Wüthrich B
Berufsdermatosen. 1977 Aug;25(4):141-51.
Occupational materials contacted systemically, either by inhalation or ingestion, are capable of producing toxic as well as allergic skin reactions in exposed persons. Depigmentations of vitiligo type due to paratertiary butyl-phenol, various exanthems due to trichlorethylene fumes in the metal industry and due to alpha-phenylindole in the plastics industry, and the so-called vinyl chloride sickness in the PVC industry are examples of conditions with a probable toxic pathogenesis. Allergic skin conditions may occur as either immediate type (urticaria and Quincke's edema) or delayed type (endogenic contact eczema, more rarely pigmented purpuric eruptions) reactions. Relevant examples from the literature and our own case histories are briefly presented. Some types of eczema and dysidrosiform eruptions, which show an immediate type sensitization to occupational allergens of a protein nature in the skin tests, are difficult to interpret pathogenically. The prototype of such reactions is bakers' eczema with cutaneous vascular sensitization to flour. In addition, farmers' eczema can be related to an immediate type sensitivity to animal hair, resp. farm dust. Our own observations concerning such cases are briefly described.
通过吸入或摄入而全身接触的职业性物质，能够在接触者身上引起中毒性以及过敏性皮肤反应。由对叔丁基苯酚导致的白癜风样色素脱失、金属行业中三氯乙烯烟雾以及塑料行业中α-苯基吲哚引起的各种皮疹，还有聚氯乙烯行业中所谓的氯乙烯病，都是可能具有中毒性发病机制的病症实例。过敏性皮肤病可能表现为速发型（荨麻疹和昆克水肿）或迟发型（内因性接触性皮炎，较少见的色素性紫癜性皮疹）反应。本文简要介绍了文献中的相关实例以及我们自己的病例。某些类型的湿疹和汗疱状皮疹，在皮肤试验中对蛋白质性质的职业性变应原呈现速发型致敏，其发病机制难以解释。这类反应的典型例子是面包师湿疹，皮肤对面粉有血管致敏反应。此外，农民湿疹可能与对动物毛发或农场灰尘的速发型敏感性有关。本文简要描述了我们对这类病例的观察结果。
