Informative criteria for signs of early development of occupational allergic dermatoses

Abstract

Introduction. Occupational allergic dermatoses are multifactorial diseases. In addition to the effects of occupational etiological factors, various endogenous and exogenous factors play an important role in the development of occupational allergodermatoses. For a personalized approach to identifying early manifestations of profallergodermatoses and determining their prevention systems, it is necessary to develop an algorithm for a consistent diagnostic procedure taking into account informative indicators of signs of early development of occupational skin diseases. The study aims to develop a pathogenetically based set of criteria for various signs of early manifestations of occupational allergodermatoses, taking into account changes in the reactivity of the body. Materials and methods. Scientists have developed a design and a plan for passing the stages of the study based on a retrospective analysis (in the clinic of the Izmerov Research Institute of Occupational Health from 2012 to 2022) of archival materials from 1411 case histories. On the basis of the clinic at the Izmerov Research Institute of Occupational Health, specialists have examined 105 people who made up three main groups, including 47 patients with occupational skin diseases with occupational allergodermatosis in combination with mycoses, 36 patients with occupational allergodermatosis and 22 people with a combination of occupational allergodermatosis in bronchial asthma. Results. The authors have revealed the influence of concomitant pathologies (atopy and mycosis) on the functional capabilities of the skin barrier. The authors also revealed a high level of total immunoglobulin E in patients with concomitant pathology, which indicates a mutually aggravating course of these diseases. In patients with profallergodermatoses, a polymorphic variant of the ins/del filaggrin gene was detected in 7.4% of the examined patients (χ2=8622, p<0.01), which is 3.7 times higher than the population control. At the same time, all patients had impaired indicators of skin barrier function, which indicates the role of the polymorphic variant of the filaggrin gene in the mechanisms of formation of occupational allergodermatoses in combination with atopy and mycotic infection. Limitations. The study is limited by the number of patients treated in the Department of Dermatology with occupational allergodermatoses, as well as with combined and comorbid pathology. Conclusion. As a result of the study, experts have proposed an algorithm for a consistent diagnostic procedure based on informative criteria of clinical and anamnestic, functional and molecular genetic indicators to identify early manifestations of occupational allergodermatoses, which will allow a personalized approach to the development of a system of preventive, therapeutic, diagnostic and rehabilitation measures. Ethics. The study was performed in accordance with the Ethical standard set out in the Helsinki Declaration of the World Medical Association of 1964 (as amended and supplemented in 2013). All studies were conducted after receiving Informed Consent and a decision of the Local Ethics Committee (Extract from Protocol No. 7 of 21/10/2022).