Occupational dermatitis from proflavine.
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Biomedical subjects
Publications and source records attributed to C L Goh.
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Of 557 patients with occupational dermatoses seen at the Middle Road Hospital, Singapore, 55.7% (310) were irritant contact dermatitis, 38.6% (215) were allergic contact dermatitis and 5.7% (32) were non contact dermatitis. More than half of the patients were below 30 years old and most were from the construction (29.5%), metal/engineering (20.6%), electrical/electronic (16.4%), transport (5.5%) and food catering (3.8%) industries. Common occupational irritants included coolants, oils, cement, solvents, detergents and soldering flux. Chromates in cement was the most common occupational allergen. Other occupational allergens included rubber chemicals from rubber apparels. Thiurammix followed by carba-mix, and PPD-mix were common rubber allergens. Resins including epoxy, acrylate and paratertiary butyl phenol resins and other metals (nickel and cobalt) were less common occupational allergens. 5 workers had contact urticaria to proteinaceous food. Non dermatitic occupational dermatoses included fibreglass dermatoses, miliaria and oil folliculitis.
Chancroid is a sexually transmitted disease caused by Haemophilus ducreyi. The infection is reported to be more common in the tropics. Isolation of H. ducreyi is difficult even in the best of hands. The diagnosis of chancroid is often clinical. Most chancroidal ulcers are polymicrobial in nature and this has resulted in conflicting reports of the efficacy of antibiotics used in the treatment of chancroid. In-vitro testing of clinical isolates indicated a wide variation in the prevalence of resistance to various antibiotics in different geographic areas. This paper reviews the epidemiology, diagnosis and management of chancroid.
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The prevalence of HBV markers in prostitutes is known to be higher than that of the normal population of similar age range in previous studies. This study showed a significant correlation between the duration of prostitution and the prevalence of HBV antibodies amongst the prostitutes. The prevalence of HBV antibodies doubled after the first year of prostitution. A two-year follow-up study of these prostitutes showed that 37% of HBsAg positive prostitutes lost the HBsAg. The seroconversion rate of HBsAg negative prostitutes was 10% during this two-year period. Early immunization against HBV infection should be considered in this high risk group in view of these findings.
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Proflavine lotion is a commonly used topical antiseptic in the tropics, but its sensitizing potential was never emphasized and many who developed allergic contact dermatitis were never aware of it. In a study of 45 patients, most presented with acute or subacute dermatitis which started on the arms and legs. Concomitant cutaneous sensitivity to other medicaments and lanolin occurred in 66% of the patients.
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Musk ambrette has become one of the commonest photosensitizers in many countries and is the cause of persistent light reactions in many patients. A simple method is presented for qualitative analysis for musk ambrette and other nitromusks in colognes using thin-layer chromatography with toluene as carrier solvent and visualization under UVL. It is useful for identifying such colognes so that proper recommendations can be given to patients sensitive to musk ambrette. 14 of 32 men's colognes, analysed by TLC and confirmed on GC/MS, were found to contain musk ambrette, the concentration varying from 0.02 to 0.39% w/v.
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Among 1873 patch tested patients, the prevalence of contact allergy was 47.1% (421/894) in females and 51.2% (501/979) in males (N.S.). It was 46.5% (593/1274) in Chinese, 52.8% (151/286) in Malays, and 48.3% (48.3%) in Indians, there was no significant difference among these 3 races in Singapore. Prevalence among foreigners in Singapore was high (82.3% (65/79)) compared to the 3 major races. This may be due to a higher % of foreigners engaged as construction workers who are considered to run a greater risk of contact allergy. The prevalence was significantly higher in those above 40, (60.9% (290/476)) compared to those under 40 (45.2% (632/1397)).
In a study of sickness absence due to occupational dermatoses among 360 construction workers in a prefabrication construction factory in 1984, we found 3 workers with allergic contact dermatitis from chromate in cement who required medical leave. There were 5 sickness absence spells due to occupational dermatoses and the number of days lost due to occupational dermatoses was 53 days for the year. This averaged out at 0.01 spells per worker per year, 0.15 days per worker per year and 15 days per spell. It appeared that the number of workers requiring sickness absence from occupational dermatoses was low, but that those with the condition required about 2 weeks of sickness absence. Allergic contact dermatitis from chromate in cement appeared to be the only occupational dermatosis causing sickness absence in the factory.
The total cobalt and nickel concentration of 11 brands of Asian cement ranged from 8.1 to 14.2 micrograms/g and 14.9 to 28.5 micrograms/g, respectively. These metals exist mainly as insoluble salts; the water-soluble concentration of cobalt and nickel in the cements ranged from 0.39 to 0.65 micrograms/g and from 0-1.2 micrograms/g, respectively. 1.5% (4/272) of construction workers in a prefabrication construction factory had cobalt sensitivity. All had allergic contact dermatitis from chromate in cement. No worker had isolated cobalt sensitivity and cement dermatitis. It appeared that sensitization to cobalt in cement occurs only secondarily to an existing cement dermatitis. 1.8% (5/272) workers had nickel sensitivity: 2 with allergic contact dermatitis to nickel in their watches, 2 were asymptomatic and 1 had allergic contact dermatitis to chromate and cobalt in cement. The low prevalence of cobalt and nickel sensitivity from cement was probably related to the low concentration of soluble cobalt and nickel salts in the cement. However, these insoluble salts can form soluble complexes with body fluids on eczematous skin and sensitize the skin.
The concentration homogeneity of nickel sulphate 4.8% pet. and potassium dichromate 0.5% pet. in patch test materials appeared to become less homogeneous if stored at room temperature compared storage at 4 degrees C, after 2 months. The coefficient of variation of concentration for nickel sulphate after storage at 4 degrees C was 3.0883%, and at room temperature 25.3098%. The coefficient of variation for potassium dichromate after storage at 4 degrees C was 4.6324% and at room temperature 9.6334%. This indicates that patch test materials containing nickel sulphate and potassium dichromate should be kept refrigerated in the tropics.