CHLORACNE IN THE 1990s

Vazquez, E Rosas; Macías, Pablo Campos; Tirado, J G Ochoa; Solana, C Garcia; Casanova, Álvaro; Moncada, J F Palomino

doi:10.1111/j.1365-4362.1996.tb03689.x

Cited by 28 publications

(8 citation statements)

References 7 publications

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“…The lesions may occasionally be accompanied by skin or systemic manifestations (table 4) [10,11,12,13] that vary in extent depending on the degree and duration of exposure to dioxin. Chloracne can arise at any age.…”

Section: Discussionmentioning

confidence: 99%

Chloracne: Still Cause for Concern

Passarini

Infusino

Kasapi³

2010

Dermatology

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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.

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Section: Discussionmentioning

confidence: 99%

Chloracne: Still Cause for Concern

Passarini

Infusino

Kasapi³

2010

Dermatology

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“…This is also characterised by many comedones [33, 34, 35, 36]. Indeed, comedonal acne is a hallmark of this disease (fig.…”

Section: Comedonal Typesmentioning

confidence: 99%

Comedogenesis: Some Aetiological, Clinical and Therapeutic Strategies

et al. 2003

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Hypercornification is an early feature of acne and usually precedes inflammation. It is associated with ductal hyperproliferation, and there are many controlling factors such as androgens, retinoids, sebum composition and cytokines. Cycling of normal follicles and of comedones may explain the natural resolution of comedones and, in the longer term, resolution of the disease itself. There is a need to tailor treatment according to comedonal type. Suboptimal therapy can often result from inappropriate assessments of comedones, especially microcomedones, sandpaper comedones, submarine comedones and macrocomedones. Macrocomedones can produce devastating acne flares, particularly if patients are inappropriately prescribed oral isotretinoin. Gentle cautery under topical local anaesthesia is a useful therapy in the treatment of such lesions. The newer retinoids and new formulations of all-trans-retinoic acid show a better benefit/risk ratio.

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“…HCBz is very persistent and toxic compound. [33] This is because of relatively small CBzs content of the Halowaxes and in parallel also to a much higher potency of some CN congeners as dioxin-like compounds itself than of chlorobenzenes.…”

Section: Resultsmentioning

confidence: 99%

“…[21,22] The presence of HCBz, PeCBz, and unidentified TeCBz and TrCBz was observed in the ecosystem of the costal area of the Skagerrack (Norway) due to discharge of contaminated effluents after magnesium manufacture up to the 1970s. [31][32][33][34][35] Those two groups of compounds from a several decades of years also contaminate the environment on a global scale. [24][25][26][27][28][29][30] Occupational exposure to technical mixtures of chloronaphthalenes but also of chlorobenzenes led to toxic outbreaks including chloracne.…”

Section: Introductionmentioning

confidence: 99%

By-Side Impurities in Chloronaphthalene Mixtures of the Halowax Series: All 12 Chlorobenzenes

Noma

Yamamoto

Falandysz

et al. 2004

Journal of Environmental Science and Health, Part A

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Total chlorobenzene content of the Halowax mixtures ranged from 1100 to 9800 ng/g. A lower chlorinated Halowax 1031 and 1000 were a several times more contaminated with chlorobenzenes than higher chlorinated Halowax 1001, 1099, 1013, 1014, or 1051. Depending on the type of the Halowax mixture the most contributing amongst of chlorobenzene homologue groups were di-, tetra-, penta-, and hexa-CBz. A dominance and specific profile of 1,4-DiCBz, PeCBz, and HCBz were characteristic to Halowax 1001, 1099, 1013, 1014, and 1051, while for other formulation the CBzs profile varied, and 1,2,3,4-TeCBz (Halowax 1031) and 1,4-DiCBz (Halowax 1000) predominated. A steric hindrance effect seems to direct a preferential by-side formation of 1,4-DiCBz and further also of PeCBz and HCBz due to relatively elevated temperature as well as duration time of synthesis for five most chlorinated (49-70 Cl%) chloronaphthalene Halowax formulations.

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CHLORACNE IN THE 1990s

Abstract: Every patient exposed to halogenated compounds with the cutaneous manifestations of chloracne should be carefully investigated for systemic complications (such as ophthalmic, neuropathic, hepatic, and lipoprotein abnormalities).

Cited by 28 publications

References 7 publications

Chloracne: Still Cause for Concern

Chloracne: Still Cause for Concern

Comedogenesis: Some Aetiological, Clinical and Therapeutic Strategies

By-Side Impurities in Chloronaphthalene Mixtures of the Halowax Series: All 12 Chlorobenzenes

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