S1‐Leitlinie „Berufliche Hautmittel: Hautschutz, Hautpflege und Hautreinigung“ (ICD 10: L23, L24) – Kurzversion

SummaryThe pathogenesis of hand dermatitis is multifactorial, and includes factors such as genetic predisposition and exposure. A high incidence rate is associated with female gender, contact allergy, atopic dermatitis, and wet work. The most important risk factors for the persistence of hand dermatitis include its extent, contact allergic or atopic etiology, childhood dermatitis, and early onset (before the age of 20). The cost of illness of hand dermatitis corresponds to this seen in moderate to severe psoriasis. The diagnostic workup of hand dermatitis and its differential diagnoses requires a detailed assessment of occupational and recreational exposure. In case of possible work-related triggers, early notification of the accident insurer should be sought (via the dermatologist's report). Exposure to a contact allergen is a contributing factor in one-half of all cases of hand dermatitis. It is therefore imperative that all patients with hand dermatitis persisting for more than three months undergo patch testing. Successful and sustainable treatment of hand dermatitis starts with the proper identification and elimination of individual triggers, including the substitution of identified contact allergens and irritants, as well as optimizing preventive measures. Graded therapy taking the clinical severity into account is essential. Validated instruments may be used to monitor therapeutic efficacy. IntroductionThe pathogenesis of hand dermatitis is multifactorial. Both genetic as well as environmental factors play a role in the development of hand dermatitis. Despite the small body surface area affected (maximum of 4 % according to the rule of nines [1]), hand dermatitis is marked by great economic and sociomedical significance, impacting all aspects of life [2]. Hand dermatitis represents the majority of occupational skin diseases. The present article summarizes current knowledge with respect to this pathogenetically and morphologically heterogeneous entity and its differential diagnoses, and provides practical information on diagnosis and treatment. Epidemiology Incidence and prevalence of hand dermatitisHand dermatitis is common. Based on an analysis of 36 studies on the prevalence of hand dermatitis, the average point prevalence in the general Analysis of seven studies revealed a mean incidence of 5.5 cases/1,000 personyears (9.6 in women, 4.0 in men) [3].The only population-based study on the prevalence of hand dermatitis conducted in Germany to date (random sample n = 2,500, response rate 72 %, age range 18-70 years) found a point prevalence of 3.4 % (95 % confidence interval [CI] 2.6-4.4 %) and a one-year prevalence of 6.4 % (95 % CI 5.3-7.7 %) in the Heidelberg area [4]. Risk factorsAtopic dermatitis, gender, age, contact allergy, and wet work Numerous studies, recently summarized in a review article, have investigated the incidence and risk factors of hand dermatitis: a high incidence is associated with female gender, contact allergies, atopic dermatitis, and wet work [3]. Atopic dermatitis has been id...

Section: Other Genetic Factorsmentioning

confidence: 99%

Section: Treatment Of Hand Dermatitis Starts With the Identification mentioning

confidence: 99%

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Hand dermatitis – differential diagnoses, diagnostics, and treatment options

Mahler

2015

“…The term “occupational skin products” as it relates to matters that involve employers’ liability insurance associations usually refers to products that are subject to the Cosmetics Directive or the Medicinal Products Act .…”

Section: General Aspectsmentioning

confidence: 99%

S2k guidelines for the use of topical preparations on the skin

Wohlrab

Staubach

Augustin

et al. 2018

The present guidelines are aimed at dermatology residents and board-certified dermatologists as well as policymakers and insurance companies. Developed by dermatologists in collaboration with pharmacists using a formal consensus process (S2k), they include general aspects with respect to pharmacokinetics and regulatory terminology. Recommendations are provided on the various indications for extemporaneous preparations and their quality assurance. The importance of pharmaceutical vehicles and problems associated with substituting one vehicle for another are discussed. The guidelines include criteria for choosing a suitable pharmaceutical vehicle and for specific aspects in terms of treatment planning. In addition, recommendations are given for managing allergic reactions to vehicles or additives.

“…Bei beruflichen „Hautmitteln“ im Sinne der Berufsgenossenschaften handelt es sich in der Regel um Produkte, die der Kosmetikverordnung oder dem Medizinproduktegesetz unterliegen .…”

Section: Einführungunclassified

S2k‐Leitlinie zum Gebrauch von Präparationen zur lokalen Anwendung auf der Haut (Topika)

Wohlrab

Staubach

Augustin

et al. 2018

Zusammenfassung Diese Leitlinie richtet sich an Assistenz‐ und Fachärzte der Dermatologie sowie an Kostenträger und politische Entscheidungsgremien. Die Leitlinie wurde im formellen Konsensusverfahren (S2k) von Dermatologen unter Einbindung von Apothekern erstellt.Die Leitlinie stellt allgemeine Aspekte der Pharmakokinetik sowie der regulatorischen Begrifflichkeiten dar. Es werden Empfehlungen zur Indikation von Magistralrezepturen sowie deren Qualitätssicherung gegeben. Die Bedeutung der galenischen Grundlagen und die Problematik bei einer Substitution gegeneinander verschiedener Grundlagen werden dargestellt. Die Leitlinie umfasst Kriterien zur Auswahl einer adäquaten Grundlage sowie spezifische Aspekte zur Therapieplanung. Die Leitlinie gibt Empfehlungen zum Management bei Unverträglichkeiten gegenüber Bestandteilen der Grundlagen oder Hilfsstoffe.