Irritant and contact dermatitis is more common in the adult age.
Although some types of irritants seem to be only used by the adult
children nowadays may also share the adults in certain jobs. It is
estimated that two hundred and fifty million children in the world
are working illegally in different industries and perform the
different works of adults. We are faced in our practice with
children having contact dermatitis from cement, diesel,
and many other types. This is why such chapters are included.
Fig.195.a,b,c,d."The youngest welder"!!! : 10 years old child misused
as a metal welder without even the minimal protective safety measures
and numerous irritants are available everywhere which have the
ability to cause irritant and contact dermatitis. Some of such
oils, used as coolants in metal work, , water, emulsifiers,
antioxidants, anti-corrosive agents and preservatives. These being aqueous
emulsions, have the ability to dry the skin. After repeated
exposure the oil tends to be more irritant.
lubricating oils replace the normal lipids of the horny layer. Oils,
particularly if mixed with metal particles, stick to the skin and
tempt the worker to use harmful cleansers. Some oils induce
eczematous reaction , acne and follicular hyperkeratosis.
the lipid film and water-holding substances and damage cell
membranes. Their irritating capacity depends on their chemical
structure. These include aliphatic petroleum solvents such as white
organic solvents include the following: aromatic hydrocarbons such
as benzene, toluene and aromatic petroleum solvents; chlorinated
hydrocarbons such as trichloroethylene, perchloroethylene, ethylene
chloride and chlorobenzene and alcohol .
commonly a mixture of alcohol, ketones and esters that is used in many
industrial processes including cleaning textiles and metals, the
graphics industries, floor laying (where glue is used),
wood-finishing, dyeing, painting and as a solvent.
peroxides such as benzoyl peroxide and cyclohexanone peroxide are
used in hardening polyester resins. Some are used in hair bleaching
and some for bleaching textiles, oils and flour. They are strong
cytotoxic agents and may cause unusual urticarial reactions .
hypochlorite (bleach) is used for cleaning, by printers and dyers to
remove staining from: their hands. Its cytotoxicity makes its medical
use like (Eusol) unsuitable to clean wounds and ulcers, which may
act as skin sensitizes .
oxide is used as a sterilizing agent and may remain on instruments
or rubber articles.
common sensitizing products are textiles, fur and hair dyes. Such
sensitization may sometimes be occupational .
Fig.195 Contact dermatitis
(This type is
usually due to direct contact with shoes, slippers, plastic or
active treatment should be directed to prevent contact of the feet
with such factors. Cotton socks should be used even when the child
is at home. Without this precaution recurrence of contact dermatitis
is usually the rule)
The organic dyes are
also present in cosmetics, rubber, plastics, shoes, shoe creams,
printers‘ ink, petrol, oil , alcohol for industrial, for domestic
use, sanitary paper and ballpoint pens.
are used for the prevention of oxidation, which lead to dryness or
rancidity of the products. They occur in rubber, plastics, adhesive
tapes, varnishes, oils, glues, etc.
and waxes used in medications , cosmetics and food have added anti-
used in many industries (dyeing, tanning, rubber, plastic, and
widely used in industry, e.g. chromic acid for rust proofing iron
and hydrofluoric acid used in manufactures of glass, rust stain
removal, in the electronics and petroleum industries. Sulfuric,
hydrochloric and nitric acids are other common inorganic acids,
which may cause skin sensitization.
acid is used by masons for the cleaning of building stones, but
sometimes also for cleaning their hands. Acetic and oxalic acids are
the most often used organic acids. Acid anhydrides such as
ophthalmic anhydride are stronger irritants than the corresponding
dermatitis is a common type of dermatitis affecting children and
other age groups.
dermatitis is caused
by contact of the foot with shoes or due to the chemicals used during manufacture and finishing.
is most frequently due to leather from the rubber box toe in shoes
which is the main cause. Other allergens such as dyes, chromium and
formaldehyde have an important effect. Chromium is gradually
liberated from leather collagen by the action of hydroxyl acids in
sweat especially when shoes are used without stockings.
common site first involved, is the dorsal surface of the big toe
and insteps and later spreads by extension to the other toes and the
may be acute presenting with erythematous, or vesiculation and
infection is common.
lesions are dry and lichenified.
of normal skin not in contact with the shoes between the eczematous
areas is usually important in the diagnosis of shoe dermatitis.
the type of skin sensitizer of shoe dermatitis is by patch test.
using redyed shoes. It should be noted that linings of shoes are
protected against mildew by impregnation in phenols and organic
mercury. These may cause severe toxic reaction especially in
infants and young children.
Fig.195a. Acute shoe dermatitis
Fig. 195b. shoe dermatitis
Fig. 196a. Acute contact dermatitis (Stockings)
Fig. 197. Chronic shoe dermatitis
Patients with shoe dermatitis can use special types of shoes
prepared from non-sensitizing substances such as Bloom‘s shoe.
always stockings made of absorbent cotton
Treatment of hyperhidrosis
treatment is the same as that of other types of contact dermatitis.
nylon stockings are the main cause of contact dermatitis. Azo dyes
cross sensitize with paraphenylamine diamine derivatives and other
related rubber chemicals. Nylon fabrics of the stocking may also
cause contact dermatitis.
part of the feet, popliteal region are the most commonly affected. In females
using long nylon stockings, the middle of the thighs are commonly
affected. In males, using short stockings containing rubber plastic
at the upper end of the leg may cause contact dermatitis
corresponding to the upper stretch part of the stockings due to the
rubber content of the stretched part of the stocking.
Fig.196 b. Stocking dermatitis
testing for the suspected sensitizers.
Rubber is a
common cause of shoe dermatitis especially with preservative
antioxidants as monobenzyl hydroquinone that may also cause
hypopigmentation of the skin.
materials used in rubber manufacture may cause contact dermatitis
especially when there is hyperhidrosis.
components are used also for preparation of gloves, rubber bands,
adhesive tapes as Sterri Strip , Dermacil and Band Aid plaster .
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