Skin disorders in ship's engineers exposed to oils and solvents

Ship's engineers are exposed to mineral oil and solvents in their work. This study was intended to investigate if ship's engineers had an increased prevalence of skin disorders and whether any such increased risk could be linked lo exposure to mineral oils and solvents. A self-administered questionnaire was sent to 700 male seamen from 3 Norwegian ferry companies. Of the 492 respondents. 169 were currently working as ship's engineers and 295 had never worked as ship's engineers, The outcomes eczema, acne, dry skin, a in dermatitis and hand dermatitis were defined from the questionnaire. Prevalences of these skin disorders were compared between the groups. Logistic regression was used to elucidate explanatory variables further. When comparing current ship's engineers with those who had never worked as ship's engineers, the crude prevalence ratios were 1.7 (95% CI 1.1–2.7) for dry skin. 1.7 (95%CI 1.1 2.5) for any dermatitis. 1.3(95%CI 0.66–2.67) for acne and 1.2 (CI 0.61–2.27) for eczema. The risk of these symptoms increased for the engineers in the regression analysis, after controlling for age, self-reported use of Stoddard solvent, and the use of fuel oil as a hand cleansing agent. The increased prevalence of skin disorders found among ship's engineers in this investigation may be explained by direct contact with mineral oils and solvents.     

Skin changes in epilepsy

Aims To establish the skin changes found in epileptics, and to relate these changes to drug therapy. Background Skin changes in epileptics, although welt acknowledged, have been subjected to few recent large-scale surveys. Newer anti-epileptic drugs, in addition to the older therapies, including phenytoin, phenobarbitone and primidone, are now popular. In an effort to update our knowledge of skin changes in epileptics, a study of 200 patients in a long-term epilepsy hospital was performed. Methods The study included taking a history, recording drug therapy and examining the skin of 200 patients. Results Patients ranged in age from 21 to over 70. 60% were men and 40% women. Their epilepsy was mostly well controlled, varying in length from less than 10 to greater than 40 years. 57.5% had post traumatic scars. 32.5% had gum hypertrophy, only half having dental caries. Dupuytren's contracture occurred in 24.5%. Seborrheic dermatitis was seen in 15%. 12.5% had coarse facial features and 11.5% had acne. 57.5% of women had facial hirsutes. 17.5% of all patients had sacral hirsutes, which is an unique feature in this group of patients. These clinical findings were correlated with drugs taken at the time, the age of the patients and length of epilepsy. 52% were on carbamazepine, 48% on phenytoin and 42% on primidone or phenobarbitone, singly or in combination. Conclusions A number of skin conditions are more common among epileptics. Phenytoin and phenobarbitone are linked to gingival hypertrophy, palmar fibromatosis, hypertrichosis, coarse fades and acne. Carbamazepine, too, may be implicated in gum hypertrophy, palmar fibromatosis, hypertrichosis, more specifically sacral hirsutes, seborrheic dermatitis, acne and coarse facies.     

Skin changes in hemodialysis patients

188 patients undergoing long-term hemodialysis and a control group of 371 patients without kidney diseases were examined with regard to changes of the connective tissue of the skin. The following alterations were observed: increased sensibility to low temperatures and Raynaud's syndrome (42%), Dupuytren's contracture (22.4%), sclerosis of the dorsum of the fingers (17.6%). Carpal tunnel syndrome was seen in 24.4% of the cases, significantly correlating with the duration of hemodialysis.     

Skin changes in variegate porphyria

Summary The skin of 20 patients with variegate porphyria (VP) was studied using light, fluorescent, and electron microscopy. Twelve patients had skin symptoms and markedly increased fecal protoporphyrin excretion. Their sun-exposed skin was characterized by homogeneous PAS-positive thickening and IgG deposition in the vessel walls. The basic ultrastructural change was thickening of the vascular walls caused by reduplication of the basal lamina and perivascular deposition of amorphous material. Qualitatively similar but less prominent histopathological changes occurred in sun-protected skin in some of the patients. Six patients had no skin symptoms but an increased porphyrin excretion. The light microscopical changes were comparable to those in the patients with skin symptoms, but the ultrastructural changes were less severe. No abnormal histopathological changes occurred in two symptomless patients who had low lymphocyte protoporphyrinogen oxidase activity but normal fecal porphyrin excretion. These results show that the primary site of skin damage in VP is the vessel wall, and that histopathological changes of the skin also occur in porphyric patients who have never had skin symptoms. Factors determining the occurrence of skin symptoms in VP are discussed.This study is supported partially by a grant from Sigrid Juselius Foundation     

Skin changes in drug-dependent patients

In parenteral drug abuse, cutaneous manifestations are very common. A variety of skin lesions are indicators of a possible drug addiction: obliteration of peripheral veins and hyperpigmentation of the overlying skin, punched-out scars due to subcutaneous injection, persistent edema following thrombophlebitis, and excoriations due to heroin pruritus. Infectious and non-infectious complications may be accompanied by typical skin alterations, such as ecthyma in sepsis caused by Pseudomonas aeruginosa, multiple ulcers due to embolic infarct, or hypersensitivity reactions mediated by an immunological process. A variety of serious complications may develop at the injection sites: abscesses, gangrene, necrosis, or necrotizing fasciitis. These examples show that the dermatologist is in many ways involved in the care for addicted patients. In addition, these patients frequently suffer from sexually transmitted diseases or blood-borne infections; HIV-infection is rapidly spreading in this group. We now face new problems of differential diagnosis, especially since constitutional symptoms of HIV-infection may mimic symptoms of drug abuse and vice versa. Moreover, immunological alterations similar to those in HIV patients may even occur in drug addicts who are not infected with the virus.     

Skin changes in diabetes mellitus

Basing on analysis of case histories of 264 diabetics, the authors have developed an original classification of the dermatoses occurring in diabetes mellitus. Clinical and laboratory findings evidence the identity of changes in the peripheral blood levels of calcium and immunoreactive insulin in the patients with psoriasis, neurodermatitis, and diabetes mellitus.     

Skin changes with chemotherapy

Skin changes in cancer patients have many causes and are difficult to categorize. Chemotherapy-associated cutaneous side effects are usually toxic and often show a characteristic reaction pattern, offering diagnostic clues to the consulting dermatologist. Severe chemotherapy-associated reactions which require dose reduction, change or discontinuation of the cytostatic agents are rare. Most problems are reversible and self-limiting disease. The most common chemotherapy reactions are reviewed.     

Skin changes in workers in plywood manufacture

Hypersensitivity to occupational allergens was detected in 45% of workers, allergic dermatoses and eczema in 8%, mycoses of the soles in 12%, premorbid changes of the skin in 30% of the examinees. Mycoses of the soles are more frequent in subjects with a history of, or suffering from dermatoses.     

Skin changes and anorexia nervosa

Anorexia nervosa (AN) is one of the most dangerous psychiatric diseases; it bears a poor prognosis, marked addictive potential and a high risk of suicide. The earlier the eating disorder is diagnosed and treated, the better the prognosis of AN. A number of dermatological conditions may be associated with AN, although none are specific for AN. These findings include xerosis cutis, effluvium, gingivitis, cheilitis, acne and nail lesions. The cutaneous findings often observed in AN may be localized to the hands ("anorectic hand"), which should therefore always be examined if AN is suspected. The diagnosis of AN can thus be facilitated by knowledge of the cutaneous manifestations, which are generally plain to see. If AN is strongly suspected, the patient should be encouraged to consult a psychiatrist/psychotherapist.     

Skin changes after bariatric surgery

Today, obesity is considered an epidemic all over the world and it is recognized as one of the major public health problems. Bariatric surgery is considered an appropriate therapeutic option for obesity with progressively increasing demands. The changes resulting from massive weight loss after bariatric surgery are related to numerous complications. This article will present the dermatological alterations that can be found after bariatric surgery. They will be subdivided into dermatoses that are secondary to metabolic and nutritional disorders, those derived from cutaneous structural modifications after major weight loss and the influence the latter may have in improving of certain dermatoses.