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Objectives: Occupational skin diseases (OSDs) pose significant risks to the health and well-being of restaurant workers. However, there is presently limited evidence on the burden and determinants of OSDs among this occupational group. This research aims to estimate the prevalence and associated factors of suspected OSDs among restaurant workers in Peninsular Malaysia., Design: A secondary data analysis of the 2023 Registry of Occupational Disease Screening (RODS) was performed. The RODS survey tool, which included the Nordic Occupational Skin Questionnaire, a symptoms checklist and items on work-relatedness, was used to screen for OSDs. Logistic regression analyses were performed to identify associated factors., Setting and Participants: Restaurant workers (n=300) registered in RODS from February 2023 to April 2023, aged 18 years and above and working in restaurants across Selangor, Melaka and Pahang for more than 1 year, were included in the study, whereas workers who had pre-existing skin diseases were excluded., Results: The prevalence of suspected OSDs among study participants was 12.3%. Higher odds of suspected OSDs among study participants were observed among those exposed to wet work (adjusted OR (AOR) 22.74, 95% CI 9.63 to 53.68) and moderate to high job stress levels (AOR 4.33, 95% CI 1.80 to 10.43)., Conclusions: These findings suggest that OSDs are a significant occupational health problem among restaurant workers. Interventions targeting job content and wet work may be vital in reducing OSDs among this group of workers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

IntroductionWorking during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions.Materials and MethodsAn online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables.ResultsTwo types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38–2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49–2.78, p < 0.001), which acted as risk factors.DiscussionThe enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs.

Allergic contact dermatitis is one of the most frequent occupational skin diseases. Targeted allergen avoidance can only be achieved by identification of the causative allergen. Therefore, patch testing is of utmost importance in occupational dermatology, not only in terms of assessing causal relationships but also regarding the implementation of prevention measures and evaluation of the legal criteria for an occupational skin disease in Germany (statutory occupational disease BK 5101). The lack of commercial patch test preparations poses a great diagnostic challenge. Patch testing of patient's own materials from their workplace is therefore very important to reduce diagnostic gaps. The performance and documentation of the patch test should be in line with current guidelines and recommendations to ensure the necessary test quality and comprehensibility of the test results., Competing Interests: The authors declare that there is no conflict of interest. Table 1.Examples of materials that should not be tested in a patch test. TolueneAntifreezeCar waxGasolineDiesel fuelKerosene/heating oilFloor waxSpiritSolventAstringents (e.g. AgNO3)Mineral acids (hydrochloric acid, sulphuric acid)Alkali solutionsChalkCementConcrete Table 2.Recommendations for the preparation of common occupational materials for the patch test. SubstanceConcentrationVehiclepH*RemarkHand and skin disinfectantPure (50%)WaterSurface disinfectant (use concentration)0.1% 0.01%WaterInstrument disinfectant (use concentration)0.01% (0.001%)WaterMetalworking fluid, water-soluble, used or unused concentration ≤ 8%Pure (50%)WaterX24-hour occlusion Store sample in a cool place pH not > 9.5Metalworking fluid, water-soluble, used or unused concentration > 8%50% (10%)WaterX24-hour occlusion Store sample in a cool place pH not > 9.5Metalworking fluid, water-soluble, concentrate5%WaterX24-hour occlusion pH not > 9.5Metalworking fluid, oily50% (10%)Olive oilGreasePure (20%)PetrolatumLubricating oil50% 10%Olive oilGear oil10%Olive oilHydraulic oil(50%) 10%Olive oilSilicone spray10%PetrolatumWood dustPuremoistenedExotic woods 1 : 10 petrolatum*pH value must be checked before testing (pH value 5 – 8 is unproblematic). Table 3.Recommendations for the preparation of other patient’s own materials for patch testing. ProductsConcentrationVehiclepH**RemarkMoisturizer, emollient, sunscreensPureSunscreen: photo patch test may be requiredDeodorants, perfume, hairsprayPureDrizzle/spray the product on a filter paper disk, let dry before application of test chamberHair gelPureFirst semi-open testLiquid soap, shampoo, shower gel1% 5% (10%)WaterShaving cream, gel, foam1%WaterHousehold cleaners, detergents0.1% 1%Buffer*XClothing made of fabric, leather, rubberPuremoistened*Buffer solution pH 5.5 RN (DAB 10): Citric acid monohydrate 9.054 g, sodium monohydrogen phosphate 40.796 g, purified water ad 1,000 mL; **pH value must be checked before testing (pH value 5 – 8 is unproblematic). Table 4.Frequent mistakes in the performance and documentation of patch testing patient’s own materials that severely limit the value and comprehensibility of the test results. Common mistakesTesting of products that are not suitable for patch testingFull description of the product (name) is missingInformation on the test vehicle and/or the test concentration is missing despite dilutionInsufficient dilution / too high dilutionpH value is not measured or documented, even if required for testing (e.g., testing of metalworking fluids)Reading times are not documentedReading on day 3 (72 hours) or day 4 (96 hours) is not carried out or documented, (© Dustri-Verlag Dr. K. Feistle.)

Chronic exposure to trauma, friction, or extreme conditions can generate cutaneous or ungual lesions in sports and certain occupations. Although some of these dermatologic conditions are diagnosed with a naked‐eye examination, there are cases in which the provision of the underlying anatomic alterations can be helpful for the diagnosis and management. In comparison with computed tomography or magnetic resonance imaging, ultrasound has the highest axial resolution, which is critical for the observation of anatomic changes in the skin and nail. We review the ultrasound characteristics of frequent cutaneous and ungual lesions related to sports and occupations with a clinical correlation. The ultrasound features in some particular conditions such as "biker's and surfer's panniculitis," "fiddler's neck," piezogenic papules, and lipoatrophy semicircularis, among others, are discussed. [ABSTRACT FROM AUTHOR]

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OBJECTIVES: This study aimed to assess whether the occurrence of skin problems in 2006 (baseline) was associated with response frequency, quitting a job due to health problems, and change in occupational skin exposures in 2009. METHODS: We conducted a three-year prospective study of the general working population of Norway. Associations between baseline indicators (sex, age, education, occupation), and occurrence of skin problems with response frequency at follow-up were assessed with Chi-square test and unconditional logistic regression. Associations between the occurrence of skin problems at baseline with quitting a job due to health problems and skin exposure at follow-up were also assessed with unconditional logistic regression. RESULTS: We found no evidence of an association between the occurrence of skin problems at baseline and a lower response frequency at follow-up. Age, sex, education, and occupation were the most important predictors for response at follow-up. Skin problems at baseline consistently predicted quitting a job due to health problems at follow-up. No evidence of change in the patterns of occupational skin exposures at follow up in 2009 was found for workers reporting skin problems in 2006. CONCLUSION: While skin problems at baseline were not related to a lower response frequency at follow-up, our results suggest that workers reporting skin problems may quit their jobs due to health problems. Preventive efforts are still needed to reduce hazardous occupational skin exposures among workers reporting skin problems.

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Abstract Videogame controller–induced knuckle pads may present in a strikingly unique distribution. Successful paring without recurrence can be achieved when combined with removal of the original insult.

Background: Cutaneous leishmaniasis (CL) is the most common neglected tropical disease, causing stigmatised skin lesions. It is an important public health concern, with 95% of cases occurring in low-income and middle-income countries. Despite its long-recognized endemicity and psychosocial impacts, it is largely overlooked., Objective: The main aim of this study is to investigate the magnitude and associated factors of CL in north-central Ethiopia., Design: An institution-based cross-sectional study was conducted., Setting: The study was conducted in Nefas Mewcha Primary Hospital (NMPH), north-central Ethiopia., Participants: The study was conducted among 332 individuals visiting NMPH from June to July 2022., Primary and Secondary Outcomes: The primary outcome was to estimate the burden of CL among patients visiting NMPH, and the secondary outcome was to identify factors associated with the presence or absence of CL. The association between predictor variables and CL was assessed using a binary logistic regression model. Statistical significance was declared at a p &#95;value of <0.05., Result: Out of the 332 study participants, 63 patients sought medical care with skin lesions, and 61 (18.37%, 95% CI: 14.5% to 22.9%) were patients with CL. Localized CL was the predominant type (86.9%). Male sex (adjusted OR (AOR): 4.51; 95% CI 1.94 to 10.45), older age (AOR 0.91, 95% CI: 0.87 to 0.94), secondary and tertiary educational status (AOR: 0.18, 95% CI: 0.05 to 0.6), poor knowledge of CL (AOR: 4.02, 95% CI: 1.81 to 9.76) and living with domestic animals (AOR: 5.29, 95% CI 3.24 to 7.5) were identified as predictors of CL., Conclusion: In the study area, the magnitude of CL was found to be high. Being male and young, having low educational status, having poor knowledge and living with domestic animals increase the risk of acquiring CL. As a result, increasing the knowledge of the community through scaling up of health education programmes and reducing activities that increase individuals' exposure to sandflies should be prioritised., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives This study aimed to assess whether the occurrence of skin problems in 2006 (baseline) was associated with response frequency, quitting a job due to health problems, and change in occupational skin exposures in 2009. Methods We conducted a three-year prospective study of the general working population of Norway. Associations between baseline indicators (sex, age, education, occupation), and occurrence of skin problems with response frequency at follow-up were assessed with Chi-square test and unconditional logistic regression. Associations between the occurrence of skin problems at baseline with quitting a job due to health problems and skin exposure at follow-up were also assessed with unconditional logistic regression. Results We found no evidence of an association between the occurrence of skin problems at baseline and a lower response frequency at follow-up. Age, sex, education, and occupation were the most important predictors for response at follow-up. Skin problems at baseline consistently predicted quitting a job due to health problems at follow-up. No evidence of change in the patterns of occupational skin exposures at follow up in 2009 was found for workers reporting skin problems in 2006. Conclusions While skin problems at baseline were not related to a lower response frequency at follow-up, our results suggest that workers reporting skin problems may quit their jobs due to health problems. Preventive efforts are still needed to reduce hazardous occupational skin exposures among workers reporting skin problems. [ABSTRACT FROM AUTHOR]

Dentro de la Medicina Laboral las dermatosis ocupacionales suponen entre el 30-60% del total de enfermedades profesionales y, dentro de ellas el 80-90% son dermatitis de contacto. Este alto número no se ve reflejado en datos oficiales debido a que en muchas ocasiones, al ser condiciones de rápida resolución o de escasa repercusión sistémica, no son declaradas. En relación a las dermatitis de contacto, la forma más frecuente en el entorno laboral es la forma alérgica y la que preferentemente se declara, al ser un proceso que en muchas ocasiones constituye motivo de incapacidad. Para el abordaje diagnóstico y correspondiente asociación con el entorno de trabajo es imprescindible realizar una historia clínica laboral completa junto con la descripción de las lesiones, y la utilización de métodos diagnósticos distintos a los de otros procesos no cutáneos, como son las pruebas de parche (patch test) o pruebas epicutáneas. Constituyen un método simple, accesible y seguro para llegar al diagnóstico de las dermatitis alérgicas de contacto. Incluyen una batería estándar, propia de un país donde se trabaja, ampliada de baterías específicas en relación con el perfil, las tareas y los productos manipulados por el trabajador. La prevención en el trabajo es el único tratamiento etiológico para la sustitución y control de los riesgos laborales relacionados con las dermatosis profesionales.In occupational medicine, occupational dermatoses account for 30 to 60% of the total amount of occupational diseases and, within 80 to 90% of them correspond to contact dermatitis. This high number is not reflected in official data because in most cases, as conditions of rapid resolution or low systemic impact, they are not declared. Regarding contact dermatitis, the most common type in the workplace is the allergic type, which preferably is declared, because often results in disability. For the correct diagnosis and association with the work environment is essential to make a full history of the patient' occupational background, correct description of the skin lesions, and the use of diagnostic methods other than those of non-cutaneous processes, such as patch testing. They provide a simple, accessible and safe method for the diagnosis of allergic contact dermatitis. They include a standard national baseline series, proper of the country where the patient works, and additional extended series, specific to the occupation performed by the worker. Prevention at work is the only etiological treatment for replacement and control of occupational hazards associated with occupational skin diseases.

In recent decades a comprehensive catalogue of primary and secondary inpatient and outpatient measures was developed for the prevention of occupational skin diseases (BK 5101). These measures are evidence-based and have led to a dramatic decrease of recognized cases of occupational diseases despite an increasing number of notifications. Nevertheless, health-insured patients have often been found to be excluded from preventive measures during periods of inability to work for legal reasons, which can result in a failure of prevention and compulsory cessation of working resulting in the manifestation and recognition of an occupational skin disease under BK 5101. A legal clarification as to whether the preventive requirements by § 3 of the Ordinance on Occupational Diseases refer exclusively to workers currently exposed to health hazards at work or to all employees who have suffered a health risk through occupational activities and who run a concrete danger to develop an occupational disease appears to be necessary. [ABSTRACT FROM AUTHOR]

Context: Studies on occupational skin diseases in workers of the automotive industry are few. Aim: To investigate the prevalence of occupational skin diseases in workers of the automotive industry. Materials and methods: Between September and December 2011, a total of 405 workers from the automotive repair industry in Diyarbakır were interviewed. They were active workers in the repair industry who had been employed for at least six months. Business owners, sellers of spare parts and accounting officers were not included. The employees were examined at their workplaces and the working conditions were observed. Detailed dermatological examination was performed. Results: The mean age of the 405 workers who participated in the study was 27.7 ± 10.3. The mean working time of employees was 13.3 ± 10.4 years. All of the employees were male. Dermatological diseases were not detected in 144 out of 405 workers (35.6%) and at least one condition was diagnosed in 261 (64.4%). The most frequent diagnosis was callus, hyperkeratosis, clavus (27.7%), followed by nail changes (16.8%) and superficial mycoses (12.1%). Contact dermatitis was seen at a rate of 5.9%. Discussion: Traumatic lesions such as hyperkeratotic lesions and nail changes were found most frequently. Traumatic lesions were common among individuals who did not use gloves. Most nail changes were localized leuconychia, a finding not reported in the studies on automotive industry workers. In accordance with the literature, irritant contact dermatitis was observed in patients with a history of atopy and who had been working for a long time. Conclusion: Occupational skin diseases comprise an important field in dermatology, deserving much attention. Further studies on occupational dermatology are necessary. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers (HCWs) constitute a high-risk group for developing occupational hand eczema (HE). The present systematic review and meta-analysis will compile and appraise evidence regarding prevalence and incidence of HE in HCWs., Methods and Analysis: Systematic searches will be performed in three electronic literature databases (PubMed/Medline, Web of Science-Core Collection and Embase). Further references will be retrieved by a manual search of included studies' reference lists using snowballing techniques. We will include experimental studies, observational studies, survey-based studies and clinical studies (publications in English, French and German from 2000 onwards) reporting on certified and apprentice HCWs, who actively work in the job. We will look at the following outcomes: Prevalence and incidence of clinically assessed as well as self-reported HE in the style of the Nordic Occupational Skin Questionnaire-2002; HE severity (measured by eg, Hand Eczema Severity Index, Osnabrück Hand Eczema Severity Index, Physician Global Assessment or other validated instruments as well as self-reported or by using undefined categories such as 'mild', 'moderate' or 'severe'); clinically assessed (eg, clinical diagnosis, UK Working Party's diagnostic criteria, Hanifin and Rajka diagnostic criteria for atopic dermatitis (AD)) and self-reported AD. We will assess the risk of bias within studies using detailed criteria according to the Newcastle-Ottawa Scale. As we expect heterogeneity in methods and outcomes, we will conduct sensitivity analyses. A narrative synthesis of results instead of a meta-analysis will be done in case that quantitative pooling is not feasible., Ethics and Dissemination: Ethical approval and patient consent are not required as this work is based on published studies. The results will be published in an international, peer-reviewed journal., Prospero Registration Number: CRD42022303044., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Videogame controller–induced knuckle pads may present in a strikingly unique distribution. Successful paring without recurrence can be achieved when combined with removal of the original insult. [ABSTRACT FROM AUTHOR]

The purpose of the present article is to briefly highlight some contributions of Prof. Howard I. Maibach to the field of dermatology. After a few introducing remarks regarding Howard's personal career, the article specifically reviews contributions to the understanding of percutaneous absorption and to occupational dermatology. He and his companions/coworkers established and introduced experimental prerequisites to better study and understand percutaneous absorption - both in vitro and in vivo. Not less influential was his contribution to occupational dermatology acting as a founding member of the International Contact Dermatitis Research Group and coinaugurating the North American Contact Dermatitis Group. These groups have been very active ever since. As an academic teacher, he inspired young colleagues to perform original research work and to establish their own working groups. He has done this most successfully with many fellows who worked with him over the years, and who are now leading departments or companies dedicated to dermatological research all over the world. Probably this is his most important and lasting achievement. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article focuses on patch testing in occupational medicine. It reports about occupational dermatoses which accounts for 30 to 60 percent of the total occupational diseases. It states that correct diagnosis of contact dermatitis and association with the work environment is essential to know about the occupational background of a patient. It mentions that patch testing provides a simple and safe method for the diagnosis of allergic contact dermatitis.

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An easy-to-use standardized instrument is needed for the clinical assessment of the severity of occupational hand eczema by dermatologists as well as occupational physicians. The Osnabrueck hand eczema severity index (OHSI) was developed for this purpose and the interobserver reliability investigated. The clinical severity was evaluated on the basis of the extension or clinical characteristics of six morphological characteristics. For the validation of the OHSI, hand eczema in 28 patients was investigated independently by one dermatologist and 2 occupational physicians. The agreement between the observers was determined by using kappa values, Kendall's coefficient of concordance, the intraclass correlation coefficient (ICC) and the 95% limits of agreement. The ICC for the total OHSI was 0.80 and the estimated limits of agreement (−3.6 and 3.0) were sufficiently small to expect that ratings according to OHSI performed by independent observers of different medical specialities should produce similar results. It could be demonstrated that the use of the OHSI is simple and practicable. The interobserver reliability for the summary score is good. OHSI seems a reliable tool for assessing the severity of occupational hand eczema. [ABSTRACT FROM AUTHOR]

Background: Dry air and cold weather have been shown to influence skin irritability. There is conflicting evidence concerning seasonal variability of irritant patch test results and there are no data concerning the influence of season on NaOH-induced irritation. Patients and methods: A Swift Modified Alkaline Resistance Test (SMART) was carried out simultaneously on the volar forearm (FA) and the back of the hand (BOH) of 554 consecutive individuals (277 female, median age 36 years; 277 male, median age 42 years) who had previously had an occupational skin disease. The test comprises two challenges with 0.5 M NaOH each for 10 mm. The clinical outcome in each patient was related to standardized data on the local ambient temperature (T) and absolute humidity (AH) on the day of examination obtained from the German Meteorological Service. Results: Of the 554 patients, 212 (38.3%) showed a positive reaction on the FA, and 126 (22.7%) a positive reaction on the BOH. An atopic skin disposition significantly increased the odds for a positive clinical reaction on both the FA (OR 4.8, 95% CI 3.0-7.8) and the BOH (OR 3.1, 95% CI 1.8-5.5). In a logistic regression analysis a significant association between low T and AH, respectively, and clinical reactivity to NaOH on the BOH was found. The odds of a positive reaction were increased by 3.9 (95% CI 2.1-7.6) for an ambient T of ≤6°C and by 2.9 (95% CI 1.6-5.7) for an AH of ≤8 mg 1-1. The effects of AH and T on the reactivity on the BOH were even more pronounced in atopic individuals. In contrast, there was no significant association between the test outcome on the FA and climatic parameters. Furthermore, the test outcome showed no significant association with duration of healing of hand eczema or eczema at other sites before the investigation. Moreover, there were no associations detectable between previous wet work load and NaOH reactivity on both the BOH and FA. Conclusions: Unlike skin challenge with sodium lauryl sulphate, challenge with NaOH on a body area not directly exposed to environmental factors (FA) seems robust against seasonal influences. Furthermore, a NaOH test in this location (FA) may provide supporting evidence to help identify individuals with atopic skin. On the BOH, seasonal effects were demonstrated. Thus, when interpreting NaOH challenges on the BOH it would seem helpful to take ambient meteorological parameters into consideration. [ABSTRACT FROM AUTHOR]

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The potential effect of barrier creams or emollients in the prevention of work-related hand eczema has mostly been documented in a laboratory setting on experimentally damaged skin. Publications on real intervention studies of barrier creams or emollients in a workplace setting are scarce: only four such studies could be identified. The relatively short follow-up of most studies, and the small numbers of subjects enrolled, may reflect the organisational complexity of such studies. The observed effect is a combination of the intervention effect to be measured, and a number of disturbing variables. These disturbing variables are not just measurement error, but also phenomena such as the course of the disease, confounding and effect modification. In hand-eczema studies, the outcome parameters that should form the basis of the intervention effect are ill defined. Moreover, the study itself (i.e. the investigators) influences the results because there is rarely a single intervention: unknowingly, there are improvements in glove wearing, hand-washing habits or occupational hygiene in general. The performance of a blind study is often difficult or impossible. Large numbers of subjects have to be enrolled if a meaningful reduction in incidence of hand eczema is to be detected. One can demonstrate this by calculating the required enrolment in a study among employees in a nursing home. [ABSTRACT FROM AUTHOR]

The goal of this study was to evaluate biophysically and clinically the hand skin of nurses working in the operating room in comparison with the hand skin of a control group of female administrative employees. 19 nurses and 14 employees were included in this trial. Transepidermal water loss (TEWL) and stratum corneum (SC) hydration were evaluated on 4 different test sites - dominant and non-dominant pulse, and dominant and non-dominant hand dorsum. The clinical score Dermatology Life Quality Index (DLQI) and subjective evaluation of skin sensitivity were also recorded. In comparison with the control group, TEWL values among nurses were significantly higher on all test sites, while SC hydration was significantly lower on 3 of the 4 test sites. In addition, clinical score showed the presence of irritant contact dermatitis (ICD). DLQI reported a higher level of disability among the nurses group, while the subjective evaluation of skin sensitivity was identical in both groups. The results suggest the presence of skin barrier alterations and clinical signs of chronic ICD on the hands of nurses working in operating room units. [ABSTRACT FROM AUTHOR]

Chronic irritant contact dermatitis (ICD) is one of the most pressing problems in occupational medicine and is common in the food processing industry. To date, protective creams that fulfil the special requirements in the foodstuffs industry have not been available. Therefore, we studied the efficacy of pre-exposure application of natural vegetable fats in the prevention of experimentally induced ICD. A panel of 20 healthy volunteers was tested with a repetitive irritation test using sodium lauryl sulfate (SLS) as a standard irritant in a randomized study. Application sites were assessed clinically and by the use of bioengineering techniques (evaporimetry, chromametry, and corneometry). Rape seed and palm fats showed significant protective potential. Gas-chromatographic analysis revealed differences in the fatty acid composition of the vegetable. Higher content of linoleic acid and lower content of oleic acid was associated with beneficial effects. Our results are a new approach in the prevention of ICD and towards the development of new protective preparations for workplaces in the foodstuffs industry. [ABSTRACT FROM AUTHOR]

Introduction: Hand eczema (HE) is one of the most common skin disorders and an important cause for morbidity and occupational disability. The 1-year prevalence of HE is estimated to be up to 10% and it is estimated that 5%-7% of those develop severe chronic HE. However, current clinical evidence is not compelling enough to guide clinical practice. In a survey among 194 UK dermatologists the most frequent first choice approaches were psoralen combined with ultraviolet A (UVA) treatment (PUVA), oral steroids and alitretinoin (AL). When asked which strategy was most efficient for long-term outcome 20% of clinicians indicated they did not know; 43% of clinicians reported AL and 30% reported PUVA., Methods and Analysis: ALPHA is a multicentre, open, prospective, two-arm parallel group, randomised controlled trial comparing PUVA and AL with a planned sample size re-estimation. Between 500 and 780 participants will be randomised on a 1:1 basis. The physician's global assessment (PGA) will direct treatment after randomisation, non-responders will be treated according to usual clinical practice; providing valuable pilot data on second line therapeutic approaches to inform future trials.Assessments will be conducted up to 52 weeks post randomisation. The primary outcome measure is the Hand Eczema Severity Index at 12 weeks. Secondary outcome measures include modified Total Lesion Symptom Score, PGA, time to relapse, patient reported outcome measures and DNA extraction and assessment of genetic variants. A substudy on molecular inflammatory mediators will provide information on subgroup specific treatment responses. Photographs will be taken and HE severity assessed by a central review panel., Ethics and Dissemination: Ethics approval was obtained from Leeds West Research Ethics Committee (14/YH/1259).Trial results will be disseminated at relevant clinical conferences and societies, published in peer-reviewed journals and through relevant patient groups., Trial Registration Number: ISRCTN80206075., Competing Interests: Competing interests: None: MW, CG, SB, ILS, AV-P, LS, AB, PH, FC, CF, JN, CR, AB, CHS, JTL, MG and ST is a Health economist expert on the NIHR PGfAR, the H2020 mental health in the workplace (2019), the H2020 Innovation in health technology appraisal (2018) and the Belgian FNRS. commission of doctoral FRIA scholarship., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Introduction: Working during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions., Materials and Methods: An online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables., Results: Two types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38-2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49-2.78, p < 0.001), which acted as risk factors., Discussion: The enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Santoro, Borrelli, Gualano, Proietti, Skroza, Rossi, Amantea, Daniele, Ricciardi, Potenza and Moscato.)