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      Las pruebas epicutáneas de contacto en medicina laboral Translated title: Patch testing in occupational medicine

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          Abstract

          Dentro de la Medicina Laboral las dermatosis ocupacionales suponen entre el 30-60% del total de enfermedades profesionales y, dentro de ellas el 80-90% son dermatitis de contacto. Este alto número no se ve reflejado en datos oficiales debido a que en muchas ocasiones, al ser condiciones de rápida resolución o de escasa repercusión sistémica, no son declaradas. En relación a las dermatitis de contacto, la forma más frecuente en el entorno laboral es la forma alérgica y la que preferentemente se declara, al ser un proceso que en muchas ocasiones constituye motivo de incapacidad. Para el abordaje diagnóstico y correspondiente asociación con el entorno de trabajo es imprescindible realizar una historia clínica laboral completa junto con la descripción de las lesiones, y la utilización de métodos diagnósticos distintos a los de otros procesos no cutáneos, como son las pruebas de parche (patch test) o pruebas epicutáneas. Constituyen un método simple, accesible y seguro para llegar al diagnóstico de las dermatitis alérgicas de contacto. Incluyen una batería estándar, propia de un país donde se trabaja, ampliada de baterías específicas en relación con el perfil, las tareas y los productos manipulados por el trabajador. La prevención en el trabajo es el único tratamiento etiológico para la sustitución y control de los riesgos laborales relacionados con las dermatosis profesionales.

          Translated abstract

          In occupational medicine, occupational dermatoses account for 30 to 60% of the total amount of occupational diseases and, within 80 to 90% of them correspond to contact dermatitis. This high number is not reflected in official data because in most cases, as conditions of rapid resolution or low systemic impact, they are not declared. Regarding contact dermatitis, the most common type in the workplace is the allergic type, which preferably is declared, because often results in disability. For the correct diagnosis and association with the work environment is essential to make a full history of the patient' occupational background, correct description of the skin lesions, and the use of diagnostic methods other than those of non-cutaneous processes, such as patch testing. They provide a simple, accessible and safe method for the diagnosis of allergic contact dermatitis. They include a standard national baseline series, proper of the country where the patient works, and additional extended series, specific to the occupation performed by the worker. Prevention at work is the only etiological treatment for replacement and control of occupational hazards associated with occupational skin diseases.

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          Patch Testing for Contact Allergy and Allergic Contact Dermatitis§

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            Occupational issues of irritant contact dermatitis.

            Occupational irritant contact dermatitis (ICD), a non-immunological cutaneous inflammatory response to a workplace substance, comprises a major portion of occupational dermatoses in industrialized societies, resulting in considerable social and economic implications. The sheer morphological variety of ICD presents a diagnostic and classification challenge; ideotypes identified to date include acute, chronic and cumulative irritant dermatitis, delayed acute irritant dermatitis, irritant reaction, pustular irritant dermatitis, suberythematous irritation, sensory irritation, friction dermatitis and airborne dermatitis. Hand dermatitis is the most frequent manifestation of occupational ICD. This article reviews the various types of ICD, the epidemiological data available to date, risk factors, pathophysiology, diagnosis and management of ICD, emphasizing occupational issues.
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              Occupational Contact Dermatitis

              Occupational contact dermatitis accounts for 90% of all cases of work-related cutaneous disorders. It can be divided into irritant contact dermatitis, which occurs in 80% of cases, and allergic contact dermatitis. In most cases, both types will present as eczematous lesions on exposed parts of the body, notably the hands. Accurate diagnosis relies on meticulous history taking, thorough physical examination, careful reading of Material Safety Data Sheets to distinguish between irritants and allergens, and comprehensive patch testing to confirm or rule out allergic sensitization. This article reviews the pathogenesis and clinical manifestations of occupational contact dermatitis and provides diagnostic guidelines and a rational approach to management of these often frustrating cases.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                mesetra
                Medicina y Seguridad del Trabajo
                Med. segur. trab.
                Escuela Nacional de Medicina del Trabajo. Instituto de Salud Carlos III (Madrid, Madrid, Spain )
                0465-546X
                1989-7790
                March 2013
                : 59
                : 230
                : 74-84
                Affiliations
                [03] Quito orgnameHospital Carlos Andrade Marín (USFQ-HCAM) orgdiv1Servicio de Dermatología Ecuador
                [01] Xàtiva orgnameHospital Lluís Alcanyís
                [02] Valencia orgnameEscuela Valenciana de Estudios de la Salud España
                [04] Madrid orgnameInstituto de Salud Carlos III orgdiv1Escuela Nacional de Medicina del Trabajo orgdiv2Servicio de Dermatología Laboral España
                Article
                S0465-546X2013000100004
                10.4321/S0465-546X2013000100004
                81baf22d-71d4-457c-b635-98974c9a1bb1

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 17 December 2012
                : 10 January 2013
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 11
                Product

                SciELO Spain


                Dermatosis ocupacional,pruebas epicutáneas,pruebas de parche,dermatitis de contacto,dermatología ocupacional,Occupational skin disease,patch testing,skin test,contact dermatitis,occupational dermatology

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