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Visual Treats in Dermatology
2023
:3;
117
doi:
10.25259/CSDM_134_2023

Occupational marks

Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Corresponding author: Logamoorthy Ramamoorthy, Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. logamoorthy.r@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Ramamoorthy L, Ramar S. Occupational marks. CosmoDerma 2023;3:117.

A 36-year-male coconut tree climber presented with asymptomatic hyperpigmentation and thickening over the bilateral dorsum of the foot. There is no history of itching or oozing. These lesions have been present for the past 15 years, resulting from using a belt over the ankle for climbing coconut trees. On examination, skin over the dorsum of both feet was hyperpigmented and lichenified [Figure 1]. Bilateral palms and soles showed diffuse thickening of the palms with focal yellowish callosities and loss of dermatoglyphic markings [Figure 2]. Based on the history and clinical examination, a diagnosis of occupational marks secondary to friction was made, and the patient was counseled about this.

Figure 1:
Hyperpigmented and lichenified plaques over the dorsum of both feet.
Figure 2:
Palms showing diffuse thickening with focal callosities and loss of dermatoglyphics.

Occupational marks are due to the effect of a particular occupation on the worker’s skin. Coconut tree climbing is common in southern Indian states such as Tamil Nadu, Kerala, and Karnataka. Gripping the tree with the belt over the ankle and shoulder and then pushing up the body to climb higher results in intermittent pressure over the ankle and palms. In response to friction, there is a steady rate of increase in epidermal turnover and laying down of thickened, vertically oriented collagen bundles in the papillary dermis, resulting in lichenification.[1] Occupational marks such as lichenification and hyperpigmentation over the forearms, legs, and dorsum of the foot, thickening of palms and soles, callosities, and nail damage can be seen in coconut tree climbers. Our case highlights the severe degree to which the skin can adapt in response to frictional forces in this unique occupation.

Declaration of patient consent

Patient’s consent not required as patients identity is not disclosed or compromised.

Conflicts of interest

There are no conflicts of interest.

Use of artificial intelligence (AI)-assisted technology for manuscript preparation

The authors confirm that there was no use of Artificial Intelligence (AI)-Assisted Technology for assisting in the writing or editing of the manuscript and no images were manipulated using the AI.

Financial support and sponsorship

Nil.

References

  1. , , . Occupational marks in a coconut tree climber. Indian J Dermatol Venereol Leprol. 2006;72:311-2.
    [CrossRef] [PubMed] [Google Scholar]

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