A Program for Physicians
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Slides 119 to 123
Recognition of basic morphologic patterns of skin eruptions is critical for accurate diagnosis of occupational skin disease. Acute allergic contact dermatitis is characterized by microvesicles. (Rhus Dermatitis)
A positive patch test reaction demonstrates the characteristic microvesicular morphology of acute contact dermatitis. Once an allergen has been identified, the patient must be provided with a list of possible sources of exposure to the allergen and alternatives that are free of the allergen. Many allergens have a complex array of cross reactions. The patient must be warned about these as well.
Chronic occupational contact dermatitis to chromates may remain microvesicular, or may evolve into a chronic lichenified dermatitis with accentuation of skin markings. This is true of many cases of chronic occupational contact dermatitis -- microvesicles are still present histologically, but not apparent clinically.
Phototoxic reactions appear as macular erythema. Phototoxic reactions to lime juice represent a common occupational hazard among bartenders.
Irritant contact dermatitis (non-allergic) is characterized by erythema and unilocular bullae, resulting from epithelial necrosis. (Ethylene Oxide Dermatitis)
- National Institute for Occupational Safety and Health (NIOSH)
- Centers for Disease Control and Prevention
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