PURPOSE: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. METHODS: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. RESULTS: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. CONCLUSION: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.
Dermatitis, Irritant ; Education ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Intertrigo ; Korea ; Organizational Policy ; Skin Care ; Skin

OBJECTIVETo explore the effects of mechanical irritation to the skin, eyes, and upper respiratory tract in workers exposed to rock wool.

METHODSThe gravimetric concentration of total dust and number concentration of fibre in the air of the rock wool workplace were determined . 109 rock wool manufacturing and processing workers were taken as the exposed group, 104 workers from an air separation plant, a papermaking plant and cover making plant were served as control group. All subjects accepted the questionnaire interview and clinical examination of the skin, eyes, nose and the pharynx.

RESULTS10.1% of the exposed group had the irritant contact dermatitis, which showed linear trend with the current gravimetric concentration of total dust (P < 0.05) but no association with the exposure age (P > 0.05), and the detection rate of conjunctivitis of the exposed group (12.8%) was significantly higher than the control group (2.8%) (P < 0.05). The percentages of shin and eye itching symptoms of the exposed group (54.1% and 42.9%) were significantly higher than the control group (11.5% and 26.5%) (P < 0.05), but the differences among/between the exposed subgroups with different exposure level and different exposure age were not statistically significant (P > 0.05). The differences of the detection rate of chronic rhinitis and chronic pharyngitis and the percentages of the symptoms of nose and pharynx between the exposed group and control group were not statistically significant (P > 0.05), except the rhinorrhea symptom.

CONCLUSIONSOccupational exposure to rock wool had some degree of the mechanical irritation effects on the skin and eyes. The current exposure level of total dust should be emphatically controlled.

Adult ; Asbestos ; adverse effects ; Case-Control Studies ; Conjunctivitis ; epidemiology ; Dermatitis, Irritant ; epidemiology ; Dust ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Physical Stimulation ; Workplace

Hand dermatitis is commonly seen in primary care, although it is often underdiagnosed. Exogenous causes should always be considered and a detailed environmental and occupational history taken, especially in patients presenting in adulthood. Although not life-threatening, the condition may have significant impact on the patient's quality of life and employment. Refractory cases or those suspected to be due to exogenous workplace agents may need to be referred for further investigation. Hand dermatitis can be treated effectively using pharmacotherapy and prevented by minimising subsequent exposure to irritants and allergens. Occupational skin disorders, once diagnosed, should be notified to the relevant authorities, i.e. the Ministry of Manpower in Singapore.
Adult ; Dermatitis, Irritant ; diagnosis ; Dermatitis, Occupational ; diagnosis ; therapy ; Eczema ; diagnosis ; therapy ; Female ; Hand ; pathology ; Humans ; Occupational Diseases ; diagnosis ; therapy ; Primary Health Care ; methods ; Singapore

Over the past years, hydrocolloid dressings have been introduced routinely in the treatment of various types of wounds. They provide a moist environment promoting autolytic debridement, and stimulate angiogenesis. However, long-term application often leads to inflammation of the skin in the immediate area of the ulcer, causing irritant dermatitis in many cases, but sometimes also leads to contact sensitization. A 32 year-old woman burnt herself by an iron, and presented to our clinic and was treated with Duoderm extrathin(R). Nine days later, she again presented with an erythematous oozing patch with edema, and allergic contact dermatitis was suspected. A patch test (TRUE test) was performed and a positive reaction to colophonium was obtained. Duoderm extrathin(R) contains hydrogenated rosin (colophonium) as the tackifying agent, so we could diagnose this case as allergic contact dermatitis due to the hydrogenated rosin in Duoderm extrathin(R). We report another case of allergic contact dermatitis due to Duoderm extrathin(R) in a 32 year-old woman.
Bandages, Hydrocolloid ; Debridement ; Dermatitis, Allergic Contact ; Dermatitis, Irritant ; Edema ; Female ; Humans ; Hydrogen ; Inflammation ; Iron ; Patch Tests ; Resins, Plant ; Skin ; Ulcer

Organic solvents are hydrocarbon-based substances that dissolve another substance. Organic solvents are usually lipid soluble, volatile and commonly used for painting, printing, degreasing, cleaning, thinning and extraction. Due to their volatility and lipid solubility, organic solvents are easily absorbed across the alveolar-capillary membrane and through the skin. Because organic solvents are lipophilic, they tend to be distributed to lipid-rich tissue, such as adipose tissue, nervous system and liver. Almost all organic solvent can induce skin diseases such as acute irritant dermatitis and chronic eczema. Some organic solvents are associated with allergic contact dermatitis. General and nonspecific central nervous system depression is another common toxic effect induced by most organic solvents. It shows symptoms which are the same as those from alcohol drinking, and those symptoms are completely resolved by removal from exposure to solvents. Long term and repeated exposures to organic solvents can also lead to chronic adverse neurobehavioral effects. These effects are also called as chronic toxic encephalopathy, chronic solvent intoxication and psycho-organic syndrome, and commonly reported symptoms of them are headache, depression, anxiety, and impairment of recent memory. Organic brain lesions can be found in workers suffering from psycho-organic syndrome, and in this case, there is a possibility of persistent disabilities. Carbon disulfide, n-hexane, and methyl n-butyl ketone are specifically toxic to the peripheral nervous system, and cause a symmetric ascending sensory and motor polyneuropathy. Halogenated hydrocarbons including carbon tetrachloride show toxic effects on the heart, liver, kidney, and blood. Toluene can sensitize the heart to arrhythmogenic effects of epinephrine, so sudden death in young and healthy people can be ensued from glue sniffing. Benzene is able to induce any type of leukemia, especially in victims with benzene-associated aplastic anemia. Exposure to some solvents during pregnancy has potential to induce congenital malformation and spontaneous abortion. In the treatment of diseases by organic solvents, the first step should be removal from exposure to the causative solvent.
Abortion, Spontaneous ; Adipose Tissue ; Alcohol Drinking ; Anemia, Aplastic ; Anxiety ; Benzene ; Brain ; Carbon Disulfide ; Carbon Tetrachloride ; Central Nervous System ; Death, Sudden ; Depression ; Dermatitis ; Dermatitis, Allergic Contact ; Dermatitis, Irritant ; Eczema ; Epinephrine ; Female ; Headache ; Heart ; Hexanes ; Humans ; Hydrocarbons, Halogenated ; Inhalant Abuse ; Kidney ; Leukemia ; Liver ; Membranes ; Memory ; Methyl n-Butyl Ketone ; Nervous System ; Neurotoxicity Syndromes ; Occupational Diseases ; Paint ; Paintings ; Peripheral Nervous System ; Polyneuropathies ; Pregnancy ; Resin Cements ; Skin ; Skin Diseases ; Solubility ; Solvents ; Stress, Psychological ; Toluene ; Volatilization

BACKGROUND: Self-inflicted dermatosis is a kind of self-inflicted skin disease. Most Vietnam veterans from Korea have visited the Veterans Hospitals for dermatological examination to determine the relationship between their skin diseases and Agent Orange. We were suspicious of the possibility that several Vietnam veterans intentionally produced their own skin lesions. OBJECTIVE: We conducted this study to determine the clinical characteristics of self-inflicted dermatoses of Korean Vietnam veterans. METHODS: From January, 1999 to December, 2007, a total 24 Vietnam veterans who were diagnosed as having self-inflicted dermatoses during their dermatological examinations at our hospital were included in this study. We investigated their clinical presentation, the laboratory examinations, the pathologic examinations, the medical records and the associated diseases. RESULTS: Itching was the most common subjective complaint and the duration of the itching was as follows; 20 to 30 yrs (50.0%), 1 to 10 yrs (25.0%), 10 to 20 yrs (20.8%) etc. The skin lesions were all multiple, and the involved area was as follows; upper extremities (83.3%), trunk (75.0%), lower extremities (70.8%) etc. There were two categories of clinical skin presentation. The first was the cases with lesion that were thought to be made by physical trauma such as stinging or excoriation, and the second more common cases had lesions that were thought to be made by chemical agents (70.8%). These cases resembled allergic or toxic irritant dermatitis and the lesions were composed of vesicles, erosions, ulcers and crusts that were within an arm's reach. Only 4 cases admitted to intentionally inflicting their skin lesions because of intense itching, and the others denied that they made the skin lesions by themselves. Skin biopsies were carried out in 19 of the total 24 cases, and the most common finding was spongiotic dermatitis (57.8%). CONCLUSION: This study showed the distribution and characteristics of self-inflicted dermatoses, and the study provides fundamental data for dermatologists to assess patients with self-inflicted dermatoses.
2,4,5-Trichlorophenoxyacetic Acid ; 2,4-Dichlorophenoxyacetic Acid ; Biopsy ; Bites and Stings ; Citrus sinensis ; Dermatitis ; Dermatitis, Irritant ; Hospitals, Veterans ; Humans ; Intention ; Korea ; Lower Extremity ; Medical Records ; Pruritus ; Skin ; Skin Diseases ; Tetrachlorodibenzodioxin ; Ulcer ; Upper Extremity ; Veterans ; Vietnam

Irritant dermatitis is the most frequent type of plant-related dermatitis. Plant families most commonly associated with irritation are Ranunculaceae, Euphorbiaceae, Cruciferae, Brassicaceae, Urticaceae, and Solanaceae. We report a case of irritant contact dermatitis caused by Ranunculus japonicus for the treatment of arthralgia in a 78 year old female.
Aged ; Arthralgia ; Brassicaceae ; Dermatitis ; Dermatitis, Contact ; Dermatitis, Irritant* ; Euphorbiaceae ; Female ; Humans ; Plants ; Ranunculaceae ; Ranunculus* ; Solanaceae ; Urticaceae

BACKGROUND: With the development of bioengineering techniques for noninvasive characterization of skin pathophysiology, the induction of irritant dermatitis by surfactants has been extensively studied. OBJECTIVE: We performed this study to compare the skin responses in terms of transepidermal water loss (TEWL) and erythema induced by benzalkonium chloride (BAC), a well-known non-corrosive irritant, in comparison with sodium lauryl sulfate (SLS), a representative corrosive irritant. METHOD: We applied 0.1, 0.2, 0.5, 1, and 2% solutions of BAC and SLS on volar forearm skin for 24 hours using a large Finn chamber with filter paper disc on 19 normal healthy subjects. TEWL and erythema index (E-index) were measured prior to testing, then at 30 minutes, one day, two days, three days, one week, and two weeks after the removal of the patches. RESULTS: TEWL values of BAC and SLS patch areas increased with concentration. However, BAC induced a significantly lower TEWL increase than SLS did at the corresponding concentrations. TEWL induced by BAC was highest at 30 minutes after the removal of the patch, whereas TEWL induced by SLS was highest at one day. TEWL values had recovered with the passage of time to baseline values at 2 weeks after removal of the patch at lower concentrations (0.1, 0.2, 0.5%) of SLS, but still showed significantly high TEWL values at 1% and 2% concentration SLS patch areas. TEWL values of BAC in 0.1, 0.2, 0.5 and 1% concentrations had recovered to the baseline values at 2 weeks after the removal of the patch, but not in 2% concentration BAC patch areas. E-indices of BAC and SLS increased with concentration in a similar reaction pattern. E-index induced by BAC was highest at 30 minutes after the removal of the patch, and E-index induced by SLS was highest at 30 minutes or 1 day after the removal of the patch. E-index of each concentration, except 2%, had recovered with the passage of time to baseline values on both BAC and SLS patch areas at 2 weeks, but E-indices of both 2% BAC and SLS did not recover at 2 weeks. CONCLUSION: Benzalkonium chloride showed much less damage to the skin barrier function compared to the corresponding concentration of SLS, whilst they showed a similar degree of erythema. Skin barrier function affected by the corrosive irritant SLS would need a more prolonged recovery time than skin barrier disruption by non-corrosive irritant BAC.
Benzalkonium Compounds* ; Bioengineering ; Dermatitis, Irritant ; Erythema ; Forearm ; Skin* ; Sodium Dodecyl Sulfate* ; Sodium* ; Surface-Active Agents

Dermatitis, Contact ; diagnosis ; etiology ; therapy ; Dermatitis, Irritant ; diagnosis ; etiology ; therapy ; Humans

Povidone-iodine (PVP-1) is a widely used antiseptic because of its low toxicity and germicidal effect. A 16 year old patient who had undergone incision and debridement of an anal abscess developed contact dermatitis on his buttocks postoperatively. The lesion had been exposed to a gauze immersed in a 10% povidone-iodine solution for 8 hours, but the skin around the surgical field directly painted with 10% povidone-iodine solution didn't show any effect. A patch test with povidone-iodine produced a negative response in this patient. These observations indicate that prolonged exposure to wet povidone-iodine is harmful. It is important that povidone-iodine be used carefully to prevent contact dermatitis.
Abscess ; Adolescent ; Anesthesia, Caudal* ; Buttocks ; Debridement ; Dermatitis, Contact ; Dermatitis, Irritant* ; Humans ; Paint ; Patch Tests ; Povidone-Iodine* ; Skin