Occupational scleroderma

Introduction to occupational scleroderma Occupational scleroderma refers to scleroderma-like changes caused by long-term repeated exposure to chemicals such as vinyl chloride and its polymers. Some patients may be accompanied by acral bone resorption. (acroosteolysis). According to reports, the disease mainly occurs in the hands-free cleaning of PVC workers in the reaction pot, so it is also known as vinyl chloride disease (vinylchloridedisease), the prevalence is 1% to 6%, the mechanism is still unknown. Dinman et al (1971) believe that the disease is a systemic rather than a local lesion. basic knowledge The proportion of the disease: 0.04% (the incidence of this disease in the toxic substance manufacturing industry is about 0.04%) Susceptible people: no specific population Mode of infection: non-infectious Complications: splenomegaly angiosarcoma

Occupational scleroderma

1. Perchlorethylene and trichlorethylene-induced scleroderma-like changes: their performance is similar to that caused by vinyl chloride. Perchloroethylene is an organic solvent used for dry-cleaning clothes, and trichloroethylene is used as a metal. The cleaning agent for the parts.

2. Insecticide-induced scleroderma-like changes: may be accompanied by Raynaud phenomenon, no reports of visceral involvement, pathogenic insecticides are: chlordane, heplochlor, malathion, disulfide Parathion, DDT, sodium dinitroorthocresolate and 6-chlorocyclohexane.

3. Epoxy resin and other predisposing factors: Japan reported that 6 cases of scleroderma-induced changes caused by epoxy resin, the disease is also associated with joint pain, myalgia, weight loss and fatigue, hardening agent 1,1' Bis(3-methyl-4-amino)cyclohexylmethane is considered to be a causative agent and symptoms are improved after discontinuation of exposure.

4. Other factors: South African gold miners and other countries have reported that silicosis (silicosis) is associated with scleroderma-like changes. Skin lesions often involve upper limbs and face, without Raynaud and visceral damage. Pulmonary edema and pulmonary fibrosis often occur before skin lesions occur.

Occupational scleroderma prevention

Improve the method of operation and strengthen personal protection to avoid direct contact.

Occupational scleroderma complications Complications splenomegaly

Severe patients may be associated with liver, splenomegaly, limited mobility and some changes in immunology. It has been reported that long-term exposure to vinyl chloride can induce hepatic angiosarcoma.

Occupational scleroderma symptoms Common symptoms Papria extremity skin pigmentation deepening cortical thinning skin hardening skin hypertrophy

1. Limb hard skin-like changes: The early manifestation is the Raynaud phenomenon in the hand. Further development may result in scleroderma-like changes in the forearm and facial skin. The skin is thickened and hardened. When the development is incomplete, it may be pale yellow. Or rope-like papular lesions can be accompanied by varying degrees of pigmentation.

2. Bone damage: It can be expressed as shortening of knuckles, globular knuckles and curved nails. X-ray examination found that bone-soluble changes, early in the beginning of the bone cortex absorption and thinning, can lead to complete absorption and fracture, often involving the hand phalanx , ulna and ankle joints.

Occupational scleroderma examination

X-ray examination found that bone-soluble changes, early in the beginning of the bone cortex absorption and thinning, can lead to complete absorption and fracture, often involving the hand phalanx, ulnar and ankle joints.

Histopathology: The skin histopathology is mainly characterized by a flat skin nail mutation, an increase in collagen fibers in the dermis and an elastic fiber break.

Can be expressed as poor, hematuria, proteinuria, tubular urine, increased erythrocyte sedimentation rate, decreased serum albumin, increased globulin.

Exemption examination: ANA positive rate >90%, mainly spot type and nucleolar type, about 20% anti-RNP antibody positive, about 50%-90% CREST patients anti-centromere antibody (ACA) positive, (labeled antibody ), 20%-40% of patients with systemic sclerosis are positive for serum SCL-70 antibody, (labeled antibody), 30% of patients with RF, the total number of peripheral blood T cells is normal or slightly lower, of which T helper cells increase, T suppresses cells cut back.

Diagnosis and diagnosis of occupational scleroderma

Early in the early stage, the bone cortex is absorbed and thinned, and it can cause complete absorption and fracture in the later stage. It often involves the phalanx of the hand, the ulnar ulna and the ankle joint. X-ray examination reveals osteolytic changes. Histopathological skin histopathology mainly manifests as epidermal nail mutation. Flat, the collagen fibers in the dermis increase and the elastic fibers break, which can be diagnosed.

Generally not confused with other diseases.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.