Dermatology
Original Paper
Chloracne: Still Cause for ConcernPassarini B. · Infusino S.D. · Kasapi E.Department of Internal Medicine, Aging and Nephrological Diseases, Dermatologic Clinic, S. Orsola-Malpighi, University of Bologna, Bologna, Italy
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: March 27, 2009
Accepted: January 19, 2010
Published online: May 13, 2010
Issue release date: August 2010
Number of Print Pages: 8
Number of Figures: 13
Number of Tables: 4
ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)
For additional information: https://www.karger.com/DRM
Abstract
Chloracne, first described by Herxheimer in 1899, is a dermatosis consisting of more or less diffuse acneiform lesions distributed prevalently on the face and on body areas not usually affected by acne and caused by chronic or acute exposure to halogenated chemical compounds. Dioxin is the common name for dibenzo-p-dioxins and dibenzofurans, contaminants nearly ubiquitous in the environment and highly resistant to chemical and biological degradation. These compounds can survive for decades in the environment and accumulate in the human and animal food chains. Chloracne is characterized by the onset of numerous comedo-like lesions and yellowish cysts on the face, particularly on the cheeks, that can spread to the trunk and other body regions not usually affected by acne vulgaris, with diffuse grayish skin pigmentation and sometimes associated with hypertrichosis and areas of folliculitis. The lesions may occasionally be accompanied by skin or systemic manifestations. We report 9 cases of chloracne, 8 of them with rapid onset in patients residing in the same building, and 1 in a patient occupationally exposed to halogenated compounds. In our series, the doses of dioxin and polychlorinated biphenyls in the soil, water and plant material, and the serum titer of dioxin were within the normal range. This consideration raises the issue of the need to revise the serum threshold for dioxin poisoning and the environmental threshold. We wish also to underline the value of dermatopathology in the differential diagnosis of chloracne.
© 2010 S. Karger AG, Basel
Related Articles:
References
-
Herxheimer K: Über Chlorakne. Münch Med Wochenschr 1899;46:278.
- Pesatori AC, Consonni D, Rubagotti M, Grillo P, Bertazzi PA: Cancer incidence in the population exposed to dioxin after the ‘Seveso accident’: twenty years of follow-up. Environ Health 2009;8:39.
-
Needham LL, Gerthoux PM, Patterson DG Jr, Brambilla P, et al: Serum dioxin levels in Seveso, Italy, population in 1976. Teratog Carcinog Mutagen 1997–98;17:225–240.
- Eskenazi B, Mocarelli P, Warner M, Needham L, et al: Relationship of serum TCDD concentrations and age at exposure of female residents of Seveso, Italy. Environ Health Perspect 2004;112:22–27.
- Baccarelli A, Pesatori AC, Consonni D, Mocarelli P, Patterson DG Jr, Caporaso NE, Bertazzi PA, Landi MT: Health status and plasma dioxin levels in chloracne cases 20 years after the Seveso, Italy, accident. Br J Dermatol 2005;152:459–465.
-
Collins JJ, Budinsky RA, Burns CJ, Lamparski LL, Carson ML, Martin GD, Wilken M: Serum dioxin levels in former chlorophenol workers. J Expo Anal Environ Epidemiol 2006;16:76–84.
External Resources
- Violante FS, Milani S, Malenchini G, Barbieri A: Chloracne due to o-dichlorobenzene in a laboratory worker. Contact Dermatitis 2005;52:108.
- Cellini A, Offidani A: An epidemiological study on cutaneous diseases of agricultural workers authorized to use pesticides. Dermatology 1994;189:129–132.
- Baccarelli A, Pfeiffer R, Consonni D, Pesatori AC, et al: Handling of dioxin measurement data in the presence of non-detectable values: overview of available methods and their application in the Seveso chloracne study. Chemosphere 2005;60:898–906.
- Pelclova D, Fenclova Z, Preiss J, Prochazka B: Lipid metabolism and neuropsychological follow-up study of workers exposed to 2,3,7,8-tetrachlordibenzo-p-dioxin. Int Arch Occup Environ Health 2002;75(suppl): S60–S66.
- Bertazzi PA, Bernucci I, Brambilla G, Consonni D, Pesatori AC: The Seveso studies on early and long-term effects of dioxin exposure: a review. Environ Health Perspect 1998;106(suppl 2):625–633.
- Rosas Vazquez E, Campos Macias P, Ochoa Tirado JG, Garcia Solana C, et al: Chloracne in the 1990s. Int J Dermatol 1996;35:643–645.
- Bock KW, Kohle C: Ah receptor- and TCDD-mediated liver tumor promotion: clonal selection and expansion of cells evading growth arrest and apoptosis. Biochem Pharmacol 2005;69:1403–1408.
- Pastor MA, Carrasco L, Izquierdo MJ, Farina MC, et al: Chloracne: histopathologic findings in one case. J Cutan Pathol 2002;29:193–199.
-
Abell E: Inflammatory diseases of the epidermal appendages and of cartilage; in Elder D, Elenitsas R, Jaworsky C, Johnson Jr (eds): Lever’s Histopathology of the Skin, ed 8. Philadelphia, Lippincott-Raven Publishers, 1997, pp 403–421.
- Lee S, Park SG, Lee MG: Chloracne with acantholytic dyskeratosis associated with herbicides: a new histological variant? J Am Acad Dermatol 2004;50:E8.
- Yamamoto O, Tokura Y: Photocontact dermatitis and chloracne: two major occupational and environmental skin diseases induced by different actions of halogenated chemicals. J Dermatol Sci 2003;32:85–94.
- Baccarelli A, Pesatori AC, Masten SA, Patterson DG Jr, Needham LL, Mocarelli P, Caporaso NE, Consonni D, Grassman JA, Bertazzi PA, Landi MT: Aryl-hydrocarbon receptor-dependent pathway and toxic effects of TCDD in humans: a population-based study in Seveso, Italy. Toxicol Lett 2004;149:287–293.
- Mimura J, Fujii-Kuriyama Y: Functional role of AhR in the expression of toxic effects by TCDD. Biochim Biophys Acta 2003;1619:263–268.
- Mandal PK: Dioxin: a review of its environmental effects and its aryl hydrocarbon receptor biology. J Comp Physiol B 2005;175:221–230.
- Warner M, Eskenazi B, Patterson DG, Clark G, Turner WE, Bonsignore L, Mocarelli P, Gerthoux PM: Dioxin-like TEQ of women from the Seveso, Italy, area by ID-HRGC/HRMS and CALUX. J Expo Anal Environ Epidemiol 2005;15:310–318.
Article / Publication Details
Received: March 27, 2009
Accepted: January 19, 2010
Published online: May 13, 2010
Issue release date: August 2010
Number of Print Pages: 8
Number of Figures: 13
Number of Tables: 4
ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)
For additional information: https://www.karger.com/DRM
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
