Chlorothalonil, a possible cause of erythema dyschromicum perstans (ashy dermatitis)*

Abstract

We studied 39 patients with erythema-dyschromicum-perstans-like dermatitis seen at Changuinola Hospital in Panama. They were compared with 41 controls. The 2 groups were native field workers of the banana plantations exposed to many pesticides. In 34 patients, there was a positive patch test reaction to 2,4,5,6-1,3-tetrachloroisophthalonilnitrile (chlorothalonil, TCPN) 0.001% in acetone. In 39 cases, biopsies showed a lichenoid tissue reaction compatible with a chronic pigmented dermatitis or erythema-dyschromicum-perstans-like dermatitis. Chlorothalonil is possibly the cause of the pigmented dermatitis observed in the 39 banana farm workers studied. Until additional studies are carried out, we consider this a possible rather than definite cause-and-effect relationship.

Erythema Discromicum Perstans Related with Oral Contraceptive and Progesterone Injections

“…EDP may be viewed as originating at an early stage as an inflammatory reaction to an ingested agent or contactant or a chemical, followed by a progressive persistent hyperpigmentation (1). In the literature, EDP has been linked with a number of conditions including endocrinopathies, nematode infestations, pesticide exposure, human immunodeficiency virus and chronic hepatitis C infections, ammonium nitrate consumption, cobalt allergy, radiological contrast material, and medications such as oral antibiotics, benzodiazepine, omeprazole (1)(2)(3)(4)(5)(6)(7)(8)(9).…”

“…It typically occurs in the second decade of life and generally affects those with skin phototype IV (2)(3)(4)(5)(6)(7)(8). The etiology of EDP is unknown but associations with endocrinopathies, infestations, infections, and drug allergies have been reported (2)(3)(4)(5)(6)(7)(8)(9).…”

Dermatosis cenicienta: revisión y diagnóstico diferencial con otros trastornos pigmentarios idiopáticos

“…La enfermedad también ha sido asociada a la ingesta de nitrato de amonio en un paciente 7 , a la ingesta de un medio de contraste radiográfico en otro caso 8 y más recientemente se la ha relacionado con el Virus de la Inmunodeficiencia Humana 9,10 . Existen otros casos descritos en relación al pesticida clorotalinol 11 y al fungicida fucilade 12 . En otro caso, en un paciente portador de una dermatitis de contacto al cobalto, hubo recurrencia de lesiones en relación a la exposición 13 .…”

Pesticides and Contact Urticaria Syndrome

“…It is also used as fungicide in wood preservation and as a preservative in paints. It can induce CUS and anaphylactic symptoms, allergic and irritant contact dermatitis, erythema dyschromicum perstans, and folliculitis, mainly in agricultural workers (Boman et al, 2000;Dannaker and Maibach, 1990;Dannaker et al, 1993;Lensen et al, 2007;Penagos et al, 1996). Dannaker and Maibach (1990) and Dannaker et al (1993) reported a nursery worker who developed facial erythema and edema accompanied by immediate respiratory symptoms, such as a tight chest and throat after entering the nursery greenhouse, without direct skin contact with chlorothalonil.…”