Introduction:
The skin is the largest component in the body, and one of its primary roles is to defend the body from harmful substances such as toxic chemicals, UV radiation, or prolonged or repeated contact with water. The extent of damage determines the degree of exposure. Most hazardous material exposure occurs in the workplace but may also occur at home or during regular daily activities.
What Are the Dermatologic Consequences of Rare Environmental Exposures?
The following are the dermatological consequences.
Dermatitis:
Contact dermatitis is an eczematous rash triggered by an external substance. The two main causes are allergic chemicals, which trigger immunological hypersensitivity reactions, and irritant substances, which directly cause damage to the skin.
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Irritant Contact Dermatitis - It is caused by direct skin injury from the irritant material. It appears when the skin is very susceptible, as in the case of people with atopic dermatitis (AD), or when exposure to the drug or substances is severe enough. The most frequent environmental irritants include water, solvents, soaps and detergents, and dry air. The degree of exposure determines the risk of developing irritating contact dermatitis. Hand dermatitis affects at least 10% of the population. Infant skin is more sensitive to irritants than adult skin.
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Allergic Dermatitis - Immediate allergic reactions include asthma, hay fever, and contact urticaria. Common allergens include house dust mites, pollen, grasses, dairy products, natural rubber latex, and peanuts. These allergy-causing proteins can aggravate skin conditions like AD because they can enter damaged skin more easily than normal skin. Anaphylaxis may occasionally result from exposure to these allergens. Natural rubber, latex, and peanuts are the best examples. The immune system takes many hours to respond. Preservatives, rubber additives, metals, perfumes, plants, and medications are common culprits.
Halogen Acne: Halogen acne, or chloracne acne, is a relatively common skin condition in adolescence. However, in rare cases, environmental pollution can cause a variation of acne known as chloracne. Exposure to different chemicals can cause environmental acne, manifesting as a mild eruption affecting localized contact or covered portions of the body or as a severe, disseminated form involving every follicular orifice. Chloracne is an indicator of systemic involvement with extremely harmful substances.
Chloracne is produced due to environmental exposure to specific halogen-containing aromatic hydrocarbons. It has been identified as one of the most susceptible indications of systemic poisoning from these substances.
It is a challenging environmental effort to avoid and regulate chloracne by having a completely enclosed production process that eliminates any possibility of direct contact with the skin or inhalation of harmful compounds. The only other option is to try and modify the chemical production to reduce or completely remove the exposure to the contaminating chloracnegens.
Chemical Depigmentation:
The term "chemical leukoderma" refers to skin pigmentation or hypopigmentation caused by exposure to one or more chemicals used in industry that are known to be harmful to epidermal melanocytes. Some substances are harmful to functioning melanocytes, such as substituted phenols. Many of these substances result in vitiligo-like persistent skin depigmentation.
Chemical leukoderma has no particular treatment. Removing the problematic chemical could lead to partial re-pigmentation, but this procedure may take several years or never occur. The goal of treatment is to prevent more exposure. Sunscreen should be applied to protect the depigmented skin from UV radiation and camouflage cosmetics.
Quartz-Induced Scleroderma:
Quartz (silicon dioxide, SiO2) is found in nature in large quantities. 27% of the earth's crust comprises materials generated from silicon, primarily quartz. In human tissues, quartz can remain constant for decades and acts as chemically inert. Quartz is the main cause of pulmonary silicosis. The following sectors and occupations are most susceptible to quartz exposure: building, stone, slate, mining, foundry, manufacturing, rubber (because talc is heavily polluted with silicon dioxide), and fire clay processing. Scleroderma treatment is ineffective because there is no specific medication, and the disease frequently progresses. General debility or renal, myocardial, or pulmonary sclerosis can be the causes of death. Removing the individual from exposure in cases involving the quartz industry typically does not help the patient's clinical condition.
Can Skin Cancer Occur as a Result of Environmental Changes?
Numerous worldwide outbreaks of skin cancer were linked to exposure to the environment. Polycyclic hydrocarbons, ionizing radiation, and arsenic were identified as the main environmental carcinogens. Nowadays, the primary cause of environmental skin cancer is ultraviolet radiation. Coal, natural gas, and oil shale are incompletely burned and distilled to yield polycyclic hydrocarbons. These compounds contain Bitumen, lubricating oils and greases, tar, oil shale, and fuel oils. It is essential to protect the skin with protective gear or engineering controls like machine guarding.
What Are the Effects of Sunlight on the Skin?
The UV and other non-ionizing radiation from the sun play a major role in various types of skin cancer and inflammatory skin conditions. Strong evidence suggests that sunlight, specifically ultraviolet B and, to a lesser extent, ultraviolet A radiation, contributes significantly to the development of the most common skin cancers, including squamous cell carcinoma, basal cell carcinoma, actinic keratoses, and Bowen's intraepidermal neoplasia. There is greater debate over the significance of sunlight in malignant melanoma. However, it appears to be intermittent sun exposure in childhood.
Sunlight's non-ionizing radiation plays a significant role in the clinical manifestation of idiopathic photodermatoses, cutaneous porphyrias, and drug-induced photosensitivity. It is particularly significant in rare genophotodermatoses, such as the many kinds of xeroderma pigmentosum, which all share a reduced ability to repair ultraviolet-induced DNA damage.
Several other dermatoses, such as cutaneous lupus erythematosus, Jessner's lymphocytic infiltration, melasma, pemphigus vulgaris, and actinic lichen planus, can be exacerbated by sunlight. The adverse effects of sunlight on the skin are not entirely negative; most people with common inflammatory skin illnesses, such as psoriasis and atopic dermatitis, benefit from it.
Conclusion:
Prevention is essential for reducing the effects of rare environmental exposures on dermatologic health. This involves public health campaigns to detect new environmental dangers, education for the affected people, and proper personal protection equipment in work environments. More studies are required to create efficient diagnosis and treatment plans and a deeper understanding of the mechanisms of dermatologic responses to rare environmental exposures.
