Caustic Ulcers Caused by Cement Aqua: Report of a Case

Abstract

Cement is the leading cause of occupational skin disease in the construction industry 1) , mostly due to contact allergy. Cement burns were previously reported, mostly 20 yr ago [2][3][4][5][6][7][8] . We report another case.A 48-yr-old man presented to our department with necrotic lesions on feet, ankles and shanks. Five days ago, he had been in prolonged contact with cement aqua during cleaning transport tank. He admitted spilling of cement aqua over the top of Wellington boots but he continued to wear them for 5 h until finishing work. In the evening, he noticed pain, burning sensations and blisters on described locations. The features progressively worsened; necrosis had appeared two days after contact. The legs became swollen, painful and the patient was not able to walk.Examination showed erythema around ulcers covered with black necrosis (Fig. 1). His vital signs were in the normal range, the physical examination showed no abnormality. Hematological, biochemical finding and results of urinalysis were normal. Sed rate was 80 mm in the first hour. The treatment consisted of mechanical debridement of necrosis, applications of antiseptics, hydrocolloid dressing and analgesics. No skin grafting was necessary. After 2 wk, he had few small types of erosion on both legs, but most skin was healed with scars and hyperpigmentation on the affected area (Fig. 2).Cement burns are an acute ulceration 2-9) . They may lead to severe illness needing intensive therapy, as well as significant loss of working time 2) . Cement burns are insidious in onset 2,8,9) .Most cement-related skin effects are due to allergy 1, 10) . Cement burns are caused due to strong irritation and alkalinity of cement (pH 10-12); other relevant factor is abrasion by abrasive properties of sand, lime, etc. 11) This effect is increased by occlusion due to wet clothes or shoes. A few hours after exposure, burning sensations, pain, erythema and vesicles occur as the initial symptoms. Abstract: Chromium is widely used in various industries including construction sector. Skin contact with cement has been associated with allergic or irritant contact dermatitis. Contact dermatitis is one of the most frequently reported health problems among construction workers. Irritant contact dermatitis from cement ranges from cement burns to cumulative irritant contact dermatitis. Cement burns are rarely reported and are considered a severe form of acute irritant contact dermatitis. They are associated with amateur user working in a short ready-mix timeframe with poor protective measures. They usually result in significant morbidity and initially are associated with minimal discomfort. We report a typical case.

Civil construction work: The unseen contributor to the occupational and global disease burden

“…[ 2 3 ] to severe burns by Machovcova et al . and Mehta et al .,[ 5 6 ] respectively. The response shown by workers is variable as their skin sensitivity is also highly variable, as shown in Table 3 , comparing our study with other national and international studies.…”

“…Symptoms of OCD can vary from mild forms of dermatitis[ 2 3 4 ] to severe ulcerative burns. [ 5 6 7 ] Inhalation of cement dust along with environmental pollutants irritate the bronchial tree, and particulate matter less than 2 μ in size get deposited along the alveolar walls causing prominent lung volume changes, which can be measured using spirometry. Other complications of these workers include noise-induced hearing loss,[ 8 9 ] musculoskeletal disorders,[ 10 11 ] and even pneumoconiosis.…”

An Unusual Skin Lesion in Cement Irritant Contact Dermatitis: A Case Report

“…It is known that wet cement is an alkalis (5,6), which can cause various lesions such as acute ulcerative damage (7). Necrotic skin changes appear 8-12 hours after exposure.…”

“…Cement burns are rarely reported and are considered a severe form of acute irritant contact dermatitis. To the author's knowledge most of the case reports regard this issue had been published at least one or two decades ago though this can bold that safe working is being applied in developed countries but in the developing countries we have to pay more attention to this issue which can effect occupational power of the society and can become a concern for professional workers (2,6,9). Machovcova reported a case of cement burn due to acute contact with cement while starting a new job, supporting our data this article pointed to the importance of education and awareness about contact dermatitis for workers (6).…”

Dermatological and respiratory problems in migrant construction workers of Udupi, Karnataka

“…[ 5 ] Further working with wet cement; epoxy resins; hardeners; acrylic sealants; bitumen or asphalt; solvents used in paints, glues, or other surface coatings; petrol; diesel; oils; greases; degreasers; descalers; and detergents can also increase the risk of occupational dermatitis. [ 6 7 8 9 10 ] Dermatitis usually affects the hands and forearms of the workers; however, other body parts, such as face, neck or chest, and legs, can also be affected. Manipal, a small university town in Karnataka, is in the phase of rapid urban expansion and urbanization, leading to tremendous increase in construction work.…”