Psoriasis predisposition and occupational triggering factors in the appraisal of occupational medical expertises [Psoriasis als anlagebedingte Erkrankung in der berufsdermatologischen Beurteilung]

Autor(en): Mahler, V.
Diepgen, T.
Skudlik, C. 
Becker, D.
Dickel, H. 
Fartasch, M.
Geier, J.
Häberle, M.
Hillen, U.
Krohn, S.
John, S.M. 
Weisshaar, E.
Werfel, T.
Zagrodnik, F.
Stichwörter: Allergens; contact dermatitis; disease exacerbation; disease predisposition; expert witness; human; insurance; medicolegal aspect; occupational medical expertise; psoriasis; review; skin manifestation; Dermatitis, Occupational; disability; disease course; expert witness; Germany; legislation and jurisprudence; occupational exposure; psoriasis; work capacity; workman compensation; algorithm; case report; Dermatitis, Occupational; genetic predisposition; genetics; Hand Dermatoses; health insurance; psoriasis, allergen, Allergens; Dermatitis, Occupational; Disability Evaluation; Disease Progression; Expert Testimony; Germany; Humans; Occupational Exposure; Psoriasis; Work Capacity Evaluation; Workers' Compensation; Algorithms; Dermatitis, Occupational; Genetic Predisposition to Disease; Hand Dermatoses; Insurance, Accident; Psoriasis
Erscheinungsdatum: 2014
Herausgeber: Wiley-VCH Verlag
Enthalten in: JDDG - Journal of the German Society of Dermatology
Band: 12
Ausgabe: 6
Startseite: 519
Seitenende: 529
Zusammenfassung: 
Background: Psoriasis is an immunemediated disease with a genetic background. Local psoriatic changes can be triggered by exogenous mechanical or irritant factors. Causative occupational factors have to be distinguished from the spontaneous course of psoriasis in occupational medical evaluations. The objective of this work is to demonstrate the medicolegal grounds for a homogenous assessment. Patients and methods: The presented recommendations were developed in a working group for Occupational and Environmental Dermatology (ABD) and the German contact dermatitis group (DKG) of the German Dermatologic Society (DDG) based on the German medicolegal framework. Results: Causality between the insured activity and the appearance of psoriasis is a prerequisite for the recognition of the occupational nature of the disease. This is the case if the occupational activity is the exclusive or a legally essential contributing factor either for first manifestation or aggravation of the disease. A connection must be denied if everyday events are sufficient to trigger the psoriasis. From 1995 to 2010, 130 cases of psoriasis have been recognized as occupationally related by the German statutory accident insurance. Conclusions: The appraisal of psoriatic disease in the occupational medical evaluation is subject to the case assessment of the expert witness. In this position paper we present recommendations for a homologous basis for diagnosis, causality assessment, estimation of reduction in earning capacity and rehabilitation of occupational psoriasis. © 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
ISSN: 16100379
DOI: 10.1111/ddg.12262-suppl
Externe URL: https://www.scopus.com/inward/record.uri?eid=2-s2.0-84901759132&doi=10.1111%2fddg.12262-suppl&partnerID=40&md5=c727db9f2082618cb279c0db74870ded

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