Meike Bock

Prevention of Hand Eczema: Gloves, Barrier Creams and Workers’ Education

To date, there is fair-quality evidence from a large number of countries, where preventive initiatives for occupational contact dermatitis (OCD) in selected settings and professions have proven significantly effective and successful; in this context, early dermatological intervention as well as specific teaching of affected individuals has been demonstrated as pivotal. Undoubtedly, awareness to OCD, its pathogenesis and prevention by those at risk have, as yet, to be improved in all countries. Thus, it is an imminent future task to improve on workers’ education, multi-disciplinary approaches being advisable. Prevention may increasingly become a stronghold for dermatology: by their specific knowledge and competence – in close cooperation with other disciplines – dermatologists can save their patients’ health and jobs, and thus also save expenses for tax-payers and insurance systems. Of course, preventive intervention needs to be accompanied by common regulatory efforts including evidence-based standards for adequate manufacturing and use of gloves, protective creams and after-work skin care to limit exposure to hazardous substances.

Semipermeable glove membranes–effects on skin barrier repair following SLS irritation

Background: Transepidermal water flux is the regulatory signal for barrier regeneration.

Site variations in susceptibility to SLS.

According to the European Society of Contact Dermatitis (ESCD) guidelines on the sodium lauryl sulfate (SLS) exposure test ‘the flexor side of forearm skin with cubital fossa and wrist excluded is the preferred study site’. In this study we analysed the exact anatomic region within the suggested test area in respect to the outcome of the SLS exposure test. 3 test areas at the volar forearm were chosen: ‘distal’ with a 5‐cm distance to the wrist, exact ‘midvolar’ and ‘proximal’ with a 5‐cm distance to the cubital fossa. 25 healthy volunteers were irritated for 24 hr with 1% SLS. Transepidermal water loss (TEWL) measurements were taken before and 1 and 24 hr after removal of Finn Chambers®. Median baseline TEWL showed no significant differences in the 3 test sites. However, postexposure TEWL proximal was significantly (P < 0.01) higher than midvolar and distal. The distal volar forearm showed the lowest TEWL 24 h after the irritation. The differences were in comparison to midvolar (P < 0.01) and proximal (P < 0.001) significant. The results show that it is essential to point out the exact position of the test area at the volar forearm in study reports and to randomize the irritation areas at the volar forearm if different treatments are to be compared.

Safety, effectiveness and comparability of professional skin cleansers

Background: There are no widely‐accepted methodical specifications with which to objectify cleansing effectiveness and skin compatibility of occuptional skin cleansing products in Europe. Therefore the German Social Insurance Agency (DGUV) initiated a study with the goal to evaluate such products in view of the potency and the safety of hand cleansers. A market analysis was a part of the project.

Lowering lesional surface pH in acne: A new treatment modality for Herpifix®

The acid skin surface pH has antimicrobial activities. Increased growth of Propionibacterium acnes contributes to the pathogenesis of acne. Therefore, the pH of inflammatory acne lesions was determined prior to and after lesional acidification employing Herpifix© (Courage + Khazaka, Cologne, Germany), a microphoretic system. The pH was correlated with the number of acne lesions. A total of 30 volunteers with acne vulgaris participated in this crossover study applying either Herpifix or a dummy to inflammatory lesions. Prior to treatment, the pH of acne lesions was 5.7 ± 0.2 (mean ± SD) and 22 lesions (mean ± 10) were counted in an 8 × 8 cm2 facial surface area. Fifteen volunteers (group A) used Herpifix first for 3 weeks and then the dummy, while the other group of 15 volunteers (group B) used the dummy first and then Herpifix. In group A, the lesional surface pH and number of lesions decreased (p < 0.01) initially. When the dummy was used over a second 3-week treatment period, the skin surface pH and number of acne lesions increased. Findings for group B were vice versa. When both groups were compared at the end of the study, a significant difference in pH values (p < 0.001) and the number of acne lesions (p < 0.05) was obtained. Herpifix may be considered as a new therapeutic option for inflammatory acne.

Prevention and Therapy from Contact Dermatitis (with Special Reference to Occupational Dermatology)

44.1 Prevention of and Protection from Contact Dermatitis (with Special Reference to Occupational Dermatology) . . . . . . . . 832 Jean-Marie Lachapelle 44.1.