Selected topics related to occupational exposures - Part III. Occupationaldermatology

Occupational skin disorders are very common and are a surprisingly frequent cause of lost work time. Failure to suspect an occupational cause can lead to repeated treatment failure and needlessly prolong patient misery and fr ustration. Primary care providers play a key role in recognizing possible o ccupational causes and arranging appropriate education, preventive measures , and treatment. Occupational skin conditions often occur in nonindustrial settings in worke rs such as hairdressers, health care personnel, and food handlers. Irritant contact dermatitis is by far the most prevalent occupational skin conditio n and is emphasized in this article. Allergic contact dermatitis, infection s, skin cancers, and acneform eruptions may also have significant occupatio nal associations. We will present criteria that suggest on occupational exposure, list common offending agents, and review the clinical presentations and relevant patho physiology. We provide guidance on a directed history and physical examinat ion and suggest when diagnostic testing is most likely to have value. Final ly we outline preventive measures such as contact avoidance, barrier creams , and protective gloves and address therapy and indications for referral.