Transepidermal water loss and incidence of hand dermatitis in a prospectively followed cohort of apprentice nurses

Abstract

The purpose of the study was to evaluate the incidence of hand dermatitis, the impact of potential risk factors and the efficacy of skin bioengineering in a prospectively followed cohort of apprentice nurses. 104 participants were prospectively followed for 3 years. Before the start of training, after about 1 year and in the third year of occupational exposure, a standardized questionnaire was distributed, and a clinical examination with skin bioengineering of the dorsum of hand and forearm was performed. The 12-month period prevalence of self-reported symptoms of hand dermatitis was 36.5%[95%-confidence interval (CI) 27.3-46.6] at intermediate follow-up and 43.3% (95%-CI 33.6-53.3) at the final examination. Apprentices with self-reported symptoms at the final examination showed a significant increase of transepidermal water loss (TEWL) at the dorsal hand from 10.15 g/m2h to 13.55 g/m2h. TEWL at this site did, at the initial examination, not differ significantly between persons who later reported symptoms of hand dermatitis at the final examination and those who did not (10.50 g/m2h versus 10.15 g/m2h, respectively). Our results do not support the notion that an increased basal TEWL is a good indicator for hand dermatitis risk.

A Randomized, Single-blind Comparison of the Efficacy, Tolerability and Cosmetic Acceptance of Propyless® or Fenuril® Treatment of Patients with Dry Skin

“…Only minor differences in TEWL values were observed within the same treatment and no statistically significant difference between Propyless® lotion and Fenuril® cream was observed while an improvement of other skin parameters such as itching and irritation was observed. Earlier studies showed a good correlation between TEWL in psoriatic skin lesions and the severity of psoriasis (11) while TEWL has not been confirmed to be a good measure of risk for hand dermatitis (12).…”

Impact of atopic dermatitis and loss-of-function mutations in the filaggrin gene on the development of occupational irritant contact dermatitis

“…Contact dermatitis (CD) is one of the most common occupational diseases in industrialized countries. In European surveys among workers and apprentices in ‘high‐risk’ occupations, such as hairdressing, health care and metalworking, the 1‐year prevalence varied between 20% and 30%, and mild skin symptoms were present in up to 50% of the workers or apprentices 1–7 . CD is commonly divided into allergic CD (ACD) and irritant CD (ICD), of which ICD is the more common in occupational settings 8 .…”

The Prevalence of Hand Dermatitis in Nurses: A Narrative Review Highlighting the Importance of Prevention

“…There have also been attempts to use biomarkers such as transepidermal water loss [17]. The observations of the nurses themselves remain important however.…”