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The use of soap for skin cleansing is common among the population. However, it is possible that it causes damage to skin cells and disrupts the skin barrier.To determine the cytotoxic effect of soaps on in vitro-cultured keratinocytes and to correlate it with clinical irritation.A survey was conducted to find out the most widely used commercial soaps and their number. Subsequently, their cytotoxicity was evaluated in human keratinocyte cultures using the resazurin assay. The soaps with the highest and lowest cytotoxicity were applied to the skin of healthy volunteers to assess their effect on the skin barrier using colorimetry and transepidermal water loss (TEWL) assays.Of the analyzed soaps, 37 % were shown to be toxic to keratinocytes in vitro. The soap with the highest toxicity induced the highest rate of erythema and TEWL, in comparison with the least toxic soap and the vehicle used as the control solution.Soaps marketed for skin cleansing can contain chemical ingredients that damage human keratinocytes and cause skin barrier subclinical irritation. Their use can worsen preexisting dermatoses, generate xerotic or irritant contact dermatitis, and cause atrophy and dermatoporosis.El jabón para el aseo cutáneo es de empleo común entre la población, sin embargo, es posible que cause daño a las células de la piel y modifique la barrera cutánea.Determinar el efecto citotóxico de los jabones en queratinocitos cultivados in vitro y correlacionarlo con la irritación clínica.Se realizó una encuesta para conocer los jabones comerciales más utilizados y su cantidad; posteriormente, se evaluó su citotoxicidad en cultivos de queratinocitos humanos mediante el método de resazurina. Los jabones con mayor y menor citotoxicidad se aplicaron en piel de voluntarios sanos para evaluar su efecto en la barrera cutánea mediante ensayos de colorimetría y pérdida transepidérmica de agua.De los jabones analizados, 37 % demostró ser tóxico para los queratinocitos in vitro. El jabón con mayor toxicidad indujo el mayor índice de eritema y pérdida transepidérmica de agua, en comparación con el jabón menos tóxico y el vehículo empleado como solución control.Los jabones comercializados para el aseo cutáneo pueden incluir ingredientes químicos que dañan los queratinocitos humanos y causan irritación subclínica de la barrera cutánea. Su utilización puede agravar dermatosis preexistentes, generar dermatitis xerósica o de contacto irritativa y causar atrofia y dermatoporosis.

There is a worldwide increase in food and nutrition related contact dermatitis, including irritant contact dermatitis, allergic contact dermatitis, systemic contact dermatitis, protein contact dermatitis, and photocontact dermatitis. A wide range of patients is affected by this condition, from those who consume certain foods as part of their diet to workers who handle food occupationally. Patch testing, analytical chemistry, and reporting may help in timely recognition of contact allergens. Elimination of exposure to the known food or supplement is imperative for treatment. Currently, more research is needed in order to better define the role that nutrition plays in contact dermatitis.

Background No biomarkers have been identified that can classify subtypes of hand eczema (HE). Although skin biopsies represent the golden standard for investigations of the skin, the invasive technique is not favorable when investigating skin from sensitive areas. Recent advances in the use of skin tape strips for molecular investigations enable non-invasive investigations of HE. Objective By using whole transcriptome sequencing (WTS), the molecular profile of HE according to different localizations on the hands, etiologies, and clinical/morphological subtypes was investigated. Methods Thirty adult, Danish HE patients, 12 with and 18 without concurrent atopic dermatitis (AD), as well as 16 controls were included. Tape strip samples were collected from lesional, non-lesional, and healthy skin. Total RNA was extracted, and WTS was performed. Results The largest molecular difference of HE patients with and without AD was found in non-lesional skin areas and included a downregulation of CXCL8 for HE patients without AD. Differences between allergic- and irritant contact dermatitis included promising epidermal biomarkers such as EPHA1. Conclusion Skin tape strip samples could be used to assess the gene expression profile of HE on different localizations of the hands. The skin tape strip method identified new molecular markers that showed promising result for the identification of HE subtypes. This article is protected by copyright. All rights reserved.

BACKGROUND Few studies explored the relationship between stasis dermatitis (SD) and allergic contact dermatitis (ACD). OBJECTIVE To examine trends, associations, and clinical relevance of ACD in patients referred for patch testing who had a final SD diagnosis. METHODS Retrospective analysis from 2001 to 2016 of 38,723 patients from the North American Contact Dermatitis Group. RESULTS After patch testing, 303 (0.7%) patients were diagnosed with SD; 46.7% had a concomitant diagnosis of ACD. Patients with vs. without a final SD diagnosis had similar proportions of ≥ 1 positive allergic reaction (59.7% vs. 64.7%; Chi-square, P = 0.0724) but higher odds of allergic reactions to fragrance mix I, bacitracin, quaternium-15, Myroxylon pereirae, benzalkonium chloride, ethyleneurea melamine formaldehyde, diazolidinyl urea, and propylene glycol. The most commonly relevant allergens in patients with final SD diagnosis were fragrance mix I, Myroxylon pereirae, bacitracin, quaternium-15, and formaldehyde. The most common allergen sources were personal care products, topical medications and other health aid products. CONCLUSION Nearly half of patients with a final SD diagnosis were also diagnosed with ACD, supporting the role of patch testing in select SD patients.

Nail aesthetic procedures, particularly the fashion of nail sculpting, gel nails and long-lasting polishes, have been expanding over the last years, with an increasing number of cases of allergic contact dermatitis both in aestheticians and customers. Clinical suspicion and interpretation of nail cosmetics patch test results require a general knowledge of the main current manicure techniques and chemicals used. Allergic contact dermatitis (ACD) to nail cosmetics, previously attributed mostly to tosylamide formaldehyde resin (TSFR), is now mainly caused by (meth)acrylates. In addition to pulpitis, periungual dermatitis, and lesions involving the face, neck, and chest, nail dystrophy can occur from (meth)acrylate-based techniques. The diagnosis of ACD can be confirmed by patch-testing suspected nail care product ingredients, namely, methacrylates, cyanoacrylates and TSFR. Hydroxyethyl methacrylate (HEMA), which detects most cases of ACD from nail (meth)acrylates, has been recently introduced in many baseline patch test series all over the world. Ingredients in nail cosmetics may lead to allergic and/or irritant contact dermatitis. Irritant dermatitis is mostly associated with nail hardeners and cuticle and nail polish removers. The “epidemic” of ACD to nail cosmetics has increased likely due to its expansion to untrained home users. Preventive measures and stricter regulation in the field are key measures to reduce ACD in this setting. Avoidance of the culprit is not always possible, particularly in the occupational setting. Sensitization to (meth)acrylates may have further health implications.

BACKGROUND Recent trends in the sensitization of construction workers show a decrease in potassium dichromate and an increase in epoxy resin sensitization. OBJECTIVES To present the trends of occupational contact allergy of construction workers in Greece from 2009 to 2018. METHODS We retrospectively reviewed the files of patients with eczema patch tested in our Contact Dermatitis Clinic who were construction workers. RESULTS A total of 191 construction workers initially reported contact dermatitis. Of these, 138 had occupation-relevant allergic contact dermatitis (ACD) or irritant contact dermatitis (ICD). All patients were men. After being patch tested, 98 (71.0%) were diagnosed with ACD and 40 with ICD. Median duration of occupation till onset of ACD was 2 years (interquartile range [IQR] 0.8-7). The hands were the most common location for ACD (73.5%), followed by the trunk (39.8%), the legs (38.8%), and the face (11.2%). Of the patients, 74.6% had lesions affecting multiple body sites. Potassium dichromate (67%) was the most frequent allergen, followed by thiuram mix (37.4%) and cobalt chloride (31.8%). Sensitization to epoxy resins was lower (12.1%). CONCLUSION The sensitization pattern of Greek construction workers does not follow the trends in Central or Northern Europe, rather sharing attributes with less industrialized countries.

Background Microneedling is a minimally invasive procedure that stimulates collagen and elastin proliferation. It is used in the treatment of various skin pathologies, that is, scarring, photodamage, and hair loss; however, its safety profile has yet to be comprehensively reviewed. Objective This review will discuss the reported side effects of microneedling in the current literature and delineate factors that increase the risk of complications. Materials and methods A literature search in August 2019 was conducted using the PubMed database to identify studies reporting adverse events (AEs) after microneedling therapy. Results Eighty-five articles were included in this systematic review. The most common reported AEs are transient procedural events that are expected postprocedure lasting up to 7 days, such as transient erythema/edema and pain, postinflammatory hyperpigmentation (PIH), dry skin/exfoliation, lymphadenopathy, and irritant contact dermatitis. Persistent serious adverse effects included PIH, tram-track scarring, and granulomatous reactions. Factors that increase the risk of events are active infections, darker skin, and metal allergies. Conclusion Microneedling is a relatively safe therapy. Most reported AEs are minimal, resolving quickly and spontaneously. Caution should be taken in patients with active infection, darker skin types, metal allergies, and when used in conjunction with products not approved for intradermal use.

The most common complication in individuals with ostomies is irritant contact dermatitis from the acidic stoma effluent coming into contact with the peristomal skin. Although protective powders are widely used for the treatment of peristomal skin, there is little scientific evidence to justify their use. The combined use of sodium carboxymethylcellulose cellulose fibers (SCCFs) together with a hydrocolloid dressing for fixation is an effective alternative in the management of these wounds. Here, the authors report a case series of three patients presenting at a stoma therapy clinic with peristomal skin lesions because of severe irritant contact dermatitis. Patients were men aged between 70 and 81 years, had been diagnosed with colon cancer (n = 2) or bladder cancer (n = 1), and had undergone a colostomy (n = 1), ileostomy (n = 1), or Bricker-type ureteroileostomy (n = 1). A semiocclusive care protocol was applied in a moist environment using SCCF and an extrathin hydrocolloid adhesive dressing, and the collection device was secured using adhesive resin and an ostomy belt. The combined use of SCCF and hydrocolloid dressings provided beneficial results to treat the dermatitis, with reduced discomfort after 7 days and lesions healing within 4 weeks.

Purpose of Review To provide an up-to-date, customizable approach to the worker presenting with dermatitis. Recent Findings Occupational contact dermatitis (OCD) is often a result of combined allergic, irritant, and endogenous factors. Potential causes of OCD can be categorized in 3 main groupings: workplace materials, personal protective equipment, and skin care. Although patterns of dermatitis may provide some indication of the etiological factor(s), patch testing remains essential in the diagnosis of allergic OCD. Management of OCD may require changes in workplace practices to reduce worker exposure to the causative agents and improve skin care practices. Summary OCD is a multifaceted condition with significant consequences for affected workers and their families, employers, and insurers. A methodical and individualized approach to the patient with OCD should ensure timely and accurate diagnosis(es).

Background: Alcohol-based hand rub (ABHR) is widely used for hand disinfection in the health care sector. ABHR is, however, known to cause discomfort when applied on damaged skin emphasizing the unmet need for alternative and better tolerated types of disinfectants. Active chlorine hand disinfectants (ACHDs) are potential new candidates; however, the effect on the skin barrier function compared to ABHR remains to be assessed. Materials and methods: In Study A, the forearm skin of healthy adults was repeatedly exposed to ACHD and ABHR. Skin barrier function was assessed by measurement of transepidermal water loss, electrical conductance, pH, and erythema at baseline and at follow-up after 2 days, and subjective discomfort was likewise assessed. Study B was performed in the same way; however, in order to induce an experimental irritant contact dermatitis, sodium lauryl sulfate patch tests were applied to forearms before exposure to ACHD and ABHR. Results: In both studies, the skin barrier function was unaffected after repetitive exposure to ACHD and ABHR, and with no significant differences between the products. Subjective discomfort was reported as sporadic or very mild in relation to both products. Conclusion: Our results illustrate that use of ACHD does not affect the skin barrier function negatively, neither in intact skin nor in skin with experimentally induced contact dermatitis. Future studies should include real-life evaluation of skin barrier function and subjective discomfort following ACHD use in individuals with and without hand eczema.

Background Irritant contact dermatitis (ICD) is caused by the acute locally toxic effect of a strong irritant, or the cumulative exposure to various weaker physical and/or chemical irritants. Objectives To describe characteristics of patients with ICD in the population patch tested in the European Surveillance System on Contact Allergies (ESSCA; www.essca-dc.org) database. Methods Data collected by the ESSCA in consecutively patch tested patients from January 2009 to December 2018 were analyzed. Results Of the 68 072 patients, 8702 patients were diagnosed with ICD (without concomitant allergic contact dermatitis [ACD]). Hand and face were the most reported anatomical sites, and 45.7% of the ICD was occupational ICD (OICD). The highest proportions of OICD were found in metal turners, bakers, pastry-cooks and confectionery makers. Among patients diagnosed with ICD, 45% were found sensitized with no relevance for the current disease. Conclusions The hands were mainly involved in OICD also in the subgroup of contact dermatitis patients, in whom relevant contact sensitization had been ruled out, emphasizing the need for limiting irritant exposures. However, in difficult to treat contact dermatitis, unrecognized contact allergy, or unrecognized clinical relevance of identified allergies owing to incomplete or wrong product ingredient information must always be considered. This article is protected by copyright. All rights reserved.

Healthcare workers (HCWs) can be considered at an increased risk of developing occupational contact dermatitis (OCD) due to repetitive hand washing with soaps and disinfectants and extended use of gloves for many hours during the day. The aim of this study was to summarize the incidence of OCD in HCWs. We searched the databases PubMed/Medline (1980-present), EMBASE (1980-present) and Cochrane Library (1992-present) through May 2020 using the search term "incidence of contact dermatitis in healthcare workers" according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Overall, 16 studies (six cohort; 10 register-based) with follow-up periods between 1987-2013 fulfilled the inclusion criteria. The incidence of OCD reported in studies using registers of occupational diseases ranged from 0.6 to 6.7 per 10,000 person-years. The cohort studies reported incidence from 15.9 to 780.0 per 10,000 person-years; the incidence was higher in studies which included apprentice nurses. A higher incidence was also observed amongst dental practitioners, particularly dental technicians and nurses, compared to other HCWs. Studies reporting incidence data are very scarce and results differed by study design, type of contact dermatitis, and investigated HCWs. Our study highlighted the dearth of high-quality data on the incidence of OCD and the possible underestimation of disease burden. Prospective cohort studies with harmonized designs, especially exposure assessment and outcome ascertainment, are required to provide more accurate, valid, and recent estimates of the incidence of OCD. A high incidence amongst specific occupational groups suggests the need to undertake intervention studies with a focus on prevention, particularly during pandemics such as COVID-19.

Background: Handwashing using soap or hand sanitizer is one of the health protocols that must be implemented by society to prevent the spreading of SARS-COV2 virus which can cause pneumonia, acute respiratory syndrome and death. The implementation of health protocols during the COVID-19 pandemic caused the habit of handwashing increase. Hence, it can lead to cause irritant contact dermatitis and dry hand skin due to frequent contact with soap or hand sanitizers. Method: This study is an observational study with the sample from the villager of Banyumas regency. The data collection was taken by cluster random sampling and accidental sampling. Results: Considering the health protocol, most of the villager used to wash their hands regularly and 3 respondents (3.00%) of them did not. 100 respondents took the data and 19 respondents (19.00%) have irritant contact dermatitis and the rest did not. Furthermore, for skin hydration levels with dehydration category (0% - 29%) are 50 respondents (50.00%), normal category (30% - 50%) are 38 respondents (38.00%) and hydration category (51% - 100 %) are 12 respondents (12.00%). Chi-Square analysis showed that there was no significant relationship between handwashing habit and the incidence of irritant contact dermatitis with the value of “P” is 0.394> 0.05 and there was a significant relationship between hand washing habits and skin hydration levels with the value of “P” is 0.010

Eyelid dermatitis is a common dermatologic complaint.To characterize patients with eyelid dermatitis.Retrospective analysis (1994-2016) of North American Contact Dermatitis Group data.Of 50,795 patients, 2332 (4.6%) had eyelid dermatitis only, whereas 1623 (3.2%) also had dermatitis of the eyelids and head or neck. Compared with patients without eyelid involvement (n = 26,130), groups with eyelid dermatitis only and dermatitis of the eyelid and head or neck were significantly more likely to be female, white, and older than 40 years, and to have a history of hay fever, atopic dermatitis, or both (P .01). Final primary diagnoses included allergic contact dermatitis (eyelid dermatitis only: 43.4%; dermatitis of the eyelid and head or neck: 53.5%), irritant contact dermatitis (eyelid dermatitis only: 17.0%; dermatitis of the eyelid and head or neck: 9.8%), and atopic dermatitis (eyelid dermatitis only: 13.1%; dermatitis of the eyelid and head or neck: 13.8%). Top 5 currently relevant allergens included nickel sulfate (eyelid dermatitis only: 18.6%; dermatitis of the eyelid and head or neck: 22.5%), fragrance mix I (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 18.3%), methylisothiazolinone (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 17.7%), gold sodium thiosulfate (eyelid dermatitis only: 14.7%; dermatitis of the eyelid and head or neck: 11.4%), and balsam of Peru (eyelid dermatitis only: 11.9%; dermatitis of the eyelid and head or neck: 12.6%). Both eyelid-involvement groups were significantly more likely to react to gold sodium thiosulfate, carmine, shellac, dimethylaminopropylamine, oleamidopropyl dimethylamine, and thimerosal (P .05) compared with the no eyelid involvement group.Lack of specific distribution patterns of eyelid dermatitis and no long-term follow-up data.Patch testing remains a critical tool in evaluating patients with eyelid dermatitis.

Background Hand eczema (HE) is a heterogeneous and burdensome disorder. Objective To characterize the clinical characteristics, etiologies and allergen relevance in adults with HE referred for patch testing. Methods Retrospective analysis (2000-2016) of North American Contact Dermatitis Group data (n = 37,113). Results Overall, 10,034 patients had HE, with differences of overlap between allergic contact, irritant contact, and atopic dermatitis. Allergic contact HE fluctuated, whereas atopic HE steadily increased, and irritant HE decreased over time. HE was associated with higher proportions of positive patch tests (67.5% vs 63.8%; χ2, P Limitations No data on HE phenotype. Conclusion HE in adults was associated with higher proportions of positive patch tests, with a heterogeneous profile of allergens. Patch testing remains an important tool in the evaluation of patients with HE.

Background Scalp conditions are often multifactorial. Objective To characterize patients with scalp involvement and patch-testing outcomes. Methods Retrospective cross-sectional analysis of North American Contact Dermatitis Group data (1996-2016). Study groups included patients with scalp involvement (≤3 anatomic sites coded) with or without additional sites. Results A total of 4.8% of patients (2331/48,753) had scalp identified as 1 of up to 3 affected anatomic sites. Approximately one-third of "scalp-only" individuals had a specific primary diagnosis of allergic contact dermatitis (38.6%), followed by seborrheic dermatitis (17.2%) and irritant contact dermatitis (9.3%). When adjacent anatomic sites were affected, allergic contact dermatitis was more frequently identified as the primary diagnosis (>50%). The top 5 currently clinically relevant allergens in scalp-only patients were p-phenylenediamine, fragrance mix I, nickel sulfate, balsam of Peru, and cinnamic aldehyde. Methylisothiazolinone sensitivity was notable when adjacent anatomic sites were involved. The top 3 specifically identified sources for scalp-only allergens were hair dyes, shampoo/conditioners, and consumer items (eg, hair appliances, glasses). Limitations Tertiary referral population. Conclusion Isolated scalp involvement was less likely to be associated with allergic contact dermatitis than when adjacent anatomic sites were involved. Overlap with multiple diagnoses was frequent, including seborrheic dermatitis, irritant dermatitis, other dermatoses, or all 3. p-Phenylenediamine was the most common allergen.

Irritant contact dermatitis (ICD) is a condition caused by chemicals that damage skin structures in a direct non-allergic way. Dermatologic findings may present in a broad spectrum due to frequency and route of exposure and individual susceptibility. The most critical point in the diagnosis and treatment of ICD is to determine the irritant since its cessation is the best treatment. Specifically, in geriatric patients, questioning about any irritant exposure should be done carefully. In this report, we present a 71-year-old woman with ICD that was caused by exposure to potassium hydrochloride in Arab soap and exaggerated amid the coronavirus pandemic.

Coronavirus disease 2019 (COVID-19) is currently receiving the whole world's attention. It appeared first in Wuhan city of China and rapidly spread to the world, causing many mortalities and morbidities; the disease is mainly transmitted via respiratory droplets and has a long infectivity period of about 14 days. Science shows that the virus is also transmitted via the skin if the virus by any means finds its way and land on the skin surface. Infection occurs when touching the face, eyes, or nose with the hand after the virus has landed upon it. This is the main reason for the widespread usage of skin antiseptics and disinfectants. We included the most commonly used skin antiseptics, sterilizing methods, and disinfectants, such as household bleach, hydrogen peroxide gas plasma, Formaldehyde, Glutaraldehyde, Alcohol, Chlorohexidine, Povidone-iodine, Chloroxylenol, and alcohol-based hand sanitizer (e.g. Sterlelium). We will discuss their role in preventing acquired infection of COVID-19, as well as discussing the efficacy, costs, and side effects of different sterilizers, including general health hazards, as well as skin affection as irritant contact dermatitis, which is the commonest side effect. After conducting this work, we summarized the results & started sending them to our patients & medical personnel, and we observed 60% decrease in the cases of disinfectants induced allergic contact dermatitis /month compared to the previous two months.

CONTEXT: Various skin manifestations have been reported in coronavirus disease. It may be difficult to determine the etiology of these lesions in view of the increased frequency of handwashing during the pandemic, along with occurrences of irritant contact dermatitis and allergic contact dermatitis due to disinfectant use; usage of herbal medicine and supplements to strengthen the immune system; and urticarial or maculopapular drug eruptions due to COVID-19 treatment. The variety of associated skin manifestations seen with COVID-19 makes it challenging to identify virus-specific skin manifestations. Petechiae, purpura, acrocyanosis and necrotic and non-necrotic purpura, which can be considered as manifestations of vascular involvement on the skin, have been reported. CASE REPORT: Here, we report a case of eruptive cherry angiomas, which was thought to have developed due to COVID-19, with a papulovesicular rash on distal extremities that progressed over time to reticular purpura. CONCLUSION: The case presented had a papulovesicular rash at the onset, which evolved to retiform purpura, and eruptive cherry angiomas were observed. It should be kept in mind that dermatological signs may vary in patients with COVID-19.

Background Prolonged wear of facial protective equipment can lead to occupational dermatoses. Objective To identify important causes of occupational dermatoses from facial protective equipment. Methods A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed using PubMed and Embase databases. Articles were included if they reported occupational dermatoses caused by surgical/procedure masks or N95 respirators, or both. Results We identified 344 articles, and 16 were suitable for inclusion in this review. Selected articles focused on facial occupational dermatoses in health care workers. Allergic contact dermatitis to the elastic straps, glue, and formaldehyde released from the mask fabric was reported. Irritant contact dermatitis was common on the cheeks and nasal bridge due to pressure and friction. Irritant dermatitis was associated with personal history of atopic dermatitis and prolonged mask wear (>6 hours). Acneiform eruption was reported due to prolonged wear and occlusion. Contact urticaria was rare. Limitations Only publications listed in PubMed or Embase were included. Most publications were case reports and retrospective studies. Conclusion This systematic review from members of the American Contact Dermatitis Society highlights cases of occupational dermatitis to facial protective equipment, including potential offending allergens. This work may help in the diagnosis and treatment of health care workers with facial occupational dermatitis.

Background: Prisoners fall in the most vulnerable population group, but the health issue of this group is the most understudied. The various dermatological conditions that hamper their overall health and quality of life needs to be identified and serious measures should be undertaken for preventing them. Objectives: This study is one of the rare studies that aim to identify the dermatosis pattern and to relate with its etiological factors and suggest preventive methods to be undertaken for it. Materials and Methods: Total three visits were made to the district jail located in Central India over a period of 8 months, and the prison inmates were clinically examined. The data was recorded and results were drawn. Results: Scabies accounted for 31.51% while dermatophytes accounted for 30.83%. Other dermatoses seen were acne vulgaris (5.17%), allergic contact dermatitis (ACD) in 5.03%, pyoderma (2.71%), urticaria (2.86%), and tinea versicolor (2.62%). These were followed by the other dermatoses such as milia (1.81%), alopecia areata (0.5%), and irritant contact dermatitis (0.5%); viral infections such as herpes labialis (0.45%) and molluscum contagiosum (0.45%); and pigmentary disorders such as vitiligo (0.65%) and melasma (1.16%). Three new cases of Hansen's disease were diagnosed clinically (1.75%). Conclusion: We found that common dermatoses were scabies and fungal infections which are due to the overcrowding and poor hygiene facility in the prison premises. During the subsequent visits, the number of dermatophyte infections declined which may be attributed to patient counseling and awareness regarding hygiene and general cleanliness which was provided by us to the inmates in all previous visits. A detailed look into the matter may improve the overall dermatological health of the inmates.

Background There are no reported cases of 2,4-dichloro-5-methylpyrimidine (DCP)-induced irritant contact dermatitis (ICD). Objective The aim of the study was to summarize the clinical features, treatment, and protective measures for DCP-induced ICD. Methods We retrospectively reviewed the clinical data from 64 patients with DCP-induced ICD and the protective measures in a DCP manufacturing factory. Results Disease onset occurred 1 to 10 minutes after DCP single exposure in all 64 patients. The contact site developed edematous erythematous skin lesions with clear boundaries. Other symptoms included a burning sensation (n = 48), pruritus (n = 16), headache (n = 4), nausea/vomiting (n = 3), and syncope (n = 1). Ten patients developed pruritic rash over the whole body 1 to 4 days after contacting DCP. Histopathologic examination of the lesions was performed in 8 patients; all 8 showed manifestations of ICD. A patch test with 1% DCP ethanol solution was performed in 7 patients. One patient withdrew because of pruritus and massive erythema over the whole body. Four patients had a strong reaction, and 2 patients had a very strong reaction. All patients were cured. Positive-pressure inflatable protective clothing protected workers from the outside environment to prevent DCP-induced ICD. Conclusions 2,4-Dichloro-5-methylpyrimidine exposure induces acute ICD and a delayed allergic reaction in some patients (15.6%). Positive-pressure inflatable protective clothing prevents DCP-induced ICD.

Background: Women worldwide have their own strategies to cope with menstruation, and unhygienic menstrual practices often cause vaginal diseases. During menstruation, the skin is irritated by the remaining unabsorbed menstrual flow and sweat on sanitary pads. Irritation of vulvar skin by an external agent could cause contact dermatitis, which is an important contributor to vulvar diseases. Various sanitary napkins available today share similar materials. This study compared commonly used sanitary napkin among Indonesian women with 3D-pore sanitary napkin in terms of efficacy. Methods: A randomized, controlled, single blind, crossover study of 72 participants who met the inclusion and exclusion criteria was conducted. Six areas were evaluated by dermatologists using the Grading Scale of Cutaneous Symptoms. The evaluation was performed in five visits. Results: All participants were divided randomly into two groups. Eight of the 72 participants dropped out; thus, 64 participants completed the study. Scores at Visit-2 show a significant difference between group A (3D-pore napkin) and group B (comparator napkin). Group A shows better improvement. The difference in total score at first second visit until end visit from each napkin shows that the 3D-pore napkin reduces the score by 4.77 and the comparator napkin reduces the score by 3.10. The difference between these numbers is statistically significant. The specific area (external genitalia and perianal) of both groups is significantly reduced in visit 1 and visit 2. The 3D-pore napkin reduces wetness better than the comparator napkin. Conclusion: The 3D-pore sanitary napkin significantly improves vulvar skin inflammation compared with the comparator napkin. Keywords : 3D-pore sanitary napkin, commonly used napkin, female genitalia

PURPOSE OF REVIEW To examine respiratory and skin diseases that occur among workers exposed to metalworking fluids (MWFs) used during machining processes. RECENT FINDINGS Five cases of a severe and previously unrecognized lung disease characterized by B-cell bronchiolitis and alveolar ductitis with emphysema (BADE) were identified among workers at a machining facility that used MWFs, although MWF exposure could not be confirmed as the etiology. In the United Kingdom, MWF is now the predominant cause of occupational hypersensitivity pneumonitis (HP). Under continuous conditions associated with respiratory disease outbreaks, over a working lifetime of 45 years, workers exposed to MWF at 0.1 mg/m3 are estimated to have a 45.3% risk of acquiring HP or occupational asthma under outbreak conditions and a 3.0% risk assuming outbreak conditions exist in 5% of MWF environments. In addition to respiratory outcomes, skin diseases such as allergic and irritant contact dermatitis persist as frequent causes of occupational disease following MWF exposure. SUMMARY Healthcare providers need to consider MWF exposure as a potential cause for work-related respiratory and skin diseases. Additional work is necessary to more definitively characterize any potential association between MWF exposures and BADE. Medical surveillance should be implemented for workers regularly exposed to MWF.

Introduction: Occupational contact dermatitis is the most frequent dermatoses. It is evident that Chromium causes contact dermatitis in construction workers. This study is conducted to assess the prevalence and pattern of contact dermatitis among construction workers. Materials and Methods: This was a prospective hospital based clinical study, conducted among construction workers who presented with skin manifestations from Oct 2016 to Jan 2017. Data including demographic details, clinical findings were collected. Patch test done and readings were taken according to ICDRG criteria. Results: Fifty patients were enrolled in our study. The prevalence of contact dermatitis in construction workers is 2.6% and prevalence of Chromium induced contact dermatitis is 50%. Age group predominantly affected was 41-55 years. The male to female ratio is 3.5:1. The mean duration of exposure to cement was 13.02years. The minimum and the maximum time taken for the contact dermatitis to occur after exposure were 2 weeks and 40 years respectively. The median period for the onset was 10 years. Thirteen patients had acute eczema, 29 had chronic eczema and 9 had subacute eczema. Nintey two (92%) had allergic contact dermatitis and 8% had irritant contact dermatitis. The most common allergen positive by patch testing was Chromium [50%] followed by ppd [10%], parthenium [6%] and pb [4%]. Conclusion: Our study concludes that Chromium (hexavalent) in cement causes allergic reactions in 50% of construction workers. Control measures include health education, safety measures, health surveillance and reduction of Chromium VI concentration by adding 0.35% ferrous sulfate. Keyword: Contact dermatitis, Chromium, Patch test.

Background The coronavirus infectious disease 2019 pandemic has resulted in health care workers donning personal protective equipment (PPE) for extended periods. Objectives The aims of the study were to review facial PPE (surgical masks and N95 respirators) ingredients, to identify facial PPE resterilization techniques, and to recommend strategies for prevention and management of facial PPE-related dermatoses. Methods Twenty-one facial PPE (11 N95 respirators, 10 surgical masks) were reviewed. Resterilization techniques were identified. Personal protective equipment-induced occupational dermatoses and management strategies were explored. Results Polypropylene is the most common chemical identified in facial PPE. Most masks contain aluminum at the nosepiece. Two surgical masks released nickel. Facial PPE dermatoses include irritant contact dermatitis, allergic contact dermatitis, acne, and contact urticaria. Strategies for prevention and management of facial PPE occupational dermatoses are discussed. Conclusions There are increasing reports of occupational dermatoses associated with facial PPE. This review discusses the components of facial PPE, mask resterilization methods, and strategies for prevention and management of facial PPE dermatoses.

Background Since the outbreak of SARS-CoV-2, authorities have preached the importance of personal hygiene, including hand washing and disinfection. Objective To evaluate changes in the frequency of hand washing and hand care, the onset of hand eczema (HE) and risk factors associated with HE since the outbreak of SARS-CoV-2 in Munich in January 2020. Materials & Methods All dermatologic outpatients at the university hospital between April 6 and April 19 were asked to complete a structured questionnaire. Results Data of 512 patients with a median age of 49 years (243 females, 267 males) were analysed. The frequency of hand washing and hand disinfection increased after the outbreak of SARS-CoV-2 (p < 0.001, respectively). While symptoms associated with HE were reported by 29.9% (149/499) of patients, the actual diagnosis of HE was reported less frequently by 11.2% (53/473) with a median duration of 120 days. Frequent hand disinfection (p = 0.039), atopic dermatitis (p = 0.006) and young age (p = 0.0499) were identified as risk factors for symptoms of HE. Hand care was performed more frequently during the pandemic than before (p < 0.001). A high frequency of hand care during the pandemic was not significantly associated with symptoms of HE (p = 0.172), but was associated with self-recognition of HE symptoms (p = 0.002). Conclusion After the outbreak of SARS-CoV-2, the frequency of hand hygiene measures increased. A considerably high prevalence of HE symptoms was associated with frequent hand disinfection, atopic dermatitis and young age. Awareness of HE should be raised in order for preventive measures to be taken earlier.

Dry, cracked lips are a common occurrence in both cold winter months and arid climates, leading many patients to experience discomfort year-round. Lip-licking is a compensatory measure that perpetuates the condition and often leads to lip-licking dermatitis. In patients in whom this compensatory measure becomes a chronic habit, other sequelae such as irritant contact dermatitis, cheilitis simplex, angular cheilitis, factitial cheilitis, secondary infections, and exfoliative cheilitis can arise. Given the high prevalence of lip-licking and subsequent dermatitis, it is important to counsel patients on interventions to prevent associated dermatitis and treatment methods to alleviate symptoms. Practical interventions in a daily routine should include application of a bland lip balm with ultraviolet protection, adequate hydration, protection of the lips from harsh weather conditions, and recognizing when dermatitis is present and further dermatologic care is indicated.

The terms ‘eczema’ and ‘dermatitis’ are used interchangeably to describe an inflammatory skin disorder with different clinical and histological appearances according to duration (acute versus chronic) and cause. ‘Non-atopic dermatitis’ encompasses various kinds of dermatitis that are usually classified by appearance, such as discoid eczema, or body site, such as seborrhoeic dermatitis. Attempts at classification are often unsatisfactory and different kinds of dermatitis can coexist and overlap with atopic dermatitis. The role of irritant and allergic contact factors should be considered in all cases and patch tests undertaken where allergic contact dermatitis is suspected or cannot be excluded.

BACKGROUND Hairdressers have a high risk of occupational contact dermatitis caused by exposure to wet work and allergens in hairdressing chemicals. OBJECTIVES To examine the distribution of diagnoses of occupational skin diseases (OSDs) and their main causes in hairdressers based on a national register data on occupational diseases. METHODS We retrieved cases of recognized OSDs in hairdressers from the Finnish Register of Occupational Diseases (FROD) in years 2005-2018. RESULTS During the 14-year period, a total of 290 cases of recognized OSD in hairdressers were registered in the FROD. Allergic contact dermatitis (ACD) was diagnosed in 54%, irritant contact dermatitis in 44%, and contact urticaria (CU) in 5% of them. ACD was most commonly caused by hair dye products and their ingredients (N = 57), persulfates (N = 35), and preservatives (N = 35; mainly isothiazolinones). Acrylates emerged as hairdressers' occupational contact allergens (N = 8) probably due to introduction of structure nails into hair salons. Persulfates was the most common cause of CU. CONCLUSIONS ACD was the most common OSD in hairdressers. Our analysis confirms that preservatives are important causes of ACD in hairdressers in addition to hair dye products and persulfates. Acrylates emerged as hairdressers' occupational contact allergens, but contact allergy to perming agents remained rare.

Irritant contact dermatitis (ICD) is an inflammatory epidermal disorder associated with physical or immunological provocation that results in impaired skin barrier. The prevalence of ICD is found to be 17-30% in healthcare workers compared to general population. The first-line management strategies of ICD is based on prevention. Intensive hand cleansing is one of the causes of ICD. Hand hygiene is general term that refers to any action of hand cleansing. Hand hygiene practices include hand washing and hand rubbing with antiseptics. Hand hygiene is the most effective preventive measure in preventing infection control, especially in the era of coronavirus (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since December 2019. This disease is transmitted through inhalation or contact with infected droplets. Prevention and mitigation actions are key in controlling infection.

Irritant contact dermatitis is a wide spread occupational skin condition. In addition to generalized protection and teaching schemes, a knowledge about individual risk might add to an improved awareness for hazards. Here, we report on a novel candidate biomarker, which might stage individual susceptibility to irritant skin damage. Subclinical sensitivity was proven in recent studies. As a nano-anatomical measure, it works non-invasively on corneocytes from tape strips. Here, we report on a 7-day course after exposure to sodium lauryl sulphate and compare the novel cell texture index with the classical markers water loss (transepidermal water loss) and natural moisturizing factor. All parameters show a high degree of correlation.

Sanitizers are the substances or the fluid designated to kill germs on skin and objects. As hand hygiene plays an important role in pandemic situations like COVID-19, people mostly rely on hand sanitizers than soap and water. The sanitizing effect of sanitizer depends on the ingredients such as 60-95% v/v alcohol, antiseptics, etc. The alcohol usually damages the skin by denaturation of stratum corneum proteins. The repeated or frequent use of hand sanitizers can cause skin reactions- Irritant contact dermatitis and Allergic contact dermatitis with symptoms such as burning, irritation, itching, etc. These effects can be reduced by using selected less irritating products, reducing skin irritation, use of moisturizing skin products. As microbial flora also plays an important role in human health, sanitizer overuse creates an imbalance between the good and bad bacteria in the digestive system which leads to inflammatory bowel diseases, obesity, autism, etc. As a researcher reported that sanitizer also gives an unpleasant side effect of using hand sanitizer every day and also mentioned that ‘we have to balance the benefit of sanitizer for preventing disease transmission and their potential misuse remains a challenge’.

Introduction: Cosmetics are defined by the Saudi Food and Drug Authority as any material or preparation designed to come into contact with various external body parts (epidermis, hair system, nails, lips, and external genital organs) or with the oral cavity's teeth and mucous membranes for a variety of purposes, such as cleansing, perfuming, altering their appearance and/or keeping them in a good condition. Objectives: The objective of the study was to assess the prevalence, level of awareness, and practices regarding cosmetics harmful hazards among Saudi female University Students of Albaha; Saudi Arabia. Methodology: This was a descriptive study intended to assess the prevalence, awareness and practice of Saudi female students of Albaha University. Systematic sampling methods were used to pick from each college, the predetermined sample size was taken, accordingly systematic random sampling was used to recruit 410 female students from medical and none medical colleges. Medical students at the latter level of their study were excluded from the study. Information was gathered using a self-administered questionnaire which was constructed to explore respondents’ awareness and practice toward using cosmetics. Results: A total of 410 respondents were enrolled in the study with a respondent rate of 93.2%, most of the respondents (62.4%) were none medical, and (37.6%) medical students. The prevalence of cosmetics use among our respondents is (97.8%), (82%) of them are between the age of 18 and 20 years and (76.3%) were unmarried. Most of the respondents (77.8%) used cosmetics daily while (20%) used to apply them sometimes or on need. Facial cosmetics, lipstick, and eye make-up as a group is the most commonly used cosmetics (64.9%) followed by skin lightening products (14.4%). 69% have an average level of knowledge concerning cosmetics adverse effects; (23%) have knowledge level and only (8%) having a good level of knowledge. A very significant proportion (37%) had experienced at least one side effect. Irritant contact dermatitis is the most commonly seen adverse effect affecting (38.8%) of the study population; followed by acne (27%) and allergic contact dermatitis (18.4%). Perfumes, deodorants, body lotions and creams by far the most common cosmetics products causing adverse effects (52.4%); followed by Facial cosmetics, lipstick and eye make-up in 143 (34.9%). Conclusion: A high prevalence rate of cosmetic use among Albaha university female students. Unfortunately, only 8% of them have good knowledge about the harmful effects of cosmetics. A very significant proportion was experienced at least one cosmetics-related side effect. This study concludes that cosmetics health-related hazard awareness among our respondents was not satisfactory and therefore needs a special consideration on cosmetic use-related safety concerns through awareness programs to raise their awareness. Recommendation: More researches should be directed to determine levels of knowledge and awareness towards cosmetic usage and its health hazards and safety measures. We recommended that a well-structured health education program should be done including lectures, workshops, campaigns and mass media orientation to increase the awareness level and educate the students about the hazardous effects of commonly used cosmetics.

Hand hygiene (HH) is the single most important procedure that can be followed by healthcare workers (HCWs) to reduce the risk of spreading healthcare-associated infections. The irritating contact dermatitis (ICD) that occurs due to the rehashed presentation of HH products and technique is one reason often referred to for resistance. HH is the most vital method that can be followed by HCWs to reduce the possibility of spreading of infection in human being, followed by50% of HCWs. Limited researches are published related to different features of irritant contact disorders among HCWs. This study concentrates manly on the clinical application of irritant contact dermatitis on hands and its diagnosis based on an extensive research review process. It can be concluded from this review that by proper adherence and compliance to necessary HH techniques lead to skin damage and higher pathogen load. Therefore, it is important that HCWs should appreciate this concept and are given methods or tactics of expertise to avoid skin irritation and damage. Inability to provide proper policies, practices and guidelines to these workers may lead to adherence in case of an ICD appearance.

Interventional procedures to prevent hand eczema (HE), comprising educational programs, are widely used for primary, secondary, and tertiary prevention of irritant contact dermatitis on the hands. This review gives an overview of randomized controlled trials (RCTs) addressing the efficacy of interventional procedures and educational programs in HE prevention. RCTs on HE prevention differ with respect to form and implementation of interventions, populations, and follow-up times. Overall, the education has focused on use of moisturizers, gloves, and substitution of hand washes with alcohol-based hand rubs. Regarding outcome measures, the effect of interventions on prevalence (i.e., primary prevention) has been inconclusive. Meanwhile, educational programs aiming at HE patients (secondary prevention) had a positive effect on behavior in four out of five RCTs and a decrease in HE severity in four out of six RCTs (one with group-based and three with individual-based education). Positive effect on knowledge and on health-related quality of life was only found in few studies. Overall, preventive educational programs are useful. Along with intensified, individual-based educations rather than group-based education, a shorter follow-up time seems to influence outcome measures positively. Future studies should investigate the long-term benefit from repeated educational sessions to maintain the positive benefits.

This article provides an overview of the evaluation and management of occupational contact dermatitis, including how to evaluate a patient with suspected occupational contact dermatitis. Patch testing, how to perform a site visit, and how to properly manage using preventative measures, prescribed therapies, and patient education are discussed.

Leakage of stomal effluents underneath the baseplate or inappropriate removal of stoma appliances can cause peristomal skin complications (PSCs), which are known to have many negative implications for people with a stoma. While numerous studies have examined the causes of PSCs, less is known about what drives the risk of a PSC developing. To address this gap in knowledge, the largest multinational survey to date was conducted, including 4235 people with a stoma on four continents and in 13 countries. The survey revealed that, besides leakage, other factors, such as age, gender, time since surgery and type of stoma, also drive the risk of PSCs. The survey also revealed that having a PSC resulted in greater use of stoma accessories and more frequent contact with health professionals, increasing overall healthcare costs. Collectively, the survey results reveal a need for more awareness on the risk factors for PSCs, which subsequently could have a positive effect on healthcare spending.

BACKGROUND Hair care products (HCPs) may cause both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). OBJECTIVES The aims of the study were to determine the prevalence of HCP-associated ICD/ACD and to characterize relevant allergens. METHODS This study is a retrospective analysis of North American Contact Dermatitis Group (NACDG) patch test data, 2001-2016. RESULTS Of 38,775 patients tested, 3481 (9.0%) had positive patch test reactions associated with HCPs. The HCP-positive patients were significantly more likely to be female (79.9% vs 66.0%) and/or have primary sites of dermatitis on the face (32.0% vs 27.8%) or scalp (15.4% vs 2.2%) compared with the HCP-negative patients (P < 0.0001). Of 4908 HCP-associated positive patch test reactions, 86.9% (n = 4263) were due to allergens on the NACDG screening series; p-phenylenediamine (35.8%), methylisothiazolinone (9.7%), methylchloroisothiazolinone/methylisothiazolinone (8.7%), and cocamidopropyl betaine (5.9%) were the most frequent. Most reactions (87.7%, 3736/4263) were currently clinically relevant. The most common job associated with 366 occupationally related NACDG HCP-associated allergens was hairdresser/cosmetologist (71.9%). Two hundred eighty-two patients (0.7%) had ICD associated with HCPs. Shampoo/conditioners were the most frequent source of NACDG HCP-associated reactions (47.3%) and HCP-associated ICD (45.0%). CONCLUSIONS Of the HCP-positive patients, 18.5% had HCP reactions to allergens not on the NACDG screening series, underscoring the importance of patch testing to expanded series in patients suspected of HCP allergy.

Evaluation of anogenital dermatitis requires a detailed history, including a sexual history. Men who have sex with men have different risk of certain infectious causes compared with men who have sex with women. Infectious causes of balanitis and anal dermatitis are easily treatable once identified. Irritant contact dermatitis is a common cause of balanitis, and avoidance of irritants, including decreased soap washing, helps many patients improve. Detailed histories of the personal products used by the patient and partner(s), including soaps, lotions, perfumes, lubricants, condoms, topical medications, hygiene sprays, personal wipes, and laundry detergent, may reveal possible irritants or contact allergens.

Toys are a reflection of the compounds used frequently in manufacturing. Allergic contact dermatitis to potties, metal toys, and children's jewelry is well known, however, there is a broad range of skin risks in toys. With the objective to identify and publicize the associated risk of contact dermatitis in children's toys, we have searched the PubMed database from creation to September 9, 2019. Studies were eligible if they reported a new case of contact dermatitis secondary to interaction with a toy in patients from birth to 18 years of age. A toy was defined as something children interact with for entertainment during leisure time. In this review of the PubMed database we filtered by age and language which may have prevented us from detecting cases in adults that could be extrapolated to children. In addition, several articles were excluded based on title alone. A total of 1312 articles were identified and reviewed manually for inclusion criteria. Review of the articles found 25 original articles for consideration. Several toys were found to be associated with contact dermatitis. These included electronics, toy cars, costume jewelry, bicycles, sqwish balls, slime, Play-Doh, and plasticine. Electronics such as video game controllers, cellphones, iPads, and computers were implicated. In conclusion, there is still an unmet need for observation of this segment of industry for labeling of contents and ongoing surveillance.

Background Irritant contact dermatitis (ICD) is the most frequent cause of hand eczema (HE). There is promising evidence with the use of topical oatmeal compounds in the management of inflammation- and itch-responses associated with diverse dermatologic conditions. This study aimed to evaluate the clinical benefit of colloidal oatmeal cream in the management of chronic irritant HE. Methods From October 2018 to November 2019, 79 patients with diagnosis of chronic irritant HE were allocated into either intervention or control groups by block randomization method. Besides fluocinolone 0.025% ointment for the first 2 weeks of treatment period, patients in the intervention and control groups were asked to use colloidal oatmeal 1% cream or base cream for additional 4 weeks as monotherapy. Changes in the HE severity based on the hand eczema severity index (HESCI) score, pruritus severity based on the visual analogue scale (VAS), and impact of skin disorder on patients quality of life based on the Dermatology Life Quality Index (DLQI) from baseline to weeks 2, 4, and 6 were assessed in the study groups. Results Fifty subjects, 26 in intervention and 24 in control, completed the course of the study. The results indicated, though relatively comparable decrease in mean HESI and VAS scores was observed in both groups by the end of week 2, thereafter until end of the study a non-return of symptoms to baseline conditions was observed in the intervention group, while there was a significant return of symptoms to baseline conditions in the control group (p value

BACKGROUND Skin diseases are among the most common occupational diseases, but detailed analyses on their epidemiology, diagnoses, and causes are relatively scarce. OBJECTIVES To analyze data on skin disease in the Finnish Register of Occupational Diseases (FROD) for (1) different diagnoses and (2) main causes of allergic contact dermatitis (ACD). METHODS We retrieved data on recognized cases with occupational skin disease (OSD) in the FROD from a 12-year-period 2005-2016 and used national official labor force data of the year 2012. RESULTS We analyzed a total of 5265 cases, of which 42% had irritant contact dermatitis (ICD), 35% ACD, 11% contact urticaria/protein contact dermatitis (CU/PCD), and 9% skin infections. The incidence rate of OSD in the total labor force was 18.8 cases/100 000 person years. Skin infections concerned mainly scabies in health care personnel. Twenty-nine per cent of the ACD cases were caused by plastics/resins-related allergens, mainly epoxy chemicals. Other important causes for ACD were rubber, preservatives, metals, acrylates, and hairdressing chemicals. Cases of occupational ACD due to isothiazolinones reached a peak in 2014. CONCLUSION Our analysis confirms that epoxy products are gaining importance as causes of OSD and the isothiazolinone contact allergy epidemic has started to wane.

Irritant contact dermatitis (ICD) is defined as a localized skin reaction to irritants which does not require prior sensitization of the immune adaptative system. ICD is a consequence of direct toxic effect of physical or chemical agents resulting in keratinocyte damage. The purpose of this review was to highlight the various aspects of ICD to improve its management. It is now known that ICD is a complex reaction that involved both endogenous and exogenous factors, and does not represent a homogenous entity but can cover various clinical subtypes. The management of ICD is based on its accurate diagnosis and the identification of the irritants if possible. The treatment is based on the avoidance of irritants, and strategies such as personal protective equipment (gloves, barrier creams) to be implemented at the workplace. ICD is the most frequent cause of contact dermatitis. It represents up to 95% of contact dermatitis in occupational context. This review focuses on the practical management of ICD: why it happens, which are the main clinical subtypes and what to do.

Background: Previous research using animal models demonstrated that CD44 expression may contribute to directing inflammatory cells into skin lesions during inflammation development in allergic contact dermatitis (ACD). Objectives: To examine CD44 expression in patients with ACD and irritant contact dermatitis (ICD), and to compare it to patients with psoriatic lesions and healthy controls' (HCs) skin. Methods: This study included 200 patients comprising four groups of 50 each: ACD, ICD, psoriasis vulgaris, and HCs. CD44 expression was determined by immunohistochemical analysis using an optical microscope, and the results were visualized semiquantitatively by determining the percentage of immunoreactive cells in the epidermis, dermis, and on lymphocytes. Results: The highest CD44 expression was found in ICD, followed by ACD, psoriasis vulgaris, and lastly, the HCs (P < .001). Epidermal CD44 expression was significantly higher in contact dermatoses (especially in ICD) compared with psoriasis and healthy skin (P < .001). Similarly, CD44 expression in the dermis and on lymphocytes was strongest in ICD, although less pronounced than in the epidermis. Conclusions: Because significantly elevated CD44 expression in ICD might be related to its function in maintaining and preserving the skin barrier in affected patients, further research on disease pathogenesis and new treatment options is needed.

Background Irritant contact dermatitis is the most common type of hand eczema. Effective treatment usually involves avoidance of irritants and use of appropriate topical medication. In this study, the effectiveness of using text messaging addressing preventive behaviours and appropriate medication adherence was evaluated. Methods Patients who were admitted to Istanbul Training and Research Hospital Dermatology Department March 1, 2015 to July 31, 2015, and diagnosed with hand eczema were enrolled. Patients were randomly divided into the SMS group and the non-SMS group. Text messages were sent to the mobile phones of the patients in the SMS group. Severity of hand eczema, compliance to treatment, patients' information level, adherence to preventive behaviours, and the protective behaviour score were evaluated at baseline, and at the 4th and 8th week. Results Eighty-one patients with hand eczema were included in the study. After 8 weeks, the decrease in the Hand Eczema Severity Index score was 70.2% (SD 35.2) in the SMS group and 38.9% (SD 67.7) in the non-SMS group (P = .017). Sending SMS to patients increased the use of moisturizer. There was no statistically significant difference in other behaviours. Conclusion This study demonstrated that text messaging improves the treatment success and specifically the frequency of moisturizer use in patients with hand eczema.

Objective: Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis. It is categorised by persistent erythema and can be associated with denudation and/or colonisation and infection. IAD is challenging to treat and affects 3.4–50% of patients. This case series evaluates a novel, elastomeric, advanced skin protectant (3M Cavilon Advanced Skin Protectant) in a UK acute health-care setting, for the management of IAD in patients suffering from moisture-associated skin damage (MASD) in the sacral/genital area. Method: The patient's skin was assessed by clinicians using the GLOBIAD classification tool at the point of recruitment and to monitor progress throughout the study period. The product was applied as a single layer in accordance with the instructions for use. Patients, when able, were asked to assess their own pain level using the Wong-Baker FACES pain scale. Photographs were taken as part of the ongoing assessment. Results: The skin protectant was used on average every 2.28 days. Of the 18 IAD patients recruited, 79% (n=11) were classified as IAD-free, based on the GLOBIAD categorisation tool, by the end of the evaluation period. Skin deterioration during the evaluation period was seen in one patient (6%), and of the patients able to complete pain assessments, 55% (n=6) reported a reduction in pain. Conclusion: These results suggest that the elastomeric skin protectant, applied every three days, plays a role in the improvement of IAD. The skin protectant adheres to wet and weeping partial-thickness wounds and may aid IAD management. Reducing application to every third day supports a change in practice which may offer benefits to patients and caregivers.

Purpose Irritant contact dermatitis (ICD) is a major cause of occupational disease. The aim was to review the relation between exposure to occupational irritants and ICD and the prognosis of ICD. Methods Through a systematic search, 1516 titles were identified, and 48 studies were included in the systematic review. Results We found that the evidence for an association between ICD and occupational irritants was strong for wet work, moderate for detergents and non-alcoholic disinfectants, and strong for a combination. The highest quality studies provided limited evidence for an association with use of occlusive gloves without other exposures and moderate evidence with simultaneous exposure to other wet work irritants. The evidence for an association between minor ICD and exposure to metalworking fluids was moderate. Regarding mechanical exposures, the literature was scarce and the evidence limited. We found that the prognosis for complete healing of ICD is poor, but improves after decrease of exposure through change of occupation or work tasks. There was no substantial evidence for an influence of gender, age, or household exposures. Inclusion of atopic dermatitis in the analysis did not alter the risk of ICD. Studies were at risk of bias, mainly due to selection and misclassification of exposure and outcome. This may have attenuated the results. Conclusion This review reports strong evidence for an association between ICD and a combination of exposure to wet work and non-alcoholic disinfectants, moderate for metalworking fluids, limited for mechanical and glove exposure, and a strong evidence for a poor prognosis of ICD.

Irritant contact dermatitis (ICD) is an inflammation of skin caused by direct cytotoxic effects of chemical, physical or biological agents on epidermal cells without a presence of specific antibody production. It was reported that a 40-year-old man, complaining of itching and a burned sensation on his skins accompanied by pain after contaminated by sap of Rengas. Diagnosis of ICD was established by history taking and physical examination: there are erythematous, multiple, discrete papules, partly necrotic-erythematous skin base on his forearm and right lower abdomen. The patient was treated with mometasone furoate smeared and antihistamines once a night. A characteristic of the sap is black on its woods. Compounds of the sap contain ursiol, rengol, glutarengol, laccol and thitsiol that are irritants causing the ICD.