OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical...
-
Upload
colleen-ray -
Category
Documents
-
view
215 -
download
1
Transcript of OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical...
![Page 1: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/1.jpg)
1
OTHER DERMATOSESR:ROSENSTOCK
By M.H.Davari MD
Shahid Sadoughi University of medical sciences
![Page 2: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/2.jpg)
2
Work-related health problems as reported by UK occupational physicians during 1996
Problem
Musculoskeletal
Dermatological
Respiratory
Hearing loss
Other
P.M
Percentage
45.3
23.4
9.2
8.7
13.9
Thirty percent of occupational injury and 40% of occupational disease are dermatologic
![Page 3: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/3.jpg)
3
![Page 4: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/4.jpg)
4
OCCUPATIONAL ACNE
1. Oil acne (folliculitis) Pathogenesis: hair follicle is particularly
susceptible to irritation from lipids plugging of the follicle (comedo formation) or induce an inflammatory reaction by rupture of the
follicular wall (folliculitis) Petroleum distillates, cutting oils, pitch, and tar
Clinical course: dorsae of the hands and forearms
Diagnosis: area of involvement history
![Page 5: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/5.jpg)
5
Age: any age Prevention:
Protective clothing Mandatory daily laundering of work clothes
Treatment: similar to those for routine acne Oral antibiotics (tetracycline and erythromycin) Topical antibiotics (clindamycin; erythromycin) Refractory Comedones long-term topical retinoids
![Page 6: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/6.jpg)
6
![Page 7: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/7.jpg)
7
ACNE VULGARIS
Persons at risk: workers in fast food restaurants,
actors, actresses, models, and cosmeticians
Age: peak 11-20 yrs
Pathogenesis: in addition to oil, Friction, heat, and
sweating
Clinical course: face, neck, upper chest and back
Diagnosis: history of exposure
Treatment and prognosis: like oil acnea
![Page 8: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/8.jpg)
8
![Page 9: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/9.jpg)
9
![Page 10: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/10.jpg)
10
Viktor Yushchenko, the Ukranian President who was supposedly assassinated by the KGB with dioxin poisoning.
![Page 11: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/11.jpg)
11
CHLORACNE
Sensitive indicator of systemic exposure to specific polyaromatic hydrocarbons
Persons at risk include workers: hydrocarbonbased pesticides and herbicides, electrical workers exposed to older polychlorinated biphenyl (PCB)
Pathogenesis: follicular level of the agent may be of greatest importance
Clinical course: pale yellow (straw) cyst + comedo inflammatory papules and pustules of acne vulgaris are
not evident postauricular folds, the malar crescent, and the
genitalia. The nose typically is spared onset within 2w–2m regress over a 4–6m (1-2 yr)
![Page 12: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/12.jpg)
12
Non-cutaneous findings: Hepatomegaly, Hepatic porphyria, Peripheral neuropathy
TCDD causing chloracne at the lowest concentrations
Diagnosis: history of exposure (suggest) Serum levels of suspect compounds and
metabolites should be obtained (confirmation of exposure) (GC/MS)
Biopsy cause loss of follicular sebaceous glands (DDX: actinic elastotic comedones)
![Page 13: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/13.jpg)
13
Treatment: Difficult Oral antibiotics, topical retinoic acid, and oral
isotretinoin Cyst formation prevent by early retinoid therapy
Prevention: Even minute exposures must be avoided shower facilities Use disposable clothing for workers Routinely monitor for plant contamination using
wipe samples Routinely educate and monitor workers.
![Page 14: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/14.jpg)
14
![Page 15: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/15.jpg)
15
![Page 16: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/16.jpg)
16
PIGMENTARY DISORDERS
1. Hyperpigmentation Types:
1. Exogenous pigment deposition2. Deposition in skin systemically3. Photoeruptions (more common)4. PIH (more common)Or by wood lamp examination:5. Epidermal?6. Dermal7. Mix
Workers at risk: heavy metals, organic nitrogen compounds and dyes
![Page 17: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/17.jpg)
17 Hyperpigmentation: nitro compounds and dyes that stain skin
![Page 18: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/18.jpg)
18
Hyperpigmentation: metals that may be systemically or locally deposited in skin
Clinical course: The most striking form of dyspigmentation is
argyria due to systemic deposition of silver. Pigmentation from heavy metal toxicity
exacerbated by exposure to the sun PIH occurs at the sites of skin injury
Diagnosis:1. History & examination2. Wood lamp examination3. Biopsy
![Page 19: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/19.jpg)
19
Prevention: Sun screen Protective clothes (exposure to organic dye-like
component) Treatment:
Tattoos and systemic heavy metal toxicity may be irreversible
PIH: may persist for months (dark skin)1. Retinoic acid2. Hydroquinone
![Page 20: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/20.jpg)
20
![Page 21: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/21.jpg)
21
![Page 22: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/22.jpg)
22
2. Hypopigmentation:1. PIH
Cutaneous injury, from inflammation or trauma
2. Leukodermia Hydroquinone or derivatives of alkyl phenols and
catechols Workers at risk: rubber workers, photographic
developers, hospital housekeepers, printers, and workers in the oil, paint and plastics industries
Pathogenesis: direct cytotoxic effect on melanocytes formation of antigens, which activate
lymphocytes Diagnosis : wood lamp Treatment:
1. long-term PUVA2. allograft
![Page 23: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/23.jpg)
23
![Page 24: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/24.jpg)
24
Picture of a phototoxic drug reaction
![Page 25: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/25.jpg)
25
![Page 26: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/26.jpg)
26
PHOTODERMATOSES
UVA: aging, occupational dermatosis UVB: sun burn UVA,B,C: carcinogen
Outdoor occupationsPhototoxic: Nonimmunologic, reactive O2, improve immediately with avoidancePhoto allergic: type IV imune reaction, substance convert to hapten, Not improve immediately with avoidance
![Page 27: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/27.jpg)
27
PHOTOTOXIC AGENTS
Some common plants containing furocoumarins
![Page 28: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/28.jpg)
28
Picture of photoallergic and phototoxic dermatides
![Page 29: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/29.jpg)
29 Contact photodermatitis
![Page 30: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/30.jpg)
30
Diagnosis: History of sun exposure Typical photodistribution Exposure to photoactive substances biopsy may be helpful to exclude other causes of
photosensitivity (lupus erythematosus, medications)
Prevention: Sunscreens: (SPF) rating of #15 or better ,(which
is less effective in preventing UVA) Use of protective clothing EPA (enviromental protection agency)
![Page 32: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/32.jpg)
32
Treatment: open-wet dressings bland emollients Rarely systemic steroids for severe cases.
Prognosis: Workers with clinical signs of chronic sun
exposure are at risk for cutaneous malignancies and should be followed closely
![Page 33: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/33.jpg)
33
![Page 34: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/34.jpg)
34
![Page 35: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/35.jpg)
35
![Page 36: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/36.jpg)
36
ERYTHEMA AB IGNE
The area usually is regional corresponding to the site of repeated applications of heat
Workers exposed to furnaces, such as cooks, stokers, glass blowers, and kiln operators
Clinical course: Early:
vasodilation (livedo reticularis)Later:
Poikiloderma(epidermal atrophy, telangiectasia, and pigment alteration)
SCC and Merkel cell carcinomas occur in the poikilodermatous area
![Page 37: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/37.jpg)
37
Diagnosis: The local nature of the condition, along
with a history of exposure to heat, is suggestive
Biopsy: exclude other conditions associated with livedo reticularis
Prevention: Repeated exposure avoidedEducation of workers at risk is the key to
prevention. Treatment
Cessation of exposure in early changes.permanent change: monitored for future
development of skin carcinoma
![Page 38: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/38.jpg)
38
![Page 39: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/39.jpg)
39
![Page 40: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/40.jpg)
40
![Page 41: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/41.jpg)
41
MILIARIA
Bakers, foundry workers, cooks, coke oven operators, and workers with similar exposure to excessive heat that causes sweating
blockage of the sweat ducts Trunk: most commonly affected location, especially the
chest, back, submammary, and axillary areas Clinical lesions are on a spectrum encompasssing clear vesicles 1. if the blockage is in the superficial epidermis (miliaria
crystallina)2. macules or papules if the blockage is in the lower
epidermis (miliaria rubra) or3. flesh-colored to pale white papules if the obstruction is
in the dermis (miliaria profunda).
![Page 42: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/42.jpg)
42
Symptoms usually are absent with miliaria crystallina, while miliaria rubra and miliaria profunda may be pruritic or painful
May lead to inadequate body thermoregulation with accompanying heat exhaustion
Pathogenesis: Sweating and maceration cause plugging of
the eccrine sweat duct with ductal keratin. Microbial organisms may invade the macerated keratin and cause further plugging of the duct
Diagnosis: clinical picture, symptoms, and the history of onset
after excessive heat exposure and sweating.
![Page 43: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/43.jpg)
43
Prevention: exposures should be avoided Hexachlorophene soap decrease bacterial population. Maceration of the skin should be avoided by frequent
clothing changes when sweating is profuse. Treatment and prognosis
Removal A period of a week or more should elapse before re-
exposure of the individual to the hot environment is attempted, particularly if the eruption is severe enough to cause a decrease in systemic heat tolerance.
![Page 44: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/44.jpg)
44
![Page 45: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/45.jpg)
45
![Page 46: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/46.jpg)
46
![Page 47: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/47.jpg)
47
![Page 48: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/48.jpg)
48
Cleaners of vinyl chloride polymerization reactor tanks1. Raynaud’s phenomenon 2. Osteolytic bone changes3. sclerodermia
Silica dust have been reported to be at risk for developing:1. Raynaud’s phenomenon2. Scleroderma
organic solvents has also been associated with: systemic sclerosis
OCCUPATIONAL ACRO-OSTEOLYSIS AND SCLERODERMA
![Page 49: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/49.jpg)
49
Diagnosis: Patients presenting with Raynaud’s phenomenon
without a history of vibration exposure should be questioned regarding exposure to vinyl chloride, silica, organic solvents, and epoxy resins
Prevention Workers cleaning polymerization reactor tanks of vinyl
chloride need complete skin and respiratory protection.
Respiratory protection also is critical in those workers exposed to silica.
All workers with Raynaud’s phenomenon, whether or not the condition is job related, should have protection of their hands from cold weather
Treatment and prognosis Acro-osteolysis stabilize after withdrawal from vinyl
chloride monomer exposure Scleroderma of any cause, however, tends to be
progressive.
![Page 50: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/50.jpg)
50
![Page 51: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/51.jpg)
51
FOREIGN BODY REACTIONS
Workers in construction, electronics, metal working, and mining1. Fiberglass (extremely pruritic)2. Beryllium3. Sillica 4. unusual form clam diggers as a result of exposure
to avian schistosomes5. Hairdressers
Acute reactions resemble irritant dermatitis. Chronic reactions typically are more
papulonodular Secondary bacterial infection may
complicate the clinical picture
![Page 52: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/52.jpg)
52
Pathogenesis: A granulomatous respons is typically a non-
allergic response Beryllium is due to delayed hypersensitivity
Treatment and prognosis Localized granulomas of any cause may be
treated surgically. Topical therapies including open wet
dressings and topical steroids are useful in the treatment of acute foreign body reactions.
Fiberglass may be removed by using tape stripping of the skin.
![Page 53: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/53.jpg)
53
BIOLOGIC CAUSES OF OCCUPATIONAL DISEASESBACTERIAL DISEASES:
work with animals and those in the construction trades
![Page 54: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/54.jpg)
54
FUNGAL DISEASES
workers at greatest risk are thosein the agricultural trades
Candida and dermatophyte infections are the most common superficial fungal infections
![Page 55: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/55.jpg)
55
An unusual variant of tinea pedis (one hand–two feet tinea) needs to be considered in the differential diagnosis of hand dermatitis
Diagnosis: potassium hydroxide examination of scale fungal culture
Treatment: Topical antifungal agents usually are adequate
for treatment, although occasionally administration of oral antifungals (griseofulvin, ketoconazole, itraconazole, terbinafine) is necessary
![Page 56: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/56.jpg)
56
VIRAL DISEASES
HSV1/2 infection of the finger (herpetic whitlow) 1. Healthcare workers.2. Farm workers 3. Meat handlers
Untreated infections last for 1 to 2 weeks Athough therapy with oral antivirals is helpful in
shortening the course. Diagnosis:
Tzanck smear, showing multinucleated giant cells viral culture
![Page 57: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/57.jpg)
57
PARASITIC DISEASES
Parasites are unusual causes of occupational disease in temperate climates
However, workers in developing countries are at particular risk.
![Page 58: OTHER DERMATOSES R:R OSENSTOCK M.H.Davari By M.H.Davari MD Shahid Sadoughi University of medical sciences 1.](https://reader035.fdocuments.us/reader035/viewer/2022062516/56649daa5503460f94a9790c/html5/thumbnails/58.jpg)
58