Overview on other environmental skin disorders

Abstract

Numerous environmental factors are incriminated in the occurrence of skin disorders. Here, we provide an overview on dermatitis caused by bacteria, Kawasaki disease (KD), and the association between silica-dust exposure and cutaneous autoimmune diseases. Common bacterial skin infections are caused by Staphylococcus (S. aureus, S. beta-hemolytic) and Streptococcus (S. pyogenes) species, and they include cellulitis, erysipelas, ecthyma, impetigo, and others. On the other hand, folliculitis is caused by a gram-negative bacteria known as Pseudomonas aeruginosa. Recently, reports have suggested the infectious origin of KD, and there have been several KD cases reported in Asia and western countries, and KD is considered as a leading cause of acquired heart disease in children population. Recent researchers have discovered KD-specific molecules that share the same structures with microbe-associated molecular patterns (MAMPs), suggesting that KD might have an infectious origin. In the acute phase, KD patients often present with fever, erythema, edema in the extremities and accompanied by pain, exanthema, cervical lymphadenopathy (mostly unilateral, nonsuppurative), conjunctival injection, and changes in the lips and tongue (strawberry tongue, a common sign in KD patients) and oropharyngeal mucosa. Occupational silica-dust exposure has been associated with the development of a number of autoimmune diseases, including scleroderma. Additionally, since the work by Erasmus, several case-control studies have demonstrated this association and provided clues on biomarkers (anti-centromeric proteins (anti-CNEP-B in particular), anti-Scl70) that can serve in the early diagnosis of systemic sclerosis or scleroderma as well as a screening tool among silica-dust-exposed workers.