Complications and potential affecting factors of medicamentosa like dermatitis caused by occupational trichloroethylene exposure

Objective In order to improve the treatment of the medicamentosa-like dermatitis cases caused by occupational trichloroethylene exposure,the complications of these cases and their potential affecting factors were summarized and analyzed. Methods Clinical data of 186 hospitalized cases from 1997 to 2011 were collected and analyzed.Results Complications were found among 173 cases(93%,173/186),and the complications,in the order of frequency,were:electrolyte disturbances(78.5%, 146/186),secondary infections(61.3%,114/186),ocular lesions(30.6%,57/186),anemia(19.9%,37/186),diabetes mellituses (19.4,36/186),drug eruptions(18.8%,35/186),hypoglycemia(18.8%,35/186),bleedings(18.3%,34/186) and thrombocytopenia (17.2%,32/186).The stepwise logistic regression analysis showed that:1 ) there was a correlation between occurrence of complications and the improper therapy of glucocorticoid;2) the total dosage of glucocorticoid was an independent risk factor for secondary infections,electrolyte disturbances and ENT lesions;3) pulse glucocorticoid therapy was an independent risk factor for bleedings;4) both the pulse therapy and the first dosage of glucocorticoid were the independent risk factors for diabetes mellitus. The fatality rate of these cases was 7.5%(14/186),9 cases due to acute hepatic failure,4 cases due to severe infection and 1 due to fall injury.Conclusion The incidence of complications of these disease was high,which would be the leading cause of death among these cases.Standardized glucocorticoid therapy as well as the correct and timely diagnosis of the complications contributed to reduce the fatality of the disease.