Saving the Barrier by Prevention.

One third of all occupation-related diseases are diseases of the skin, and in most of these cases the skin barrier is involved. Professions such as metalworkers, hairdressers, and health care and construction workers are mainly affected. Among them, contact dermatitis is the leading skin disease. It usually presents as hand eczema caused by or leading to impaired barrier function. All this significantly impacts the function of the hands, reduces the ability to work and especially impairs the patient's quality of life. Diagnostics and therapy are of great importance; in addition, prevention programs are meanwhile an important mainstay of the overall therapeutic concept. They comprise measures of secondary (outpatient) and tertiary (inpatient) prevention. Secondary prevention measures include occupation-tailored teaching and prevention programs, and the dermatologist's examination and report. In severe cases or if therapy is not successful in the long term, or if the diagnosis is not clear, measures of tertiary prevention may come into action. They are offered as an inpatient treatment and prevention program. The aims are prevention of the job loss, but especially to reach a long-term healing up and getting back to normal occupational and leisure life in the sense of attaining full quality of life. During the last years, research in Germany has shown that the different measures of prevention in occupational dermatology are very effective. This integrated concept of an in-/outpatient disease management reveals remarkable pertinent efficacy for patients with severe occupational dermatoses in at-risk professions.