Causes
There are a number of different causes of skin inflammation of the hands, the interplay of which is also significant: environmental factors such as excessive water; contact with allergens or irritants; and genetic disposition. A single catalyst is seldom responsible for the development of hand eczema in patients. Differences according to catalysts
Three main factors play an essential role in the development of chronic hand eczema: excessive contact with water and irritants (cumulative-toxic stress), contact with allergens, and atopic diathesis, which has a genetic component. Individual hand eczema types are identified and named according to the main catalysts involved, i.e. cumulative-toxic, contact-allergenic, or atopic hand eczema. Activities that are stressful for the skin or involve repeated, excessive contact with water or skin-irritating substances at work or home can cause damage to the skins protective abilities and increase the chances of inflammation. This also applies to prolonged wearing of protective rubber gloves and similar materials, since sweating occurs within these gloves. Disturbance of the skins protective barrier also facilitates penetration by allergenic substances and promotes the development of contact dermatitis. Contact allergies play a very important role in the development of hand eczema. If the hand is subjected to repeated contact with a substance that leads to an allergy, the skin reacts with signs of inflammation. Numerous people affected by hand eczema also experience skin inflammation on their feet. Often, a contact allergy to an ingredient in shoe leather treatment may be the catalyst.
Chapare mammarenavirus or Chapare virus is a virus from the family Arenaviridae which causes a hemorrhagic fever in humans known as Chapare hemorrhagic fever. It was first described after an outbreak of a novel zoonotic mammarenavirus infection occurred in the village of Samuzabeti, Chapare Province, Bolivia, in January 2003. A small number of people were infected and one person died.In 2019, nine people became infected with the virus in the La Paz regional area, four of whom died. Nosocomial and human-to-human transmission of the virus occurred in at least three of the cases which resulted in the death of a medical intern and a gastroenterologist. Like other members of the Arenavirus family, the specific zoonotic reservoir and primary transmission vector is suspected to be a rodent, probably the small-eared pygmy rice rat. Virology
The Chapare virus is an enveloped virus with a bi-segmented single-stranded ambisense RNA genome. The two RNA segments are denoted Small (S) and Large (L). It belongs to the New World Clade B lineage of mammarenaviruses and is most closely related to the Sabia virus. Symptoms
After an incubation period of around 9–19 days, initial symptoms include fever, malaise, headache, myalgia, back pain, dizziness, nausea, vomiting and diarrhoea. The disease often progresses to include hemorrhagic and neurological symptoms, such as gingival hemorrhage, anaemia, leukopaenia, confusion, seizures, echymoses, bleeding from mucous membranes, hemorrhagic shock and multi-organ failure.Chapare virus RNA was detected in the blood, urine, conjunctiva, semen and in broncho-alveolar and nasopharyngeal samples of the infected patients.