Systemic Diseases by Absorption Through the Skin

  • Hans DrexlerEmail author
  • Sonja Kilo
Reference work entry


The relevance to health of percutaneous absorption of hazardous substances is often underestimated.

The transdermal absorption of hazardous substances or pharmaceuticals usually requires exposure to just a few square centimeters of the skin in order to administer an effective dose to the body.

Skin contamination can occur in the workplace or in the general environment.

The systemic effects (acute intoxication, chronic intoxication, cancer) of substances are in principle independent of the uptake path.


Acetylcholinesterase poisoning ACGIH Amphiphilic Aromatic amines Benzene Bladder cancer Dimethylformamide Dinitrotoluene Internal exposure MAK Mercury Pesticides Skin notation Skin-absorbable substances Transdermal Warfare agents 


  1. Bader M, Wrbitzky R, Blaszkewicz M, Schaper M, van Thriel C (2008) Human volunteer study on the inhalational and dermal absorption of N-methyl-2-pyrrolidone (NMP) from the vapour phase. Arch Toxicol 82(1):13–20. Scholar
  2. Drexler H (1998) Assignment of skin notation for MAK values and its legal consequences in Germany. Int Arch Occup Environ Health 71(7):503–505CrossRefGoogle Scholar
  3. IPCS (1991) Environmental health criteria 114 dimethylformamide. WHO, GenevaGoogle Scholar
  4. Johanson G, Boman A (1991) Percutaneous absorption of 2-butoxyethanol vapour in human subjects. Br J Ind Med 48(11):788–792PubMedPubMedCentralGoogle Scholar
  5. Kennedy GL, Brock WJ, Banerjee AK (1993) Assignment of skin notation for threshold limit values chemicals based on acute dermal toxicity. Appl Occup Environ Hyg 8(1):26–30. Scholar
  6. Kesavachandran CN, Fareed M, Pathak MK, Bihari V, Mathur N, Srivastava AK (2009) Adverse health effects of pesticides in agrarian populations of developing countries. Rev Environ Contam Toxicol 200:33–52. Scholar
  7. Kilo S, Zonnur N, Uter W, Göen T, Drexler H (2015) Effect of skin protection and skin irritation on the internal exposure to carbon disulfide in employees of the viscose industry. Ann Occup Hyg 59(8):972–981. Scholar
  8. Kilo S, Göen T, Drexler H (2016) Cross-sectional study on N,N-dimethylformamide (DMF); effects on liver and alcohol intolerance. Int Arch Occup Environ Health 89(8):1309–1320. Scholar
  9. Korinth G, Weiss T, Penkert S, Schaller KH, Angerer J, Drexler H (2007) Percutaneous absorption of aromatic amines in rubber industry workers: impact of impaired skin and skin barrier creams. Occup Environ Med 64(6):366–372. Scholar
  10. Letzel S, Göen T, Bader M, Angerer J, Kraus T (2003) Exposure to nitroaromatic explosives and health effects during disposal of military waste. Occup Environ Med 60(7):483–488CrossRefGoogle Scholar
  11. Nierenberg DW, Nordgren RE, Chang MB et al (1998) Delayed cerebellar disease and death after accidental exposure to dimethylmercury. N Engl J Med 338(23):1672–1676. Scholar
  12. Nies E, Korinth G (2008) Commentary on “Penetration of benzene, toluene and xylenes contained in gasolines through human abdominal skin in vitro”. Toxicol In Vitro 22(1):275–277. Scholar
  13. Nies E, Barrot R, Drexler H et al (2005) Perkutane Aufnahme von Benzol – Folgerungen für die retrospektive Expositionsabschätzung. Arbeitsmed Sozialmed Umweltmed 40:585–594Google Scholar
  14. Schaller KH, Drexler H (1995) N,N-dimethylformamide. In: Greim H, Lehnert G (eds) The MAK–collection for occupational health and safety part II: BAT value documentations (DFG). VCH, Weinheim, pp 52–57Google Scholar
  15. Sin KW, Tsang HF (2003) Large-scale mercury exposure due to a cream cosmetic: community-wide case series. Hong Kong Med J = Xianggang yi xue za zhi 9(5):329–334PubMedGoogle Scholar
  16. Triunfante P, Soares ME, Santos A, Tavares S, Carmo H, Bastos Mde L (2009) Mercury fatal intoxication: two case reports. Forensic Sci Int 184(1–3):e1–e6. Scholar
  17. Wellner T, Göen T, Drexler H (2006) Systemische Therapie durch dermale Applikation: Transdermale Therapeutische Systeme (TTS). Dermatol Beruf Umwelt 54(1):13–18CrossRefGoogle Scholar
  18. Wellner T, Lüersen L, Schaller KH, Angerer J, Drexler H, Korinth G (2008) Percutaneous absorption of aromatic amines – a contribution for human health risk assessment. Food Chem Toxicol 46(6):1960–1968. Scholar
  19. Weschler CJ, Bekö G, Koch HM et al (2015) Transdermal uptake of diethyl phthalate and di(n-butyl) phthalate directly from air: experimental verification. Environ Health Perspect 123(10):928–934. Scholar
  20. Woolf A, Burkhart K, Caraccio T, Litovitz T (1996) Self-poisoning among adults using multiple transdermal nicotine patches. J Toxicol Clin Toxicol 34(6):691–698. Scholar
  21. Wu ML, Deng JF (2009) Acute hemolysis caused by incidental trichlorfon exposure. J Chin Med Assoc: JCMA 72(4):214–218. Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Institute and Outpatient Clinic for Occupational, Social and Environmental MedicineFriedrich-Alexander-University, Erlangen-NürnbergErlangenGermany

Personalised recommendations