A family in Taiwan is reported to have Mai de Meleda with possibly autosomal recessive inheritance among 5 of its members. The glove- and sock-like erythrokeratosis and the hyperkeratotic plaques of the knees and elbows are the common features. Erythema of the nose, cheeks, and the perioral area in 4 affected members, actinic elastosis in 2 severely affected members, and partially impaired cell-mediated immunity in vitro in both affected and unaffected members are notable findings. Tigason (etretinate) treatment was beneficial in regard to hyperkeratinization, but not to erythema.
An outbreak of poisoning, characterized clinically by hyperpigmentation and a chloracne-like eruption. broke out in mid-Taiwan in Feburary 1979. Probably over a thousand persons were affected. The source of poisoning was found to be a specific brand of rice bran oil which was contaminated accidentally with polychlorinated biphenyls (PCB). PCB was detected from suspected oil samples in concentrations of 40 to 106 ppm. The blood PCB levels were 70 to 460 ppb in some patients. The amount of oil consumed by the individual patients was approximately one liter per month.A total of 358 cases of suspected rice bran oil poisoning was seen in the special clinics of Provincial Taichung Hospital and National Taiwan University Hospital. There were 171 males and 187 females. aged between 7 days and 78 years. Half of the patients were aged 11 to 30 years. One hundred and twenty-three patients were from families and the rest were groups from Hwei-Ming Blind School. factories. and temples.In general. the age distribution of the patients. the symptomatology. the skin pathology and the way the poisoning occurred, were similar to those of Yusho patients. However. differences were noted in some clinical signs, namely a higher incidence of hyperpigmentation and a lower incidence of acneform eruption in our series when compared with Goto's series. It is speculated that this may be partly due to different isomers or concentrations of PCB in the blood and tissues.
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