Progressive Systemic Sclerosis Sine Scleroderma which Developed after Exposure to Epoxy Resin Polymerization

Inachi, Shin; Mizutani, Hitoshi; Ando, Yoko; Shimizu, Masayuki

doi:10.1111/j.1346-8138.1996.tb04028.x

Cited by 17 publications

(3 citation statements)

References 9 publications

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“…23 Scleroderma-like disease exposed to epoxy resin polymerization was also reported in a form of ssSSc. 24 It is an absolutely unique case of such a form of the disease.…”

Section: Special Situationsmentioning

confidence: 99%

Systemic sclerosis sine scleroderma

Kucharz¹,

Kopeć-Mędrek²

2017

Adv Clin Exp Med

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Systemic sclerosis is a rare generalized disease with scleroderma, i.e. skin thickening as one of the most common symptoms. The disease has 2 main subsets, diffuse and limited forms. The subset known as systemic sclerosis sine scleroderma (ssSSc) is a very rare subset characterized by the total or partial absence of cutaneous manifestations of systemic sclerosis with the occurrence of internal organ involvement and serologic abnormalities. The classification of ssSSc into 3 groups was proposed. Type I (complete) is characterized by the lack of any cutaneous changes typical for the disease at least until systemic sclerosisrelated insufficiency of any internal organ occurs. Type II (incomplete) is characterized by the absence of sclerodactyly, but other cutaneous involvements (e.g. calcifications, telangiectasies, pitting scars) can be found. Type III (delayed) is characterized by clinical internal organ involvement typical for systemic sclerosis that has appeared before skin changes (complete or incomplete). In general, the demographic and clinical characteristics of the ssSSc patients suggest that they are similar to those with diffuse or limited form of the disease. Diagnosis of ssSSc still remains difficult and this disease form should be considered in all cases of unexplained fibrotic involvement of the internal organs.

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“…23 Scleroderma-like disease exposed to epoxy resin polymerization was also reported in a form of ssSSc. 24 It is an absolutely unique case of such a form of the disease.…”

Section: Special Situationsmentioning

confidence: 99%

Systemic sclerosis sine scleroderma

Kucharz¹,

Kopeć-Mędrek²

2017

Adv Clin Exp Med

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“…Generalized morphea, defined by the presence of ≥4 morphea lesions (circumscribed or deep) in ≥2 anatomic locations, has been described in several workers engaged in the polymerization process of epoxy resins. 3 , 4 , 9 , 10 , 11 The mechanism of pathogenesis is unclear but may be caused by the accumulation of the amine, Bis(4-amino-3-methylcyclohexyl)methane (BAMM), derived from epoxy fumes, or to the binding of oligomers of epoxy resins with BAMM or biogenic amines in tissue. These changes in turn damage blood vessels and sympathetic nerve endings, eliciting sclerosis.…”

Section: Discussionmentioning

confidence: 99%

Generalized morphea/eosinophilic fasciitis overlap after epoxy exposure

et al. 2018

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Generalized morphea is associated with epoxy resin vapors and is characterized by the development of lesions shortly after exposure. Morphea presenting along with eosinophilic fasciitis (EF), or morphea/EF overlap, is rare and an indicator of poor prognosis and resistance to treatment. Here we present a case of generalized morphea/EF overlap linked to epoxy exposure. Our patient received multiple therapies—ultraviolet A1 phototherapy, prednisone, methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide, cyclosporine, and rituximab—none of which led to a significant response. The refractory nature of this disease warrants vigilance in its association with epoxy exposure.

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“…The role of organic solvents and other chemicals has been suspected as contributing to disease risk in scleroderma on the basis of several case reports [ (17,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45); for review see Silman and Hochberg(^6')](Table2). However, when these associations were tested in case-control studies, variable results were obtained.…”

Section: Solvent Exposurementioning

confidence: 99%

Epidemiologic Studies of Environmental Agents and Systemic Autoimmune Diseases

Mayes¹

1999

Environmental Health Perspectives

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Systemic lupus erythematosus and systemic scleroderma are autoimmune diseases thought to have an exogenous trigger. This review summarizes relevant case-control and cohort studies that investigated exogenous sex hormones, silica, silicone, solvents, pesticides, mercuric chloride, and hair dyes as putative risk factors for the development of these diseases. These studies indicate that estrogen replacement therapy in postmenopausal women increases the risk of developing lupus, scleroderma, and Raynaud disease, although the increase in risk is relatively modest. Oral contraceptives may also play a role in disease susceptibility in lupus but not apparently in scleroderma. Environmental endocrine modulators, in the form of pesticides, may represent another opportunity for estrogenlike effects to occur, but there is scant evidence that these agents play a role in human systemic autoimmune disease. Although exposure to silica dust increases the risk of scleroderma in men occupied in the industry, this does not explain most male scleroderma cases. When this exposure was investigated among women, no significant risk was found. Additionally, silicone in implanted devices as well as occupational exposure to silicone-containing compounds did not pose an increased risk among women for scleroderma. The role of solvent exposure has been investigated as a risk factor for scleroderma with mixed findings. One study suggested a potential role in male patients or in those individuals with Scl-70 antibody positivity either male or female. Two other studies were unable to corroborate this finding. Mercuric chloride causes antifibrillarin antibodies and immune complex glomerulonephritis in susceptible mouse strains. Antifibrillarin antibodies, but not glomerulonephritis, occur in a subset of scleroderma patients and preliminary evidence suggests that mercury levels may be higher in this group of individuals. Hair products have been studied as possibly raising the risk of developing lupus, since such products contain an aromatic amine similar to a compound known to cause drug-induced lupus. A 1986 study suggested a positive association, but two subsequent studies did not support this association.

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Progressive Systemic Sclerosis Sine Scleroderma which Developed after Exposure to Epoxy Resin Polymerization

Cited by 17 publications

References 9 publications

Systemic sclerosis sine scleroderma

Systemic sclerosis sine scleroderma

Generalized morphea/eosinophilic fasciitis overlap after epoxy exposure

Epidemiologic Studies of Environmental Agents and Systemic Autoimmune Diseases

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