Is occupational irritant contact dermatitis predictable by cutaneous bioengineering methods? Results of the Swiss Metalworkers' Eczema Study (PROMETES).
BACKGROUND
Since identification of subjects with high eczema risk by screening tests is desirable, different skin bioengineering methods were studied for their validity as predictive measures for the development of hand eczema.


METHODS
205 metalworker trainees were followed up over 2.5 years from the beginning of their apprenticeship to observe the occurrence of hand eczema. Within the first weeks of their training they underwent a number of noninvasive biophysical tests. Transepidermal water loss, skin moisture and skin roughness were measured, and irritation tests with dimethyl sulfoxide (DMSO), sodium hydroxide (NaOH) and sodium lauryl sulfate were conducted. Sensitivity, specificity and predictive values of the performed tests and test combinations were calculated.


RESULTS
None of the observed single biophysical methods can be considered a valid screening test.


CONCLUSIONS
A combination of short irritation tests (DMSO and NaOH tests) and the measurement of skin moisture, however, allows to identify individuals at high risk for hand dermatitis with a high sensitivity, though low specificity.
Berndt
U
U
Department of Dermatology, University Hospital, Zurich, Switzerland.
Hinnen
U
U
Iliev
D
D
Elsner
P
P
D000328:Adult; D001698:Biomedical Engineering / Q000379:methods; D015331:Cohort Studies; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000209:etiology*; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000209:etiology*; D004121:Dimethyl Sulfoxide / Q000009:adverse effects; D004485:Eczema / Q000175:diagnosis / Q000209:etiology; D005500:Follow-Up Studies; D006229:Hand Dermatoses / Q000139:chemically induced; D006801:Humans; D007509:Irritants / Q000009:adverse effects; D008403:Mass Screening; D008670:Metals / Q000009:adverse effects; D016273:Occupational Exposure / Q000009:adverse effects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology / Q000503:physiopathology; D012972:Sodium Hydroxide / Q000009:adverse effects; D013557:Switzerland; D014870:Water Loss, Insensible / Q000187:drug effects
D007509:Irritants; D008670:Metals; D012972:Sodium Hydroxide; D004121:Dimethyl Sulfoxide