Informative criteria for signs of early development of occupational allergic dermatoses

Introduction. Occupational allergic dermatoses are multifactorial diseases. In addition to the effects of occupational etiological factors, various endogenous and exogenous factors play an important role in the development of occupational allergodermatoses.

For a personalized approach to identifying early manifestations of profallergodermatoses and determining their prevention systems, it is necessary to develop an algorithm for a consistent diagnostic procedure taking into account informative indicators of signs of early development of occupational skin diseases.

The study aims to develop a pathogenetically based set of criteria for various signs of early manifestations of occupational allergodermatoses, taking into account changes in the reactivity of the body.

Materials and methods. Scientists have developed a design and a plan for passing the stages of the study based on a retrospective analysis (in the clinic of the Izmerov Research Institute of Occupational Health from 2012 to 2022) of archival materials from 1411 case histories. On the basis of the clinic at the Izmerov Research Institute of Occupational Health, specialists have examined 105 people who made up three main groups, including 47 patients with occupational skin diseases with occupational allergodermatosis in combination with mycoses, 36 patients with occupational allergodermatosis and 22 people with a combination of occupational allergodermatosis in bronchial asthma.

Results. The authors have revealed the influence of concomitant pathologies (atopy and mycosis) on the functional capabilities of the skin barrier. The authors also revealed a high level of total immunoglobulin E in patients with concomitant pathology, which indicates a mutually aggravating course of these diseases. In patients with profallergodermatoses, a polymorphic variant of the ins/del filaggrin gene was detected in 7.4% of the examined patients (χ²=8622, p<0.01), which is 3.7 times higher than the population control. At the same time, all patients had impaired indicators of skin barrier function, which indicates the role of the polymorphic variant of the filaggrin gene in the mechanisms of formation of occupational allergodermatoses in combination with atopy and mycotic infection.

Limitations. The study is limited by the number of patients treated in the Department of Dermatology with occupational allergodermatoses, as well as with combined and comorbid pathology.

Conclusion. As a result of the study, experts have proposed an algorithm for a consistent diagnostic procedure based on informative criteria of clinical and anamnestic, functional and molecular genetic indicators to identify early manifestations of occupational allergodermatoses, which will allow a personalized approach to the development of a system of preventive, therapeutic, diagnostic and rehabilitation measures.

Ethics. The study was performed in accordance with the Ethical standard set out in the Helsinki Declaration of the World Medical Association of 1964 (as amended and supplemented in 2013). All studies were conducted after receiving Informed Consent and a decision of the Local Ethics Committee (Extract from Protocol No. 7 of 21/10/2022).

Contribution:
Izmerova N.I. — concept and design, data collection and processing, writing the text, editing;
Kuzmina L.P. — concept and design, writing the text, editing;
Chistova I.Ya. — data collection and processing, writing the text.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 23.04.2024 / Accepted: 25.04.2024 / Published: 20.06.2024

1. Izmerov N.F. ed. Russian encyclopedia of occupational medicine. M.: Meditsina; 2005 (in Russian).

2. Bauer A., Rönsch H., Elsner P. Interventions for preventing occupational irritant hand dermatitis. Cochrane Database Syst Rev. 2018; 30(4). https://doi.org/10.1002/14651858.CD004414.pub3

3. Izmerova N.I., Selissky G.D. National guidelines: Occupational dermatoses and their prevention. M.: GEOTAR-Media; 2011: 648-658 (in Russian).

4. Izmerova N.I., Kuzmina L.P., Chistova I.Ya., Ivchenko E.V., Tsidilkovskaya E.S., Kolyaskina M.M., Lazarashvili N.A., Petinati Ya.A., Bogacheva N.A., Larkin A.A., Prokhorova I.I. Occupational skin diseases as a socio-economic problem. Med. truda i prom. ekol. 2013; 7: 28-33 (in Russian).

5. Krasavina E.K., Kryuchkova E.N. Non-drug methods for the prevention of occupational allergic dermatoses in chemical production workers. Zdorov’e — osnova chelovecheskogo potentsiala: problemy i puti ikh resheniya. 2022; 17(1): 345–350 (in Russian).

6. Skripkin Yu.K., Butov Yu.S., Izmerova N.I., Selissky G.D., Fedorov S.M. Clinical dermatovenerology. Guide for doctors. M: GEOTAR-Media; 2009 (in Russian).

7. Findley K., Oh J., Yang J., Conlan S., Deming C., Meyer J.A., Schoenfeld D., Nomicos E., Park M. Topographic diversity of fungal and bacterial communities in human skin. Nature. 2013; 498(7454): 367–70. https://doi.org/10.1038/nature12171

8. Izmerova N.I., Kuzmina L.P., Ivchenko E.V. The role of mycotic sensitization in the pathogenesis of professional. Uspekhi meditsinskoj mikologii. 2014; 13: 50–52 (in Russian).

9. Dietz J.B., Menné T., Meyer H.W., Viskum S., Flyvholm M.-A., Ahrensbøll-Friis U., John S.M., Johansen J.D. Impact of atopic dermatitis on occupational contact dermatitis among young people: A retrospective cohort study. Сontact dermatitis. 2022. https://doi.org/10.1111/cod.14050

10. Kryuchkova E.N., Yatsyna I.V., Antoshina L.I. Early clinical and laboratory diagnosis of allergic dermatoses in workers of galvanic shops. Zdravookhranenie Rossijskoj Federatsii. 2021; 65(4): 365–371. https://doi.org/10.47470/0044-197X-2021-65-4-365-371 (in Russian).

11. Slodownik D., Levi A., Lapidoth M., Moshe S. Occupational Chronic Contact Dermatitis Successfully Treated with Dupilumab: A Case Series. Dermatology. 2022. https://doi.org/10.1159/000524380

12. Havmose M., Uter W., Gefeller O., Friis U.F., Thyssen J.P., Zachariae C., Johansen J.D. A nationwide skin protection program introduced in hairdressing vocational schools was followed by a decreased risk of occupational hand eczema. Сontact dermatitis. 2022. https://doi.org/10.1111/cod.14207

13. Sedeh F.B., Michaelsdóttir T.E., Jemec G.B.E., Mortensen O.S., Ibler K.S. Prevalence, risk factors, and prevention of occupational contact dermatitis among professional cleaners: a systematic review. Сontact dermatitis. 2023; 96: 345–354. https://doi.org/10.1007/s00420-022-01937-6

14. Izmerova N.I., Kolyaskina M.M., Ivchenko E.V. Determination of filaggrin gene polymorphism to assess skin barrier function in patients with occupational allergodermatoses. Med. truda i prom. ekol. 2015; 9: 61 (in Russian).

15. Visser M.J., Landeck L., Campbell L.E., McLean W.H.I et al. Impact of atopic dermatitis and loss-of-function mutations in the filaggrin gene on the development of occupational irritant contact dermatitis. The British Journal of Dermatology [Br. J. Dermatol]. 2013. https://clck.ru/3AQqoy

16. Krasavina E.K., Yatsyna I.V. Correction of cytochemical changes in patients with occupational allergic dermatoses. Med. truda i prom. ekol. 2019; 59(9): 661 (in Russian).

17. Khadartseva A.V., Khamitseva I.S. Allergic contact dermatitis: immunological characteristics, treatment features, treatment. Tendentsii razvitiya nauki i obrazovaniya. 2021; 80(7): 74–75 (in Russian).

18. Uter W., Johansen J.D., Macan J., Symanzik C., John S.M. Diagnostics and Prevention of Occupational Allergy in Hairdressers. Current Allergy and Asthma Reports. 2023; https://doi.org/10.1007/s11882-023-01076-z

19. Krasavina E.K., Kryuchkova E.N., Yatsyna I.V. Prevention of occupational allergic dermatoses using pathogenetically based techniques. Zdravookhranenie Rossijskoj Federatsii. 2024; 68(1): 52–58 (in Russian).

20. Yatsyna I.V., Moiseeva I.V., Saarkoppel L.M. Modern approaches to the prevention and treatment of dermatological diseases under the influence of production factors of secondary precious metals. Med. truda i prom. ekol. 2018; (9): 4–9. https://doi.org/10.31089/1026-9428-2018-9-4-9 (in Russian).