Dogger Bank itch is a

cutaneous Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different de ...

condition characterized by a long-lasting

dermatitis Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can v ...

caused by exposure to the sea chervil, ''Alcyonidium diaphanum'', a bryozoan. The disease, common in fishermen who work in the

North Sea The North Sea lies between Great Britain, Norway, Denmark, Germany, the Netherlands and Belgium. An epeiric sea on the European continental shelf, it connects to the Atlantic Ocean through the English Channel in the south and the Norwegian S ...

, has been recognized by the Danish Workman's Compensation Act since 1939.

Signs and symptoms

Pathogenesis

(2-hydroxyethyl) dimethylsulfoxonium chloride

The

rash A rash is a change of the human skin which affects its color, appearance, or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cr ...

is caused by a type of cell-mediated

hypersensitivity Hypersensitivity (also called hypersensitivity reaction or intolerance) refers to undesirable reactions produced by the normal immune system, including allergies and autoimmunity. They are usually referred to as an over-reaction of the immune s ...

reaction; this type of hypersensitivity normally occurs in people who become sensitized to

volatile organic compounds Volatile organic compounds (VOCs) are organic compounds that have a high vapour pressure at room temperature Colloquially, "room temperature" is a range of air temperatures that most people prefer for indoor settings. It feels comfortable to a ...

. Although in some instances several years may be required to develop sensitivity, this time period may vary greatly depending on the individual. In Dogger Bank itch, sensitivity is acquired after repeated handling of the sea chervils that become entangled in fishing nets. The specific toxin responsible for the rash was determined to be the

sulfur Sulfur (or sulphur in British English) is a chemical element with the symbol S and atomic number 16. It is abundant, multivalent and nonmetallic. Under normal conditions, sulfur atoms form cyclic octatomic molecules with a chemical formula ...

-bearing

salt Salt is a mineral composed primarily of sodium chloride (NaCl), a chemical compound belonging to the larger class of salts; salt in the form of a natural crystalline mineral is known as rock salt or halite. Salt is present in vast quantitie ...

(2-hydroxyethyl) dimethylsulfoxonium chloride. This salt is also found in some

sea sponges Sponges, the members of the phylum Porifera (; meaning 'pore bearer'), are a basal animal clade as a sister of the diploblasts. They are multicellular organisms that have bodies full of pores and channels allowing water to circulate through ...

and has potent

in vitro ''In vitro'' (meaning in glass, or ''in the glass'') studies are performed with microorganisms, cells, or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in biology an ...

activity against

leukemia Leukemia ( also spelled leukaemia and pronounced ) is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called ''blasts'' or ' ...

cells.

Treatment

A study of two cases in 2001 suggests that the rash responds to oral

ciclosporin Ciclosporin, also spelled cyclosporine and cyclosporin, is a calcineurin inhibitor, used as an immunosuppressant medication. It is a natural product. It is taken orally or intravenously for rheumatoid arthritis, psoriasis, Crohn's disease, ...

. Initial treatment with oral and topical

steroid A steroid is a biologically active organic compound with four rings arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter membrane fluidity; and a ...

s failed.

Epidemiology

The causative agent, ''A. diaphanum'' (formerly ''A. gelatinosum''), is a bryozoan, a class of animals consisting of minute,

sessile Sessility, or sessile, may refer to: * Sessility (motility), organisms which are not able to move about * Sessility (botany), flowers or leaves that grow directly from the stem or peduncle of a plant * Sessility (medicine), tumors and polyps that ...

, filter-feeding animals that live in colonies. ''A. diaphanum'' is a gelatinous, smooth, sponge-like colony up to long, growing on rocks and shells from lower shore down to approximately ; superficially, they resemble seaweed. The distribution of this animal is from the North Sea to the Mediterranean. The disease is especially prevalent among trawlermen working in the

Dogger Bank Dogger Bank (Dutch: ''Doggersbank'', German: ''Doggerbank'', Danish: ''Doggerbanke'') is a large sandbank in a shallow area of the North Sea about off the east coast of England. During the last ice age the bank was part of a large landmass c ...

, an important fishing bank in the

. It has also been reported from the

Baie de la Seine The Baie de Seine (Bay of the Seine River) is a bay in northern France. Geography It is a wide, rectangular inlet of the English Channel, approximately 100 kilometres (east-west) by 45 kilometres, bounded in the west by the Cotentin Peninsula, i ...

in France.

History

A medical case reported in 1957 tells of a fishing captain who worked in the

in the North Sea. The sea chervil, abundant in the area, frequently came up with the fishing nets and had to be thrown back into the water. After doing this repeatedly, the captain "developed an itching red eruption on the flexor aspects of the elbows and forearms which became moist, oozed serum, and spread to involve the backs of the hands, fingers and most of the arms within a few days." Although the

disappeared after leaving the area, it reappeared with greater severity when he returned to the area and performed the same activities; this time the rash spread to his neck and face, and continued to ooze serum for two months.

References