    Book  Google Scholar 

  26. Johnston GA. Standardization of patch tests and the doctors who read them. Br J Dermatol. 2009;161:493–5.

    Article  CAS  PubMed  Google Scholar 

  27. Uter W, Schwitulla J, Thyssen JP, Frosch PJ, Statham B, Schnuch A. The ‘overall yield’ with the baseline series – a useful addition to the array of MOAHLFA factors describing departmental characteristics of patch test patients. Contact Dermatitis. 2011;65:322–8.

    Article  PubMed  Google Scholar 

  28. Geier J, Lessman H, Dickel H, et al. Patch test results with the metalworking fluid series of the German Contact Dermatitis Research Group (DKG). Contact Dermatitis. 2004;51:118–30.

    Article  CAS  PubMed  Google Scholar 

  29. Geier J, Lessman H, Becker D, et al. Patch testing with components of water-based metalworking fluids: results of a multicentre study with a second series. Contact Dermatitis. 2006;55:322–9.

    Article  CAS  PubMed  Google Scholar 

  30. Holness DL, Nethercott JR. Results of patch testing with a specialized collection of plastic and glue allergens. Am J Contact Dermatitis. 1997;8:121–4.

    Article  CAS  PubMed  Google Scholar 

  31. Holness DL, Nethercott JR. Results of patch testing with a special series of rubber allergens. Contact Dermatitis. 1997;36:207–11.

    Article  CAS  PubMed  Google Scholar 

  32. Wang MZ, Farmer SA, Richardson DM, Davis MD. Patch-testing with hairdressing chemicals. Dermatitis. 2011;22:16–26.

    PubMed  Google Scholar 

  33. Aalto-Korte K, Suuronen K, Kuuliala O, et al. Occupational contact allergy to monomeric isocyanates. Contact Dermatitis. 2012;67(2):78–88.

    Article  CAS  PubMed  Google Scholar 

  34. Geier J, Uter W, Lessmann H, Frosch PJ. Patch testing with metalworking fluids from the patient’s workplace. Contact Dermatitis. 2004;51:172–9.

    Article  CAS  PubMed  Google Scholar 

  35. Houle M-C, Holness DL, DeKoven J, Skotnicki S. Additive value of patch testing custom epoxy materials from the workplace at the Occupational Disease Specialty Clinic in Toronto. Dermatitis. 2012;23:214–9.

    CAS  PubMed  Google Scholar 

  36. Slodowink D, Williams J, Frowen K, Palmer A, Matheson M, Nixon R. The additive value of patch testing with patients’ own products at an occupational dermatology clinic. Contact Dermatitis. 2009;61:231–5.

    Article  Google Scholar 

  37. Saary J, Qureshi R, Palda V, et al. A systematic review of contact dermatitis treatment and prevention. J Am Acad Derm. 2005;53:845–55.

    Article  PubMed  Google Scholar 

  38. Diepgen TL, Elsner P, Schliemann S, Fartasch M, Kollner A, Skudlik C, John SM, Worm M. Guideline on the management of hand eczema ICD-10 Code: L20. L23. L24. L30. JDDG. 2009;Suppl 3.

  39. John SM, Skudlik C, Wulfhorst B, et al. An integrated inpatient/outpatient rehabilitation program – the German approach. Dermatitis. 2011;22(5):301–2.

    Google Scholar 

  40. Weisshaar E, Skudlik C, Scheidt R, et al. Multicentre study ‘rehabilitation of occupational skin diseases – optimization and quality assurance of impatient management (ROQ)’ – results from 12-month follow-up. Contact Dermatitis. 2013;68:169–74. demonstrates the value of a multidisciplinary, multi-faceted program for rehabilitation of workers with occupational contact dermatitis.

    Article  PubMed  Google Scholar 

  41. Van Gils RF, Boot CRL, Knol DL, et al. The effectiveness of integrated care for patients with hand eczema results of a randomized, controlled trial. Contact Dermatitis. 2012;66(4):197–204.

    Article  PubMed  Google Scholar 

  42. Van Gils RF, Groenewoud K, Boot CRL, et al. Process evaluation of an integrated multidisciplinary intervention programme for hand eczema. Contact Dermatitis. 2012;66(5):254–63.

    Article  PubMed  Google Scholar 

  43. Gomez P, Kudla I, Wozniak G, et al. The impact of a multidisciplinary team and a dedicated return-to-work coordinator for workers with work-related skin disease. Dermatitis. 2011;22(3):176.

    Google Scholar 

  44. Holness DL. Return-to-work issues for workers with contact dermatitis: results of a stakeholder survey. Contact Dermatitis. 2003;49:273–5.

    Article  PubMed  Google Scholar 

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Conflict of Interest

D. Linn Holness has received honoraria for reviewing student scholarships from Worksafe BC, and has received grant support from the Ontario Ministry of Labour, Social Science Humanities Research Council, Workplace Safety and Insurance Board.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by the author. With regard to the author’s research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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Correspondence to D. Linn Holness.

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This article is part of the Topical Collection on Occupational Allergies

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Holness, D.L. Occupational Skin Allergies: Testing and Treatment (The Case of Occupational Allergic Contact Dermatitis). Curr Allergy Asthma Rep 14, 410 (2014). https://doi.org/10.1007/s11882-013-0410-8

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  • DOI: https://doi.org/10.1007/s11882-013-0410-8

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