Mahler Vera
Abteilung Allergologie, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2017 Jun;60(6):605-617. doi: 10.1007/s00103-017-2543-8.
Multiple environmental exposures may derange the regulatory and repair mechanisms of the skin and lead to dermatological disease.
Provide an overview of non-allergic skin diseases associated with environmental factors.
Review of current scientific evidence for associations of non-allergic skin diseases with environmental exposures: irritation, chemicals, infection, UV-radiation, temperature.
Predisposition (constitution e. g. for atopic dermatitis, psoriasis and filaggrin gene mutations) and exposure (environment) are crucial for disease development or maintenance of health in an individual. Specific chemical and contagious agents lead to characteristic skin diseases (e. g. halogen acne) which under certain conditions may be recognized as occupational disease. The most frequent cause for irritant contact dermatitis is water (wet work). Natural optical radiation of different wavelength may cause light-induced inflammatory skin diseases. Phototoxic reactions due to psoralens, furocoumarins and drugs are frequent. The polymorphous light eruption is not an exogenous delayed type allergy, but seems to be a reaction against a UV-induced neoantigen of the skin. UVB exhibits direct mutagenic effects on DNA. Sun exposure and defective DNA-repair mechanisms are risk factors for skin tumors. Heat/cold exposure under specific conditions also triggers skin diseases (primary: congelations, frostbite, heat burn, scalding, chronic-inducible urticaria; secondary: deterioration of preexisting inflammatory diseases (e. g. systemic sclerosis)).
To keep the skin healthy, an early identification and elimination of harmful environmental factors and treatment of early disease stages is necessary. This requires strategies of environmental prevention and behavioral prevention, as well as global action (e. g. with regard to increasing incidence of skin cancer).
多种环境暴露可能扰乱皮肤的调节和修复机制，导致皮肤病。
概述与环境因素相关的非过敏性皮肤病。
综述当前关于非过敏性皮肤病与环境暴露（刺激、化学物质、感染、紫外线辐射、温度）之间关联的科学证据。
易感性（如特应性皮炎、银屑病和丝聚合蛋白基因突变的体质）和暴露（环境）对个体疾病的发生或健康维持至关重要。特定的化学物质和传染性病原体可导致特征性皮肤病（如卤代痤疮），在某些情况下可被认定为职业病。刺激性接触性皮炎最常见的病因是水（湿作业）。不同波长的自然光辐射可引起光诱导的炎症性皮肤病。补骨脂素、呋喃香豆素和药物引起的光毒性反应很常见。多形性日光疹不是外源性迟发型过敏反应，而似乎是对皮肤紫外线诱导的新抗原的反应。紫外线B对DNA具有直接诱变作用。阳光暴露和有缺陷的DNA修复机制是皮肤肿瘤的危险因素。在特定条件下的热/冷暴露也会引发皮肤病（原发性：冻伤、冻疮、热烧伤、烫伤、慢性诱导性荨麻疹；继发性：既往炎症性疾病（如系统性硬化症）的恶化）。
为保持皮肤健康，有必要尽早识别和消除有害环境因素，并治疗疾病早期阶段。这需要环境预防和行为预防策略，以及全球行动（如针对皮肤癌发病率上升的情况）。
