Glove-Induced Hand Dermatitis: A Study in Healthcare Workers during COVID-19 Pandemic in Indonesia.

Skin damage among healthcare workers has been reported by many centers around the world. Occupational hand dermatitis is one of the most commonly known occupational skin diseases and a socially significant health issue. The use of gloves is one of the risk factors for the occurrence and/or aggravation of hand dermatitis. This cross-sectional study involved healthcare workers in 14 referral hospitals for COVID-19 throughout Indonesia. Questionnaires were distributed to the participants, which consisted of the subject's characteristics, glove-related skin problems, history of glove use, and clinical history. This study involved a total of 845 healthcare workers. Approximately 156 healthcare workers (18.46%) had glove-induced hand dermatitis during the pandemic. Itchy skin was the most common symptom (44.23%), and the palm was the most frequently complained area (48.72%). There was a significant association between glove use and glove-induced hand dermatitis among healthcare workers. In particular, equal to or more than 2 hours per day of glove use was significantly associated with hand dermatitis. Glove-induced hand dermatitis also had a significant association with the subject's history of atopic dermatitis and previous history of hand dermatitis. The use of gloves by healthcare workers should be considered carefully, especially in individuals at increased risk, including those who use gloves for 2 hours or more per day and those who have a history of atopic or hand dermatitis, in order to prevent the incidence of glove-induced hand dermatitis among healthcare workers, as well as to provide a safe working environment.

Lupus panniculitis: a rare bilateral and symmetrical manifestation of cutaneous lupus erythematosus in an adolescent girl.

Lupus panniculitis is included in the chronic cutaneous lupus erythematosus group. An 18-year-old female patient came with the complaint of lumps on her face. When she was 16 years old, the patient started to complain about lumps on her right lower arm. Lumps were observed on her left cheek and right chin during the ongoing treatment. Histopathology results showed lymphocyte infiltration in between lobular adipocyte with fibrotic and fat necrosis in the subcutis. Lupus panniculitis lesions in this patient were found both on her face and on her lower arms, which are not considered common predilection sites of lupus panniculitis. The skin lesion observed in this patient was also bilateral and symmetrical, which was a rare finding.

Occupational skin dermatoses among health care workers: A review of adverse skin reactions to personal protective equipment.

Occupational skin-related problems include dermatoses caused by agents in the working environment. For health care workers, these occupational dermatoses could be due to usage of Personal Protective Equipment (PPE), such as gloves, masks, goggles, and other protective equipment. These PPE contribute to both allergic and irritant contact dermatitis. This review summarized the skin damage after PPE usage and hand hygiene protocol. Recommendations should be established to prevent these occupational dermatoses from PPE usage.

Acquired Perforating Disorder: A Case with Multiple Underlying Diseases.

A 51-year-old man came to the dermatology and venereology outpatient clinic with the complaint of multiple itchy lumps on his body. The patient had a previous history of hemodialysis due to end-stage renal disease. He also had a previous history of hepatitis B, an abnormal liver function test, and high blood sugar. Histopathological examination with Masson's trichrome revealed that the patient had extrusion collagen in the epidermis which had invagination. Acquired perforating disorder is frequently misdiagnosed as other skin diseases, thus this condition is underdiagnosed. In addition, underlying diseases frequently associated with acquired perforating collagenosis are chronic kidney disease, hepatic insufficiency, and diabetes mellitus. The patient in this case had all 3 conditions. Further investigation is needed to determine whether acquired perforating disorder with multiple underlying diseases will have similar severity with single underlying disease.

Characterization of Ovine Dermal Papilla Cell Aggregation.

CONTEXT: The dermal papilla (DP) is a condensation of mesenchymal cells at the proximal end of the hair follicle, which determines hair shaft size and regulates matrix cell proliferation and differentiation. DP cells have the ability to regenerate new hair follicles. These cells tend to aggregate both in vitro and in vivo. This tendency is associated with the ability of papilla cells to induce hair growth. However, human papilla cells lose their hair-inducing activity in later passage number. Ovine DP cells are different from human DP cells since they do not lose their aggregative behavior or hair-inducing activity in culture. Nonetheless, our understanding of ovine DP cells is still limited. AIM: The aim of this study was to observe the expression of established DP markers in ovine cells and their association with aggregation. SUBJECTS AND METHODS: Ovine DP cells from three different sheep were compared. Histochemistry, immunoflourescence, and polymerase chain reaction experiments were done to analyze the DP markers. RESULTS: We found that ovine DP aggregates expressed all the 16 markers evaluated, including alkaline phosphatase and versican. Expression of the versican V0 and V3 isoforms, neural cell adhesion molecule, and corin was increased significantly with aggregation, while hey-1 expression was significantly decreased. CONCLUSIONS: Overall, the stable expression of numerous markers suggests that aggregating ovine DP cells have a similar phenotype to papillae in vivo. The stability of their molecular phenotype is consistent with their robust aggregative behavior and retained follicle-inducing activity after prolonged culture. Their phenotypic stability in culture contrasts with DP cells from other species, and suggests that a better understanding of ovine DP cells might provide opportunities to improve the hair-inducing activity and therapeutic potential of human cells.

The Effect of Ovine Secreted Soluble Factors on Human Dermal Papilla Cell Aggregation.

CONTEXT: In androgenetic alopecia, follicular miniaturization and dynamic changes to the hair cycle produce patterned baldness. The most effective treatment for baldness is hair transplantation surgery. The major limitation to hair transplantation is the availability of donor hair from the relatively unaffected occipital scalp. Hair induction with in vitro expansion of donor follicle populations has the potential to overcome this. The major obstacle to this is that in vitro expansion of human dermal papilla cell (DPC) colonies is associated with irreversible loss of aggregative behavior and hair follicle-inductive potential. In contrast, cultured ovine DPCs maintain these properties after extensive proliferation. AIMS: To determine whether aggregating ovine DPC secrete factors that enhance the aggregative behavior or inductive potential of human DPC. SUBJECTS AND METHODS: Fluorescently-labelled ovine DPC were mixed in culture with human DPC at passage number seven-nine, which had lost their aggregative behavior. The effects of different culture substrates and medium compositions on aggregative behavior were determined. Ovine and human papilla cells were co-cultured, separated by a permeable membrane to determine whether the ovine cells secrete soluble factors that affect human papilla cells. RESULTS: In direct co-culture experiments, well-formed aggregates were produced by 90:10 human:ovine and 50:50 human:ovine DPC mixtures. In contrast, unmixed human DPC remained in a monolayer state after 18 days. Both human and ovine DPC had a higher tendency to aggregate in medium containing 20% (v/v) lamb serum (LS) compared to 10% (v/v) fetal calf serum (FCS). In co-culture experiments separated with permeable membrane, the human DPC aggregates were bigger and more rapidly formed with the addition of ovine secreted soluble factors. CONCLUSIONS: Soluble factors secreted by ovine DPC and present in LS increase the aggregative behavior of human DPC. These molecules might improve follicle inductiveness of human DPCs for the purpose of hair replacement therapy.