Suskind R R
Environ Health Perspect. 1977 Oct;20:27-37. doi: 10.1289/ehp.772027.
The skin is an important interface between man and his environment; it is an important portal of entry for hazardous agents and a vulnerable target tissue as well. It is a uniquely accessible model system for detecting hazards and for studying mechanisms of a wide variety of biologic funcitons. Environmental causes of skin reactions comprise a vast array of physical, chemical and biological agents. To appreciate the role of the skin as an interface with man's environment, it is necessary to understand the multiple adaptive mechanisms, and the defenses of the skin against the environmental stresses. The skin is endowed with a versatile group of defenses against penetration, fluid loss from the body, thermal stress, solar radiation, physical trauma and microbial agents. Patterns of adverse response range in quality and intensity from uncomplicated itching to metastatic neoplasia. Environmental problems comprise a large segment of disabling skin disease. Although critical epidemiologic data is limited, cutaneous illnesses comprise a significant segment of occupational disease. This represents a significant loss in productivity and a major cause of disability. The most serious research needs include the development of surveillance systems for identifying skin hazards and determining frequency of environmental skin disease; the development of new models for studying cutaneous penetration; the elucidation of the mechanisms of nonallergic inflammatory reactions (primary irritation) and of the accommodation phenomenon; the development of more sensitive models for predicting adverse responses to marginal irritants; the utilization of modern skills of immunobiology and immunochemistry to elucidate mechanisms of allergic responses; the launching of epidemiologic studies to determine the long term effects of PCBs and associated compounds such as dioxins; and the expansion of research in the mechanisms of skin cancer in relation to susceptibility, genetic and metabolic considerations, ultraviolet light, and phototoxic agents.
皮肤是人与环境之间的重要界面；它是有害因子进入人体的重要门户，也是一个易受损害的靶组织。它是检测危害和研究多种生物功能机制的独特且易于研究的模型系统。皮肤反应的环境成因包括大量物理、化学和生物因子。为了理解皮肤作为人与环境界面的作用，有必要了解多种适应机制以及皮肤对环境压力的防御机制。皮肤具有多种防御功能，可抵御物质渗透、身体水分流失、热应激、太阳辐射、物理创伤和微生物因子。不良反应的形式在性质和强度上差异很大，从不复杂的瘙痒到转移性肿瘤。环境问题在致残性皮肤病中占很大比例。尽管关键的流行病学数据有限，但皮肤疾病在职业病中占很大一部分。这意味着生产力的重大损失和致残的主要原因。最迫切需要开展的研究包括开发监测系统，以识别皮肤危害并确定环境性皮肤病的发病率；开发研究皮肤渗透的新模型；阐明非过敏性炎症反应（原发性刺激）和适应性现象的机制；开发更敏感的模型以预测对边缘性刺激物的不良反应；利用现代免疫生物学和免疫化学技术阐明过敏反应机制；开展流行病学研究以确定多氯联苯及二恶英等相关化合物的长期影响；以及扩大关于皮肤癌机制的研究，涉及易感性、遗传和代谢因素、紫外线和光毒性物质。
