Dermatitis Part 1 Osteopathic Medical School Top 接触性皮炎1骨科医学学院顶课件.ppt

Contact Dermatitis Part One Boris Ioffe, D.O., Pharm.D. 08-14-06 Irritant contact dermatitis (ICD) Accounts for approximately 80% of all contact dermatitis ICD is the result of a local toxic effect when the skin comes in contact with irritant chemicals such as soaps, solvents, acids, or alkalis Introduction to Irritant Contact Dermatitis ICD is a cutaneous inflammation resulting from a direct cytotoxic effect of a chemical or physical agent Constitutes nearly 80% of occupational contact dermatitis (OCD) OCD is a matter of public health importance, contributing to combined direct and indirect annual costs (in the USA) of up to $1 billion when accounting for medical costs, workers compensation, and lost time from work Epidemiology of ICD The US Bureau of Labor Statistics data show that occupational skin diseases accounted for 10% to 15% of all occupational illnesses High-risk occupations with frequent irritant exposure in caterers, furniture industry workers, hospital workers, hairdressers, chemical industry workers, dry cleaners, metal workers, florists, and warehouse workers Epidemiology of ICD Clinical manifestations of ICD are determined by: Properties of the irritating substance Host factors Environmental factors including concentration, mechanical pressure, temperature, humidity, pH, and duration of contact Cold alone may also reduce the plasticity of the horny layer, with consequent cracking of the stratum corneum Occlusion, excessive humidity, and maceration increase percutaneous absorption of water-soluble substances Bilateral shoe irritant dermatitis resulting from chronic occlusive footwear Epidemiology of ICD Important predisposing characteristics of the individual include: Age, race, sex, pre-existing skin disease, anatomic region exposed, and sebaceous activity Both infants and elderly are affected more by ICD because of their less robust epidermal layer Patients with darkly pigmented skin seem to be more resistant to irritant reactions Oth