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Work-related skin disease is common and usually presents as hand eczema. From the Occupational Injury Information System in Sweden, as well as from registers of industrial injuries in other countries, it is evident that females report skin disease more often than males. Epidemiological studies of hand eczema also show that women are more often affected than men, in particular young women. The most common type of hand eczema is irritant contact dermatitis, which is often caused by wet work. Many female-dominated occupations involve extensive wet work, e.g., hairdressing, catering, cleaning and health-care work. These occupations are also high-risk occupations for hand eczema. Experimental studies of skin irritation have not confirmed differences between the sexes; thus, the higher prevalence of irritant contact dermatitis among females is most likely due to exposure, occupational and non-occupational. Nickel allergy is the most common contact allergy, which is most frequent in young females, and in 30-40% results over time in hand eczema. Hand eczema has an impact on quality of life and females seem to report a higher degree of discomfort than males. To achieve the optimal effect of preventive efforts regarding occupational skin disease, the focus for prevention should aim at reducing wet exposure.
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PMID:Differences between the sexes with regard to work-related skin disease. 1094 43

In this questionnaire study, the authors compared the prevalence of certain symptoms and signs associated with Sick Building Syndrome and perceptions relative to environmental discomfort of employees in a central-air-conditioned dropping center and in natural-ventilation commercial shops located on the streets of Niteroi, Rio de Janeiro, Brazil. There was a statistically significant higher prevalence of symptoms (e.g., water and itching of eyes, sore throat, nose irritation, difficulty breathing, skin irritation, sneezing) that were characteristic of Sick Building Syndrome in the air-conditioned building than in the naturally ventilated stores. The results indicated that there exists a continuing need for further research in Brazilian work environments.
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PMID:Effect of ventilation systems on prevalence of symptoms associated with "sick buildings" in Brazilian commercial establishments. 1100 34

Skin is an attractive target for delivery of genetic therapies and vaccines. However, new approaches are needed to access this tissue more effectively. Here, we describe a new delivery technology based on arrays of structurally precise, micron-scale silicon projections, which we term microenhancer arrays (MEAs). In a human clinical study, these devices effectively breached the skin barrier, allowing direct access to the epidermis with minimal associated discomfort and skin irritation. In a mouse model, MEA-based delivery enabled topical gene transfer resulting in reporter gene activity up to 2,800-fold above topical controls. MEA-based delivery enabled topical immunization with naked plasmid DNA, inducing stronger and less variable immune responses than via needle-based injections, and reduced the number of immunizations required for full seroconversion. Together, the results provide the first in vivo use of microfabricated devices to breach the skin barrier and deliver vaccines topically, suggesting significant clinical and practical advantages over existing technologies.
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PMID:Improved genetic immunization via micromechanical disruption of skin-barrier function and targeted epidermal delivery. 1192 50

The impact of use of bed-nets treated with alphacypermethrin, at 20 mg (ai)/m2, in comparison to untreated nets or no nets on malaria vectors and malaria incidence was studied in tribal villages of Malkangiri district, Orissa state, India, which are highly endemic for falciparum malaria. Treated or untreated nets were supplied to the villagers in June 1999 and the nets were re-treated in September 1999, just before the rise in vector abundance and malaria incidence. The seasonal pattern of indoor resting Anopheles fluviatilis females was similar in all the three groups of villages before the start of intervention and the indoor resting catches were not significantly different between treatment-groups (two-way ANOVA, F = 1.53; d.f. = (2, 78); P = 0.2). During intervention, the indoor resting catches differed significantly among treatment groups (two-way ANOVA, F = 38.9; d.f.= (2, 66); P < 0.005). There was a 99% reduction in the indoor resting catches of An. fluviatilis in villages with treated nets and 61% reduction in villages with untreated nets compared with no-net villages. Comparison between villages with and without treated nets showed that there was 97% reduction in indoor resting catches in villages with treated nets. Pair-wise comparison showed that the reductions between villages with and without nets as well as between villages with treated and untreated nets were significant (Dunnett's C-test, P < 0.05). The indoor resting catches of Anopheles culicifacies did not differ significantly among the three groups of villages either before (F = 0.99; d.f. = (2, 121); P = 0.4) or during intervention (F = 0.21; d.f. = (2, 66); P = 0.8). Bioassay with 3 min exposure to treated bed nets showed 100% mortality of An. culicifacies for 2 months and with An. fluviatilis for 4.5 months after which tests were not carried out. In villages with treated nets, the Annual Parasite Incidence (API) significantly declined (P < 0.05) by about 65.7% and prevalence of infection among children (< 15 years) declined by 57.1%, whereas in villages with untreated nets, there was only 34% reduction in API and 13% in the prevalence of infection. In villages with treated nets, there was 48% reduction in API and 64% in prevalence of infection compared with villages with untreated nets. The impact of use of treated bed nets on other arthropod pests lasted for at least 1.5 months. After 1.5 months, observations on arthropod pests were not continued. The use rate of treated nets varied from 49.8 to 93.7% in three seasons and about 68.3% of treated bed nets and 60% of untreated nets were in good condition 1 year after distribution. Out of 489 users of treated net, five people complained of a burning sensation on the face (skin irritation) for 5 days following the distribution of treated nets. There were no other complaints of any discomfort in using the treated nets. The use of alphacypermethrin treated bed nets at 20 mg (ai)/m2 can be one of the options for reducing the vector abundance and incidence of malaria in this area.
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PMID:Impact of alphacypermethrin treated bed nets on malaria in villages of Malkangiri district, Orissa, India. 1463 83

Actinic Keratoses (AKs) are epidermal skin lesions that have the potential to develop into squamous cell carcinoma. Many of the treatment options available can cause discomfort, pain or skin irritation. Topical 3% diclofenac in 2.5% hyaluronan gel (Solaraze, Bioglan Pharma) is a relatively new treatment that has been shown to be effective and well tolerated for the treatment of AKs.
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PMID:Topical 3% diclofenac in 2.5% hyaluronan gel for the treatment of actinic keratoses. 1471 39

The skin is the main target tissue for exogenous noxes, protecting us from harmful environmental hazards, UV-irradiation and endogenous water loss. It is composed of three layers, whereas the outermost epidermis is a squamous epithelium that mainly consists of keratinocytes. These cells execute a terminal differentiation, which finally results in the assembly of the stratum corneum. This layer, consisting of cornified keratinocytes, is an effective barrier against a vast number of substances. Apart of this, keratinocytes play crucial roles in the immune surveillance and the initiation, modulation and regulation of inflammation in the epidermis. Regarding cutaneous inflammatory reactions, skin irritation is one of the most common adverse effect in humans. For reasons of human safety assessment new chemicals are still evaluated for irritant potentials by application to animals followed by visible changes such as erythema and oedema. Testing for skin irritation in animals potentially cause them pain and discomfort. Furthermore, the results are not always predictive for those found in humans. In order to replace animal testing and to improve the prediction of irritants, the cosmetic and toiletry industry, in Europe represented by Colipa, develops and uses several alternative in vitro test systems. In this respect, the use of in vitro reconstructed organotypic skin equivalents are mostly favored, because of their increasingly close resemblance to human skin. Due to ethical and scientific questions and on account of the 7th amendment of the European Council Directive 76/768/EEC, the authors see the requirement to drive the development of alternative tests for irritants. Therefore, this article centres on cosmetic ingredients and provides the readership an overview of the state of art of cellular mechanisms of skin irritation and summarizes the results of the commonly used skin equivalents to evaluate irritation in vitro.
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PMID:In vitro skin irritation: facts and future. State of the art review of mechanisms and models. 1504 69

The insulated environment of the lower-limb prosthesis can result in elevated residual-limb skin temperatures that may contribute to skin irritation, blistering, and a reduced quality of life. The design and materials of the prosthetic socket, suspension system, and liner can potentially alleviate these conditions, but the thermal load may vary with activity and location within the socket. To characterize the thermal environment at the skin-prosthesis interface, we made temperature measurements on five transtibial amputees at 14 locations on the residual limbs. After the participants donned their prosthesis and rested in the seated position for 15 min, the mean skin temperatures of their residual limbs increased by 0.8 degrees Celcius. Subsequent walking for 10 min resulted in a 1.7 degrees Celsius total increase in mean skin temperature. Thermal contour maps revealed the skin was coolest at the anterior proximal location and warmest across the posterior section, correlating with areas of low and high perfusion. From the results, we determined that residual-limb skin temperature depends on activity and locality. This information may aid in understanding where and why skin problems develop on lower-limb residual limbs and may provide design requirements for new prosthetic socket systems intended to alleviate temperature-related discomfort.
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PMID:Residual-limb skin temperature in transtibial sockets. 1594 79

Removal of hardware in children after orthopaedic procedures is controversial. The authors retrospectively reviewed hospital charts and radiographs of 143 children who underwent removal of flexible titanium nails from the femur and the forearm. In 16 children the nails were removed because of protrusion, skin irritation, and some discomfort. Most of the patients were asymptomatic and underwent nail removal electively, according to the authors' policy for routine hardware removal in children. Complications included unsuccessful nail removal in three children and refractures after nail removal in two. Although the authors are still inclined to remove flexible titanium nails in most of the patients, the need for routine elective execution of this procedure may be questionable.
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PMID:Removal of flexible titanium nails in children. 1655 32

To study the indoor climate, the psychosocial work environment and occupants' symptoms in offices a cross-sectional questionnaire survey was made in 11 naturally and 11 mechanically ventilated office buildings. Nine of the buildings had mainly cellular offices; five of the buildings had mainly open-plan offices, whereas eight buildings had a mixture of cellular, multi-person and open-plan offices. A total of 2301 occupants, corresponding to a response rate of 72%, completed a retrospective questionnaire. The questionnaire comprised questions concerning environmental perceptions, mucous membrane irritation, skin irritation, central nervous system (CNS) symptoms and psychosocial factors. Occupants in open-plan offices are more likely to perceive thermal discomfort, poor air quality and noise and they more frequently complain about CNS and mucous membrane symptoms than occupants in multi-person and cellular offices. The association between psychosocial factors and office size was weak. Open-plan offices may not be suited for all job types. PRACTICAL IMPLICATION: Open-plan offices may be a risk factor for adverse environmental perceptions and symptoms.
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PMID:Indoor climate, psychosocial work environment and symptoms in open-plan offices. 1694 15

Despite their beneficial effects on the treatment of acne vulgaris, topical and oral retinoids may cause severe local irritation (retinoid dermatitis) due to their mechanism of action, thereby jeopardizing patient adherence, and thus compromising treatment efficacy. Alleviating dryness and improving skin comfort by using a moisturizer concomitantly to retinoids could enhance efficacy. In the present study, 30 subjects receiving either oral isotretinoin for at least 2 months or topical tretinoin for at least one month applied a moisturizing cream (Cetaphil Moisturizing Cream) twice daily for 15 days on one half of the face while the other side remained untreated. Clinical assessments, confirmed by biophysical measurements, showed that the moisturizer provided a significant improvement in skin dryness, roughness, and desquamation. Skin properties and skin discomfort were also greatly improved and subjects were very satisfied with the product. Retinoid-induced skin irritation can be relieved by the regular use of a gentle moisturizing cream as an adjunctive treatment.
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PMID:Beneficial effect of a moisturizing cream as adjunctive treatment to oral isotretinoin or topical tretinoin in the management of acne. 1737 48


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