Irritant Dermatitis (eBook)

Preface 5
Contents 6
List of Contributors 20
1 Ten Genotypes of Irritant Contact Dermatitis 25
1.1 Introduction 25
1.2 Clinical Classification of Irritant Contact Dermatitis 25
References 29
2 Irritant Contact Dermatitis Versus Allergic Contact Dermatitis 30
2.1 Introduction 30
2.2 Clinical Aspects 30
2.3 Histology and Immunohistochemistry 31
2.4 Pathogenetic Mechanisms 33
2.5 Conclusions 35
References 35
3 Barrier Function and Perturbation: Relevance for Interdigital Dermatitis 39
3.1 Introduction 39
3.2 Lamellar Body Secretion 39
3.3 Stratum Corneum Lipids 40
3.4 The Autonomous Stratum Corneum 41
3.5 Synthetic Activities to Barrier Function 41
3.6 Regional Variations in Skin Permeability 42
3.7 Irritant Contact Dermatitis 42
3.8 Interdigital Dermatitis – A Form of Irritant Contact Dermatitis 43
References 44
4 Friction Melanosis 47
4.1 Introduction 47
4.2 The Feature and Cause of Friction Melanosis 47
4.3 Comment 47
References 51
5 Diaper Dermatitis 52
5.1 Introduction 52
5.2 Birth 53
5.3 Factors Influencing Diaper Dermatitis 56
5.4 Effect of Diaper Type and Composition 60
5.5 Diapers for Delivery of Topical Preparations 63
5.6 Effect of Diaper Occlusion 64
6 Summary 64
References 65
6 Chemical Skin Burns 67
6.1 Introduction 67
6.2 Definition 67
6.3 Diagnosis 70
6.4 Clinical Features 70
6.5 Treatment 71
6.6 Complications 72
6.7 Prevention 73
6.8 Summary 73
References 74
7 Contact Urticaria Syndrome 76
7.1 Introduction 76
7.2 Epidemiology 76
7.3 Mechanisms of Contact Urticaria 76
7.4 Symptoms and Signs 78
7.5 Site Specificity of Contact Urticaria Reactions 78
7.6 Human Experimental Protocols 78
7.7 Clinical Assessment and Quantitative Methods 80
7.8 Animal Experimental Protocols 81
7.9 Conclusion 81
References 82
8 Airborne Irritant Dermatitis 84
8.1 Introduction 84
8.2 Airborne Irritant Dermatitis Due to Fibers 84
8.3 Airborne Irritant Dermatitis Due to Dust Particles 87
8.4 Airborne Irritant Dermatitis Due to Sprays, Vapors, and Gases 89
8.5 Diagnostic Procedures: Tools Available to Investigate and Confirm ( or Refute) the Diagnosis of Airborne Irritant Dermatitis 91
References 91
9 Irritant Dermatitis of the Scalp 93
9.1 Introduction 93
9.2 Irritant Dermatitis of the Scalp Due to Mechanical Factors 93
9.3 Irritant Dermatitis of the Scalp Due to Chemical Agents 95
References 99
10 Irritant Contact Dermatitis of the Nails 101
10.1 Mechanical Irritation 101
10.2 Physical Agents 102
10.3 Chemical 102
10.4 Biological 104
10.5 Prevention and Therapy 104
References 104
11 Importance of Irritant Contact Dermatitis in Occupational Skin Disease1 107
11.1 Patients and Methods 107
11.2 Results 108
11.3 Discussion 108
11.4 Conclusions 112
References 112
12 Irritant Contact Dermatitis in the Tropics 114
12.1 Introduction 114
12.2 Epidemiology of Irritant Contact Dermatitis in the Tropics 114
12.3 Common Sources and Types of Contact Irritant Dermatitis in the Tropics 115
12.4 Conclusions 116
References 117
13 Occupational Issues of Irritant Contact Dermatitis 119
13.1 Introduction 119
13.2 Clinical Features and Classification 119
13.3 Epidemiology 120
13.4 Modulation of Occupational Irritant Contact Dermatitis 121
13.5 High-Risk Occupations and Irritants 122
13.6 Diagnosis 124
13.7 Management: Prevention and Therapy 125
References 126
14 Hairdressing 129
14.1 Occupational Tasks and Their Irritants 129
14.2 Epidemiology, Pattern, and Course of Irritant Contact Dermatitis 131
14.3 Risk Factors for Irritant Contact Dermatitis in Hairdressers 134
14.4 Prevention of ICD 135
References 139
15 Occupational Irritant Dermatitis – Metal Workers 142
References 143
16 Health Care Workers 145
16.1 Health Care Workers: A Diverse Group 145
16.2 Prevalence and Clinical Features 145
16.3 Risk Factors 146
16.4 Specific Irritants 146
References 149
17 The Electronics Industry 151
17.1 Introduction 151
17.2 Irritant Contact Dermatitis Among Electronics Workers 152
17.3 Skin Irritants in the Electronics Industry 152
17.4 Concluding Remarks 154
References 154
18 Painters, Lacquerers, and Varnishers 156
18.1 Paints 156
18.2 Prevalence of Dermatitis Caused by Paints, Lacquers, and Varnishes 159
18.3 Clinical Aspects of Irritant Dermatitis 160
18.4 Causes of Irritant Dermatitis 160
18.5 Investigations 162
18.6 Prevention 162
References 163
19 Age 166
19.1 Introduction 166
19.2 Skin Barrier Function 166
19.3 Aging and Human Skin Barrier Function 167
19.4 Conclusions 170
References 170
Suggested Reading 172
20 Gender 173
20.1 Occurrence of Irritant Contact Dermatitis 173
20.2 Other Gender-Associated Risk Factors 174
20.3 The Influence of Gender on Skin Function and Irritability 174
References 175
21 Ethnicity 177
21.1 Introduction 177
21.2 Black Versus Caucasian Irritation Response 177
21.3 Asian Versus Caucasian Irritation Response 179
21.4 Conclusion 182
References 182
22 Atopy 184
22.1 Clinical Evidence of Skin Sensitivity in Atopic Dermatitis 184
22.2 The Skin in Subjects with Atopic Dermatitis 186
22.3 Reactivity to Irritants of Eczematous Skin as Assessed by Noninvasive Methods 190
22.4 Susceptibility to Skin Irritation in Atopics Without Dermatitis 192
References 193
23 Prediction Bioengineering 198
References 200
24 Quantitative Sonography for the Evaluation of Irritant Reactions 201
24.1 Sodium Lauryl Sulfate-Induced Irritation 202
24.2 Other Model Irritants: Nonanoic Acid, Hydrochloric Acid, and Sodium Hydroxide 203
24.3 Dithranol-Induced Irritation 203
24.4 Vitamin D Analogs 204
24.5 Evaluation of Subclinical Irritation 204
24.6 Skin Sensitivity to Irritant Substances in Different Patient Groups 204
References 205
25 Functional Skin Testing: the SMART Procedures 207
25.1 Irritant Patch Testing with Sodium Hydroxide 207
25.2 Swift Modified Alkali Resistance Test ( SMART) 207
25.3 Applications of the SMART: Differential Irritation Test 214
25.4 Outlook: Implications for Medicolegal Evaluationsin Occupational Dermatology 215
References 216
26 Bioengineering Correlates of the Sensitive Skin Syndrome: The Sensory Irritation Component 218
26.1 Defining Sensitive Skin 218
26.2 Modeling the Sensory Irritation Component of the Sensitive Skin Syndrome: The Lactic Acid Sting Test 218
26.3 Factors Determining Chemically Induced Stinging 219
26.4 Stingers Versus Nonstingers: Differences Presumed Apparent from Bioengineering Measurements 219
26.5 Discussion 220
References 223
27 Squamometry 225
27.1 Introduction 225
27.2 Squamometry: Methodology 225
27.3 Subclinical Nonerythematous Irritation with Surfactant 226
27.4 Conclusion 228
References 228
General Readings 229
28 Corrosive Materials 231
28.1 Introduction 231
28.2 Identification and Classification of Corrosive Substances 231
28.3 Catalogue of Corrosive Substances 232
28.4 Commentary References 239
29 Detergents 240
29.1 Introduction 240
29.2 Classification of Surfactants 240
29.4 Choice of Surfactants for Detergents 241
29.5 Irritant Properties of Detergents 242
29.6 Irritancy Ranking of Detergents 242
29.7 Reduced Irritant Potential of Mixed Surfactant Systems 29.8 Effects of Detergents on Different Skin Conditions 244
29.9 Conclusion 245
References 245
30 Sodium Lauryl Sulfate 248
30.1 Sodium Lauryl Sulfate 248
30.2 Application Methods 249
30.3 Biologic Endpoints 251
30.4 Host-Related Factors 253
30.5 Conclusion 255
References 255
31 Organic Solvents 259
31.1 Introduction 259
31.2 Adverse Effects of Skin Exposure 262
31.3 Prevention 266
31.4 Treatment 266
References 267
32 Oils, Cutting Fluids, and Lubricants 269
32.1 Introduction 269
32.2 Metalworking Fluids 270
32.3 Epidemiology 270
32.4 Irritation and Risk Prediction 271
32.5 Prognosis and Prevention 272
32.6 Conclusion 272
References 273
33 Food 274
33.1 Introduction 275
33.2 Epidemiology 275
33.3 Clinical Pictures 275
33.4 Diagnosis 280
33.5 Irritant Foods and Food Components 281
References 293
34 Dithranol 305
34.1 Introduction 305
34.2 Mechanism of Action 305
34.3 Factors Influencing Dithranol Irritation 306
34.4 Relation Between the Concentration of Dithranol and Dithranol Irritation 307
34.5 Dithranol Irritation and Skin Barrier Function 307
34.6 Dithranol Irritation and Treatment Results 307
34.7 Concomitant Treatment and Dithranol Irritation 307
34.8 Treatment of Dithranol Irritation 308
34.9 Histopathology of Dithranol Irritation 308
34.10 Electron Microscopy 308
34.11 How to Avoid Dithranol Irritation 309
References 309
35 Copper 311
35.1 Introduction 311
35.2 Exposure to Copper 311
35.3 Solubilization of Copper Metal 312
35.4 Incidence and Epidemiology of Irritation Due to Copper 313
35.5 Pharmacology of Copper 313
35.6 Copper Irritancy in Skin and Mucosa 314
35.7 Conclusions 319
References 320
36 Fatty Acid Binding Proteins 322
36.1 Introduction 322
36.2 Fatty Acid Metabolism and Transport 322
36.3 Stratum Corneum Fatty Acids 323
36.4 Fatty Acid Uptake in Keratinocytes 323
36.5 Fatty Acid Transport in Keratinocytes 324
References 325
37 Histopathology of Irritant Contact Dermatitis 329
37.1 Introduction 329
37.2 Acute Irritant Contact Dermatitis 330
37.3 Chronic Irritant Contact Dermatitis References 334
38 Percutaneous Absorption and Irritant Dermatitis 336
38.1 Percutaneous Absorption and Toxicological Response 336
38.2 Percutaneous Absorption and Irritant Dermatitis Testing 336
38.3 Percutaneous Absorption Principles 338
38.4 Discussion 342
References 342
39 Cytokines and Irritant Dermatitis 343
39.1 Introduction 343
39.2 Cytokines 343
39.3 Upregulated Cytokines Following Chemical Irritant 344
39.4 Upregulated Cytokines Following Mechanical and Physical Irritation 350
39.5 Conclusion 351
References 352
40 Oxidative Stress 357
40.1 Introduction 357
40.2 Reactive Oxygen Species and Oxidative Macromolecular Damage 357
40.3 Antioxidant Defense 359
40.4 Oxidative Stress in Irritant Dermatitis 361
40.5 Summary 362
References 362
41 Langerhans Cells and Skin Irritation 365
41.1 Introduction 365
41.2 Biology of Skin Sensitization 365
41.3 Langerhans Cells and the Acquisition of Skin Sensitization 365
41.4 Langerhans Cells, Cutaneous Trauma, and Skin Irritation 367
41.5 Mechanisms of Skin Irritant- Induced Langerhans Cell Migration 369
41.6 Contribution of Langerhans Cells to Irritant Dermatitis 370
41.7 Concluding Comments 370
References 371
42 Hydration Injury 374
42.1 Introduction 374
42.2 Mechanism of Hydration Injury 374
42.3 Occlusion and Its Effects 375
42.4 Conclusion 375
References 376
43 Primary Prevention of Irritant Contact Dermatitis 379
43.1 Characteristics of Primary Prevention in Irritant Dermatitis 379
43.2 The Role of the Dermatologist 380
43.3 Prevention by Collective Measures 381
43.4 Prevention by Individual Measures 382
References 384
44 Protective Gloves 387
44.1 Introduction 387
44.2 Field of Application— Rules and Regulations 387
44.3 Risk Evaluation— Glove Selection 389
44.4 Protective Effect 390
44.5 Limitation of Use Due to Side Effects 392
44.6 Glove Operating Instructions 393
44.7 Testing of the Protective Glove Barrier 393
44.8 Glove Materials and Manufacturing 395
44.9 Conclusions 395
References 396
45 Anti-Irritants 398
45.1 Introduction 398
45.2 Insults to the Skin: Skin Irritants 398
45.3 Pathways of Irritation 399
45.4 Anti-irritants 402
45.5 Conclusion 407
References 408
46 Barrier Creams 412
46.1 Introduction 412
46.2 Definition and Terms 412
46.3 Reasons for Using Barrier Creams 412
46.4 Mechanism of Action and Duration 413
46.5 Application Methods and Efficacy 413
46.6 US Food and Drug Administration Monograph Skin Protectants 413
46.7 Conclusion 413
References 414
47 Moisturizers 416
47.1 Introduction 416
47.2 Terms and Definitions 416
47.3 Stratum Corneum: An Important Protection Barrier 416
47.4 Effect of Moisturizers 417
47.5 Moisturizers in Preventing Irritant Dermatitis 418
47.6 Conclusion 419
References 419
48 Moisturizers and Irritant Contact Dermatitis (2) 421
48.1 Introduction 421
48.2 Dryness of the Skin and Its Changed Structure and Function 422
48.3 Aspects on the Methods to Study Moisturizer Effects 423
48.4 Clinical Experiences on Barrier- Influencing Effects in Normal Skin 423
48.5 Clinical Experiences on Barrier- Influencing Effects in Experimentally Damaged or Diseased Skin 424
48.6 Discussion 425
References 426
49 Effects of CO2 on Barrier Recovery 430
References 432
50 Treatment of Irritant Contact Dermatitis 434
50.1 Introduction 434
50.2 Treatment Strategies and Their Scientific Rationale 434
50.3 Clinical Investigations 438
50.4 Conclusion 438
References 439
51 Topical Corticosteroids in the Treatment of Irritant Dermatitis 442
51.1 Introduction 442
51.2 Bioengineering Measurements 442
51.3 Clinical Investigations 442
51.4 Mechanism of Action 445
51.5 Adverse Effects 446
51.6 Conclusion 447
References 448
52 Barrier Creams and Emollients 451
52.1 Introduction 451
52.2 Barrier Creams 451
52.3 Emollients 452
52.4 Conclusion 455
References 455
53 In Vivo Models of Skin Irritation 459
53.1 Introduction 459
53.2 Theoretical Models of Irritation 459
53.3 The Initial Effects of Surfactants on the Skin 460
53.4 The Role of Skin Condition on the Irritant Response 462
53.5 Models for Assessing Skin Irritation 463
53.6 Models for Measuring the Moisturizing Potential of Cleansers 466
53.7 Bioengineering Measurements of Skin Condition 468
References 468
54 In Vitro Methods to Predict Skin Irritation 470
54.1 Current In Vitro Methods 470
54.2 Human Volunteer Studies 475
54.3 Conclusions 475
References 476
I Questionnaire Methods for Hand Dermatitis Studies 479
Existing Questionnaire Tools Concluding Remarks 480
References 480
Hand Protection for Hand Dermatitis 482
II Patient Information Sheets 482
Overnight Plastic Occlusion for Hand Dermatitis Hand Dermatitis Treatment 483
Chapters in General Dermatology Texts 485
III Selected Sources of Information for Irritant Contact Dermatitis 485
Chapters in Pediatric Texts 486
Irritant Contact Dermatitis Texts 486
Chapters in Contact Dermatitis, Occupational Dermatology, and Related ( e. g. “ Clinics”) Texts 486
Selected Journal Articles and Reviews 488
Atlases 489
Journals ( Contact, Environmental and Toxicology) 489
Internet Resources 491
Subject Index 493