Following several turbulent months for UK farmers, with outbreaks of foot and mouth and blue tongue, dermatologists have now discovered a disorder which affects the farmers themselves.
The strange disorder specifically targets the ears, which initially become hot, itchy and sore and soon suffer blistering and crusting which can be painful and unsightly. No other parts of the body are affected.
The symptoms are also confined to lambing season (which usually lasts from one to three months) and disappear promptly when lambing is over.
In some farmers, the blistering appears every year during lambing, in one case for the previous 30 years, and in all patients both ears are affected. It also occurs in farmers who are calving, but less frequently.
The condition was discovered by George Heathcote, a farmer from Hampshire and one of the study’s authors, who experienced blistering on his ears and consulted doctors in Southampton.
He said: “I was convinced that lambing was involved, so I decided to place a letter in Farmer’s Weekly magazine and equivalent overseas publications, asking other farmers with similar symptoms to contact me. I received responses from 69 affected UK farmers but, interestingly, none from abroad.”
The Southampton doctors reviewed his and four comparable cases seen over a four-year period, and discovered striking similarities that suggest a new skin disorder linked to the farming practice, which they named ‘lambing ears’.
The reasons for the phenomenon remain unclear, but the study’s authors suggest several possibilities.
Biopsies showed a similarity to ‘polymorphic light eruption’ (PLE), a rash that comes up after exposure to sunlight.
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This led to the idea that sunlight or artificial light sources could be part of the problem. The absence of reported cases in Australia, a sunny climate where lambing tends to take place outdoors, suggests that indoor artificial lighting is a more likely culprit than sunlight. However, this could also be due to the minimal contact with the sheep involved in outdoors farming.
It is also thought that lighting alone is not responsible, as the disorder only occurs specifically during lambing, whereas lighting is used for other farming practices throughout the year.
Consultant Dermatologist at Southampton General Hospital and one of the study’s authors, Professor Peter Friedmann said: “During shearing, which takes place in May or June and may be indoors or outdoors, the same farmers who suffer lambing ears can shear the sheep with no symptoms at all.
“This suggests that bodily fluids from the sheep, such as amniotic fluid, sac and placenta, or chemicals used as part of the process, play a part, although intriguingly, the disorder does not affect the hands, which have maximum contact with fluids and products involved in lambing.
“The disorder is far more common in farmers who conduct lambing indoors. Bodily fluids are the only unique factor at lambing time, and give another reason aside from natural lighting why ‘lambing ears’ may not occur in farmers who conduct lambing outdoors, as these farmers have far less contact with the ewes during the birth.”
Nina Goad of the British Association of Dermatologists said: “This study is fascinating and illustrates how dermatologists are coming up against new diseases all the time.
“Following foot and mouth and blue tongue, the discovery of a disease affecting the farmers themselves may seem like an extra blow. However, it is actually positive that the disorder has been identified and can now be shared with dermatologists across the UK, as it will allow for more research and shared knowledge. The next step is to carry out an epidemiological study to clearly define the numbers of farmers affected.”
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Notes to editors:
1. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.
2. Articles in the BJD can be viewed online: http://www.blackwell-synergy.com/loi/BJD
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3. Study details: ‘Lambing ears’: a blistering disorder affecting farmers at lambing time; to be published in British Journal of Dermatology (planned date Jan 2008), K. Heathcote, J.M. Theaker*, N. Gibbins, E. Healy², G.B. Heathcote³, P.S. Friedmann²
Departments of ENT Surgery, *Cellular Pathology and ²Dermatology, Southampton University Hospitals NHS Trust, Southampton S016 6YD, UK
³Warborne Farm, Hampshire, UK
4. The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
5. Blackwell Publishing is a leading society publisher, partnering with 665 medical, academic and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print.
For more information please contact: Nina Goad, Communications Manager, British Association of Dermatologists, Phone: 0207 391 6355, Email: nina@bad.org.uk, Website: www.bad.org.uk
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