ABSTRACT
I. Introduction 269
II. Prevalence 269
III. Clinical Features 271
A. Irritant Contact Dermatitis 271
B. Allergic Contact Dermatitis 271
C. Atopic Hand Dermatitis 272
D. Hybrids 272
E. Cheiropompholyx 272
F. Hyperhidrosis 272
G. Nail Changes 273
H. Pilonidal Sinus 273
I. Callosities 273
IV. Causative Factors 273
A. Wet Work 273
B. Irritants 274
C. Friction and Pressure 274
D. Thermal Changes 274
E. Allergens 275
1. Hairdressing Chemicals-Dyes and Permanent Wave Solutions 275
2. Other Sensitizers 277
a. Nickel 276
b. Formaldehyde 278
c. Cocamidopropylbetaine (CAPB) 278 d. (Chloro)methylisothiazolinone (CMI/MI) 278 e. Fragrances 278
f. Various Allergens 278
g. Systemic Toxicity 278
F. Immediate-Type Reactions 279
V. Diagnosis 280
VI. Treatment 280
VII. Prognosis 280
VIII. Prevention 281
References 282
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I. INTRODUCTION
Hairdressers undoubtedly have an increased risk of developing an occupational dermatitis. Continual exposure to numerous irritants and allergens as well as to frictional forces and microclimatic changes are some of the factors causing hand dermatitis. In many patients the condition worsens progressively, in spite of correct diagnosis and various measures of treatment, leading to repeated sick leaves and, finally, surrender of the profession. The costs for medical care, and particularly for the retraining of the (usually) young patient, are substantial. The socioeconomic aspect, together with the personal suffering from the disease, and certain clinical features, justify a special chapter in a book on hand eczema.
