title: Are obsessive-compulsive disorders and personality disorders sufficiently considered in occupational dermatoses? A discussion based on three case reports.
abstract: Hand dermatitis is relatively common in the general population. Among work-related diseases, it is the most common form of occupational skin disease. Irritant hand dermatitis is the most frequent type. Besides wet work and direct contact to irritating occupational substances frequent hand washing can damage the barrier function of the skin facilitating the manifestation of hand dermatitis that frequently occurs chronically. According to own observations the role of obsessive-compulsive washing as part of an anxiety disorder or personality disorders may not be considered sufficiently. A possible pathogenetic relation between hand dermatitis and psychogenic disorders is discussed in a 22-year old physician's assistant, a 50-year old male nurse working in intensive care, and a 54-year old cleaner. All three patients complained about feelings of revulsion, fear of contamination and a high frequency of hand washing. These cases may encourage dermatologists to consider psychological aspects of hand dermatitis e.g. obsessive compulsive washing, overcome their inhibitions and consider these aspects in an integrated way when planning patient's therapy.
authors.affiliation: Department of Clinical Social Medicine, Occupational and Environmental Dermatology, University Clinic of Heidelberg, Heidelberg, Germany.
authors.forename: Arna
authors.initials: A
authors.lastname: Shab
authors.forename: Uwe
authors.initials: U
authors.lastname: Matterne
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Diepgen
authors.forename: Elke
authors.initials: E
authors.lastname: Weisshaar