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      Compensation for Occupational Skin Diseases

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          Abstract

          The Korean list of occupational skin diseases was amended in July 2013. The past list was constructed according to the causative agent and the target organ, and the items of that list had not been reviewed for a long period. The revised list was reconstructed to include diseases classified by the International Classification of Diseases (10th version). Therefore, the items of compensable occupational skin diseases in the amended list in Korea comprise contact dermatitis; chemical burns; Stevens-Johnson syndrome; tar-related skin diseases; infectious skin diseases; skin injury-induced cellulitis; and skin conditions resulting from physical factors such as heat, cold, sun exposure, and ionized radiation. This list will be more practical and convenient for physicians and workers because it follows a disease-based approach. The revised list is in accordance with the International Labor Organization list and is refined according to Korean worker's compensation and the actual occurrence of occupational skin diseases. However, this revised list does not perfectly reflect the actual status of skin diseases because of the few cases of occupational skin diseases, incomplete statistics of skin diseases, and insufficient scientific evidence. Thus, the list of occupational diseases should be modified periodically on the basis of recent evidence and statistics.

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          Scabies: a ubiquitous neglected skin disease.

          Scabies has been a scourge among human beings for thousands of years. Its worldwide occurrence with epidemics during war, famine, and overcrowding is responsible for an estimated 300 million people currently infested. Scabies refers to the various skin lesions produced by female mites, and their eggs and scybala that are deposited in the epidermis, leading to delayed-type hypersensitivity reaction. Recent immunological findings such as cross-reactivity with house dust mite allergens and an altered T-helper-1/T-helper-2 pattern contribute to a better understanding of the pathomechanism. Furthermore, progress in molecular biology and cloning of relevant antigens could enable the development of a diagnostic ELISA system and candidate vaccines in the near future. Typical and atypical clinical presentations with pruritus as a hallmark of scabies occur in young, pregnant, immunocompromised, and elderly patients and include bullous and crusted (Norwegian) manifestations as well as those masked by steroid use (scabies incognito). This article reviews scabies management strategies in developed countries and resource-poor communities as well as typical complications, including the emergence of resistance and drug-related adverse events. Other problems such as post-scabies eczema and reinfestation, and newer treatments such as ivermectin are also discussed.
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            Epidemiology of systemic sclerosis: incidence, prevalence, survival, risk factors, malignancy, and environmental triggers.

            To identify the recent data regarding prevalence, incidence, survival, and risk factors for systemic sclerosis (SSc) and to compare these data to previously published findings. SSc disease occurrence data are now available for Argentina, Taiwan, and India and continue to show wide variation across geographic regions. The survival rate is negatively impacted by older age of onset, male sex, scleroderma renal crisis, pulmonary fibrosis, pulmonary arterial hypertension, cancer, and antitopoisomerase and anti-U1 antibodies. It appears that silica exposure confers an increased risk for developing scleroderma, but this exposure accounts for a very small proportion of male patients. Smoking is not associated with increased SSc susceptibility. Malignancies are reported in scleroderma at an increased rate, but the magnitude of this risk and the type of cancer vary among reports. Prevalence and incidence of SSc appears to be greater in populations of European ancestry and lower in Asian groups. Exposure to silica dust appears to be an environmental trigger, but this only accounts for a small proportion of male cases. Evidence for increased risk of neoplasia is suggestive, but the magnitude of the risk and the types of malignancies vary among reports.
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              Geoepidemiology of systemic sclerosis.

              Systemic sclerosis (SSc) is a rare and potentially severe connective-tissue disease, characterized by skin fibrosis and involvement of internal organs. Because of its rarity and heterogeneous clinical presentation, reliable epidemiological studies on SSc have been particularly difficult to carry out. SSc prevalence is estimated between 3 and 24 per 100,000 population and appears to be higher in North America and Australia as compared to Europe and Japan. Incidence estimates have significantly increased between the fifties and the eighties, but this could result from greater physician awareness of the disease and more reliable ascertainment methods. Risk factors for SSc include female sex and African origin. Reports of sporadic clusters of higher prevalence also suggest environmental risk factors. In particular, silica and solvents exposure has been associated with SSc by several rigorous case-control studies. The ten-year cumulative survival of SSc has improved significantly from 50% in the seventies to over 70% at the present time. Pulmonary fibrosis and pulmonary arterial hypertension are now the two main causes of death. Diffuse cutaneous forms, as well as cardiac, pulmonary, and renal involvement are independent risk factors for SSc-related mortality. 2009 Elsevier B.V. All rights reserved.
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                Author and article information

                Journal
                J Korean Med Sci
                J. Korean Med. Sci
                JKMS
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                1011-8934
                1598-6357
                June 2014
                13 June 2014
                : 29
                : Suppl
                : S52-S58
                Affiliations
                [1 ]Department of Occupational and Environmental Medicine, College of Medicine, Chosun University, Gwangju, Korea.
                [2 ]Teo Center of Occupational and Environmental Medicine, Changwon, Korea.
                Author notes
                Address for Correspondence: Han-Soo Song, MD. Department of Occupational and Environmental Medicine, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, Korea. Tel: +82.62-220-3689, Fax: +82.62-443-5035, oemsong@ 123456chosun.ac.kr
                Author information
                http://orcid.org/0000-0001-6000-1572
                Article
                10.3346/jkms.2014.29.S.S52
                4085176
                eadabd3a-d56b-44fe-b708-d25126bbe5a4
                © 2014 The Korean Academy of Medical Sciences.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 December 2013
                : 02 May 2014
                Categories
                Original Article

                Medicine
                workers' compensation,dermatitis, occupational,korea
                Medicine
                workers' compensation, dermatitis, occupational, korea

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