Pasricha J S, Srinivas C R, Krupashanker D S, Shenoy Kalpana, Subba Rao P V, Singh K K
Indian J Dermatol Venereol Leprol. 1988 Jan-Feb;54(1):15-20.
Seventy five female workers employed in the cashew nut industry in Karnataka to slice off the outer hard shells from the nuts and thus exposed to the chashew nut shell oil had a characteristic cauterization type of reaction manifesting as brownish-black, thickened sheets of dead skin covering the dorsal as well as the palmar aspects of hands including the fingers and feet. Smaller but similer lesions were also seen on these parts of the forearms, abdomen, neck and face which were not covered with clothes. The fingers were thinned and tapering and several nails of the hands and feet were thickened, discolored and eaten away. The other changes included loss of the dermatoglyphic patterns, maceration of the hands, small pits on the finger tips and pitted keratolysis seen in some cases only. Similar changes were also seen on the feet of both the male workers exposed to the same oil, in the section which extracts the oil from the sliced shells. In contrast 29, feamle wokers engaged to peel off the thin reddish covering on the cashew nut had normal hands and feet, except for the two callosities on the flexural aspect of the proximal phalanx of the right middle finger and proximal interphalangeal joint of the right index finger respectively, caused by the friction of the peeling knife. An open patch test with the cashew nut shell oil used as such in 17 workers produced a cauterization type of reaction in 32 workers irrespective of the nature of their duties, while the standard occluded patch test with 10% cashew nut shell oil in polyethylene glycol showed a mild cauterization type of reaction in only 6 workers. Patch tests with 1% and 0.1% concentrations of the shell oil were negative in all the workers. Two barrier creams tested to protect the workers from the cashew nut shell oil produced reasonably effective results within a week.
在卡纳塔克邦腰果产业中，有75名女工从事从坚果上切下外层硬壳的工作，因而接触到腰果壳油，她们出现了一种典型的烧灼样反应，表现为覆盖双手背侧及手掌面（包括手指和足部）的棕黑色、增厚的死皮层。在未被衣物覆盖的前臂、腹部、颈部和面部的这些部位也可见较小但类似的损害。手指变细呈锥形，手脚的一些指甲增厚、变色且有缺损。其他改变包括皮纹消失、手部浸渍、仅在部分病例中可见的指尖小凹和凹坑状角质松解。在从切片坚果壳中提取油的部门，接触相同油类的男工足部也出现了类似改变。相比之下，29名从事剥去腰果淡红色薄外皮工作的女工，除右手中指近节指骨屈侧和右手示指近端指间关节分别因剥皮刀摩擦而出现两处胼胝外，手脚均正常。17名工人直接使用腰果壳油进行开放性斑贴试验，无论其工作职责如何，32名工人出现了烧灼样反应，而用10%腰果壳油溶于聚乙二醇进行标准封闭性斑贴试验时，仅6名工人出现轻度烧灼样反应。用1%和0.1%浓度的壳油进行斑贴试验，所有工人结果均为阴性。两种用于保护工人免受腰果壳油侵害的防护霜在一周内产生了相当有效的效果。
