Occupational Dermatosis is described as any alteration in the skin, mucosa or annexes that is directly or indirectly caused, conditioned, maintained or aggravated by agents present in the occupational activity or work environment. The authors of the present study describe the importance of the topic and the epidemiology and etiopathogeny of the main forms of occupational dermatoses: allergic and irritative contact dermatitis, phytodermatitis, acne (elaioconioses and chloracne), keratosis, cancers, foreign body granuloma, infections, onychias, and ulcerations. Clinical findings of occupational dermatosis are presented in relation to various professions. Laboratory tests used to diagnose this condition are analysed, with special emphasis on patch testing, which is the gold standard. Information about the treatment and prevention of this disorder is provided. Collective and individual measures, especially regarding the proper use of individual protection equipment for the prevention of occupational dermatosis, are detailed. Keywords: Barbering; Chloracne; Dermatitis, contact; Dermatitis, occupational; Keratosis Resumo: Dermatose ocupacional é qualquer alteração da pele, mucosa e anexos, direta ou indiretamente causada, condicionada, mantida ou agravada por agentes presentes na atividade ocupacional ou no ambiente de trabalho. Os autores referem a importância do tema, a epidemiologia e a etiopatogenia das principais dermatoses ocupacionais: dermatites de contato irritativas e alérgicas, fitodermatites, acnes (elaioconiose e cloracne), ceratoses, cânceres, granulomas de corpo estranho, infecções, oníquias e ulcerações. A clínica da dermatose ocupacional é apresentada em diferentes profissões. Analisam-se os exames laboratoriais pedidos nessas dermatoses, com especial destaque para testes de contato, que são o padrão ouro, e fornecem-se dados do tratamento e prevenção; quanto à prevenção da dermatose ocupacional, informam-se as medidas coletivas e individuais, especialmente, no que respeita ao uso adequado dos equipamentos de proteção individual.

BackgroundTopical phenytoin is a powerful skin wounds healing and it may be useful in clinical practice. The purpose of this study was to evaluate the effect of topical phenytoin 0.5%, by comparing it with cream (control) in wounds resulting from excision of two melanocytic nevi in the same patient. Our purpose was also to assess if phenytoin had better therapeutic and cosmetic outcomes when compared with cream (control).MethodsThis study evaluated 100 patients with skin wounds from excision of melanocytic nevi. 50 patients with lesions on the face and 50 patients with lesions on the back, totalizing 200 lesions excised with modified punch. The resulting superficial skin wounds had the same diameter and depth, and second intention healing followed.Patients were followed for 60 days. Student's t-test, Mann Whitney nonparametric test, analysis of variance, LSD test, Shapiro-Wilks test and Fisher test were used to analyze the results, depending on the nature of the variables being studied.ResultsPhenytoin showed better therapeutic and cosmetic results, by healing faster, with more intense epithelization in wounds in comparison with cream (control). Phenytoin showed a statistically significant difference regarding the following parameters (p < 0.05): wounded area and healing time. Phenytoin application resulted in a smaller area and a shorter healing time. Also the intensity of exudates, bleeding, and the epithelization were more intense in phenytoin-treated wounds. Regarding the shape and thickness of the scar, injuries treated with phenytoin had round and flat shaped scars in most of the cases. Considering patient's gender and phototype, female patients presented smaller wounds and scar areas; and phototype I had the largest scar areas. Contact eczema was an adverse reaction in 7 injuries located on the back caused by cream (control) and hypoallergenic tape.ConclusionsPhenytoin showed better therapeutic and cosmetic results compared with cream (control). Phenytoin is a low cost drug, which accelerates skin wounds healing in human patients. Trial registration: ISRCTN96539803

There are no recent data on allergens in the construction industry in Brazil; apparently there were no changes in allergenic substances. The objective of this study was to identify sensitization to allergens in adult males working in the construction industry. A cross-sectional study with adult males submitted to patch tests from May 2000 to December 2005. Out of 169 male patients, 83 were construction workers. The five most frequent allergens among the construction workers were potassium dichromate (57%), carba-mix (34.9%), cobalt chloride (30.2%), thiuram-mix (27.9%) and neomycin (19.8%). There is a significant sensitization to potassium dichromate, cobalt, carba-mix, and thiuram-mix, demonstrating that cement and rubber gloves of personal protection equipment still account for allergic contact dermatitis in construction industry workers.

The persistence of tumoral residues after 2 curettage and electrofulguration cycles for basal cell carcinoma was found in 5 sites treated (25%). Despite the small cohort, such findings are very similar to those of other studies that applied curettage and electrocoagulation and indicated the probability of 25% of tumoral persistence.

Tangential excision is an alternative surgical technique for the treatment of nevi. It is simple, fast, and efficient, has low risks and low cost for the patient, and yields excellent results when used for cosmetic purposes.

Background Urticarias are frequent diseases, with 15% to 20% of the population presenting at least one acute episode in their lifetime. Urticaria are classified in acute ( ≤ 6 weeks) or chronic (> 6 weeks). They may be induced or spontaneous. Objectives To verify the diagnostic and therapeutic recommendations in chronic spontaneous urticaria (CSU), according to the experience of Brazilian experts, regarding the available guidelines (international and US). Methods A questionnaire was sent to Brazilian experts, with questions concerning diagnostic and therapeutic recommendations for CSU in adults. Results Sixteen Brazilian experts answered the questionnaire related to diagnosis and therapy of CSU in adults and data were analyzed. Final text was written, considering the available guidelines (International and US), adapted to the medical practices in Brazil. Diagnostic work up in CSU is rarely necessary. Biopsy of skin lesion and histopathology may be indicated to rule out other diseases, such as, urticarial vasculitis. Other laboratory tests, such as complete blood count, CRP, ESR and thyroid screening. Treatment of CSU includes second-generation anti-histamines (sgAH) at licensed doses, sgAH two, three to fourfold doses (non-licensed) and omalizumab. Other drugs, such as, cyclosporine, immunomodulatory drugs and immunosuppressants may be indicated (non-licensed and with limited scientific evidence). Conclusions Most of the Brazilian experts in this study partially agreed with the diagnostic and therapeutic recommendations of the International and US guidelines. They agreed with the use of sgAH at licensed doses. Increase in the dose to fourfold of sgAH may be suggested with restrictions, due to its non-licensed dose. Sedating anti-histamines, as suggested by the US guideline, are indicated by some of the Brazilian experts, due to its availability. Adaptations are mandatory in the treatment of CSU, due to scarce or lack of other therapeutic resources in the public health system in Brazil, such as omalizumab or cyclosporine.

BACKGROUNDS: One of the most frequent causes of allergic contact dermatitis of occupational origin are rubber additives, which are present in Personal Protective Equipment (PPE). The most allergenic additives of natural and synthetic gloves are thiurams, carbamates and mercapto group. OBJECTIVE: To investigate the state of knowledge about the chemical additives used in the manufacture of synthetic rubber gloves. METHODS: This was a qualitative research study in which professionals working in the manufacture, research, prescription and commercialization of gloves answered an open questionnaire. RESULTS: 30 individuals were interviewed: 4 researchers in occupational medicine, 5 occupational physicians, 2 occupational safety technicians, a rubber workers' union physician, an occupational safety engineer, a pro duction engineer of rubber gloves, 4 importers of gloves, a manufacturer of gloves, 3 businessmen who sell PPE, 3 salesclerks working in stores that sell PPE, 2 businessmen who own stores that sell products for allergic individuals, and 3 dermatologists. CONCLUSION: Knowledge of the chemical composition of rubber gloves is scant. The labeling of gloves, with the description of their chemical composition, would facilitate choosing the best type of glove for each person. This low-cost action to businesses would be a gain from the standpoint of public health, with huge repercussions for users of rubber gloves. Keywords: Allergy and immunology; Dermatitis, allergic contact; Dermatitis, contact; Dermatitis, occupational; Gloves, protective; Rubber Resumo: FUNDAMENTOS: Uma das causas mais frequentes de dermatite de contato alérgica, de origem ocupacional, são os aditivos da borracha, presentes nos Equipamentos de Proteção Individual. Os aditivos das luvas natural e sintética mais alergênicos são tiurams, mercaptos e carbamatos. OBJETIVO: levantar o nível de conhecimento em relação aos aditivos químicos utilizados na fabricação das luvas de borracha sintética. MÉTODOS: Foi aplicado um questionário aberto a profissionais que trabalham com fabricação, pesquisa, prescrição e comercialização das luvas. Foi adotado o método de pesquisa qualitativa. RESULTADOS: Foram entrevistadas 30 pessoas: 4 pesquisadores na área de Medicina do Trabalho, 5 médicos do Trabalho, 2 técnicos de segurança do Trabalho, 1 médico do sindicato de trabalhadores da borracha, 1 engenheiro de Segurança do Trabalho, 1 engenheira de Produção do setor de fabricação de luvas de borracha, 4 empresários importadores de luvas, 1 empresário fabricante de luvas, 3 empresários que comercializavam Equipamentos de Proteção Individual, 3 vendedores de lojas de Equipamentos de Proteção Individual, 2 empresários de lojas que comercializavam produtos para alérgicos e 3 dermatologistas. CONCLUSÃO: O conhecimento da composição química das luvas é pequeno. A rotulagem das luvas, com a descrição da composição química, facilitaria a escolha do melhor tipo de luva para cada pessoa. Esta ação, de baixo custo para as empresas, seria um ganho, do ponto de vista d...

No abstract