Background: Glove occlusion might enhance skin sensitivity to a subsequent detergent challenge (occlusion effect). Thus, some skin protection creams (PC) claim to protect against this effect of occlusion, and are recommended to be used before wearing liquid-proof gloves.Objectives: To evaluate the effect of PC applied prior to glove occlusion on the 'occlusion effect'-refers to increased susceptibility of the skin to a model detergent.Methods: One hundred and eleven volunteers were enrolled in a single-blind, randomized study. Seven PCs were applied before glove occlusion over 7 days (D1-D7).After sodium lauryl sulphate (SLS) challenge, we compared the irritation between the areas treated with PC and occlusion alone. Clinical scoring and bioengineering methods (capacitance, transepidermal water loss [TEWL], and colourimetry [erythema]) were used to quantify the irritant reactions.Results: After 1 week of occlusion and PC application, we did not observe significant changes in TEWL, nor in erythema, whereas skin hydration raised in three creamtreated areas. On day 10, after a challenge with SLS, some products significantly aggravated the skin irritation as compared to occlusion alone. Conclusions:The 'occlusion effect'-shown as higher skin susceptibility to a model detergent-was not mitigated by PCs when applied prior to glove occlusion. On the contrary, some PCs might have negative effects on skin barrier function and augment such sensitivity.

Background: Veterinary assistants and veterinarians are at an increased risk of developing an occupational skin disease, for example, irritant/allergic contact dermatitis, contact urticaria and hand eczema (HE).Objectives: We aimed to investigate the prevalence of skin problems and the influence of predisposing factors especially among veterinary assistants.Methods: We conducted a cross-sectional study among veterinary assistant staff (n = 103) and veterinarians (n = 19). A questionnaire, specific IgE determination and photographs of hands were evaluated for skin symptoms. Logistic regression models assessed predisposing factors.Results: Over 50% (n = 62/122) of our study population reported hand eczema (HE) in the last 12 months (1-year prevalence). Twenty-seven subjects reported redness and contact urticaria directly after animal contact, 35 had a positive history of allergic contact dermatitis. HE was associated with (i) increased frequency of hand washing (11-15 times per day; OR 4.15, confidence interval [CI] 95% 1.18-14.6, p = 0.027, univariate model) and (ii) unprotected contact to fluids and tensides >5 times per day (OR 4.56,, multivariate model). Conclusions:We observed a high prevalence of self-reported HE among staff in veterinary practices. Excessive hand washing, unprotected contact with irritants and long-term glove use should be avoided.

Background: To prevent irritant contact eczema even in occupational fields with heavy-duty soiling, it is generally recommended to use 'mild' hand cleansers (mild detergent without grits, MC). On the other hand, since grit-containing cleansers (GC) show a higher washing power that minimizes washing time, their usage is generally preferred in specific occupational fields.Objectives: To compare whether a shorter, intense washing period might cause less skin damage than a longer washing period with an MC. Methods: Differences in cleaning time were first verified in a pilot study using standardized model dirt. In the main study, the forearms of 35 healthy volunteers were washed with three standardized procedures over a period of 3 days, either using 2 min of MC with/without hand brush or 1-min GC. Clinical scoring, transepidermal water loss (TEWL), corneometry, colourimetry and scaliness/roughness (Visioscan) were used to evaluate the epidermal barrier, topography and irritation. Results:The pre-study showed that washing time doubled when using MC vs. GC. Using GC resulted in stronger barrier disruption, even after a shorter washing periodmedian ΔT4-T1 TEWL 0.96 g/m 2 /h vs. 4.91 g/m 2 /h respectively, p < 0.0001. The most harmful procedure for the skin was the additional application of a hand brush (18.86 g/m 2 /h).Conclusions: Short-time washing with GC damages the skin barrier more significantly in comparison to a longer application of an MC. When washing with MC, the strongest irritant reaction occurred when accompanied with hand brushing.

Hautschutzprodukte werden an Arbeitsplätzen verwendet, um der Entwicklung irritativer Kontaktekzeme der Hände vorzubeugen, für die insbesondere Feuchtarbeit und Umgang mit milden Irritanzien verantwortlich sind. Unklar ist die Rolle der Hautschutzprodukte und deren Wirksamkeit im Falle einer reinen Okklusion durch feuchtigkeitsdichte Handschuhe.

pile, rolling up the individual wrap and tying on a label which listed both the ingredients as well as the price (Figure 1). We hypothesize that as multiple wraps were regularly being rolled by hand there was likely to be direct transfer of colophonium from the hands to the skin on the face and eyelids, however, there was also the potential for airborne exposure. The patient has denied any form of hand eczema this is most likely because the skin on the hands is thicker than the face and eyelid; it is likely if she has continued to handle the beeswax wrap; that she would have developed ACD on her hands as well. DISCUSSIONBees wax wraps are increasingly popular products used as a sustainable multi-use alternative to tin foil/cling film for wrapping and covering foods. They can be bought from eco-friendly retail shops and online sites. They can also be handmade with many popular internet sites displaying videos for how to make these items at home. Colophonium (rosin) is the sticky sap produced by pine and spruce trees. It is used in a wide range of home and occupational products, most classically sticking plasters, cosmetics, waxes, polishes and paper products. Colophonium, in the form of pine resin, is often added to bees wax wraps to increase their adhesive properties.Occupational colophonium ACD is most commonly associated with the wood industry, glues, metal working fluids and soldering materials. 1 Our patient is likely to have developed her colophonium ACD through regular contact with pine resin from the bees wax wraps in her occupational setting. It is likely however that other patients may be similarly exposed in a home setting if making and using the wraps on a regular basis.We present this case to raise awareness of bees wax wraps as a new potential eco-friendly source of colophonium ACD. AUTHOR CONTRIBUTIONSIman Hamid: Writingoriginal draft; writingreview and editing.