Chloracne

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Chloracne
Chloracne in a herbicide worker
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Cysts, comedones, pustules, nodules
Complications	Scarring, hyperpigmentation
Onset	Delayed, typically weeks to months after exposure
Duration	Can be long-lasting, sometimes years
Types	N/A
Causes	Exposure to chlorinated hydrocarbons such as dioxins
Risks	Occupational exposure, industrial accidents
Diagnosis	Clinical examination, biopsy
Differential diagnosis	Acne vulgaris, rosacea, folliculitis
Prevention	Avoidance of exposure to causative chemicals
Treatment	Topical retinoids, oral retinoids, dermabrasion
Medication	N/A
Prognosis	Variable, can be persistent
Frequency	Rare
Deaths	N/A

Chloracne

Chloracne in herbicide worker

Chloracne is a rare skin condition that is caused by exposure to certain toxic chemicals, particularly dioxins and polychlorinated biphenyls (PCBs). It is characterized by acne-like eruptions on the skin, primarily affecting the face, neck, and upper body. Chloracne is considered a hallmark of dioxin exposure and is often used as a clinical indicator of such exposure.

Pathophysiology

Chloracne results from the toxic effects of certain halogenated aromatic compounds on the skin. These compounds, such as dioxins, interfere with the normal function of the sebaceous glands, leading to the formation of cysts and comedones. The exact mechanism involves the activation of the aryl hydrocarbon receptor (AhR), which alters the expression of genes involved in skin homeostasis and sebaceous gland function.

Clinical Presentation

The clinical presentation of chloracne includes the development of blackheads, cysts, and pustules. These lesions are most commonly found on the cheeks, behind the ears, in the armpits, and in the groin area. The severity of chloracne can vary, with some individuals experiencing mild symptoms and others developing severe, disfiguring lesions.

Diagnosis

Diagnosis of chloracne is primarily clinical, based on the characteristic appearance of the skin lesions and a history of exposure to potential causative agents. In some cases, a skin biopsy may be performed to confirm the diagnosis. Laboratory tests to measure levels of dioxins or PCBs in the blood or tissues can also support the diagnosis.

Treatment

Viktor Yuschenko with chloracne

Treatment of chloracne focuses on reducing exposure to the causative agent and managing the skin lesions. Topical and systemic treatments used for acne, such as retinoids and antibiotics, may be employed. In severe cases, surgical intervention may be necessary to remove large cysts or nodules. However, the condition can be persistent and difficult to treat, especially if exposure to the causative agent continues.

Epidemiology

Chloracne is a rare condition, primarily affecting individuals who have been exposed to high levels of dioxins or PCBs. Occupational exposure is a common cause, particularly in industries involved in the production or use of these chemicals. Notable cases of chloracne have occurred in industrial accidents and environmental contamination incidents.

Notable Cases

One of the most well-known cases of chloracne involved Viktor Yushchenko, the former President of Ukraine, who developed the condition after being poisoned with dioxin in 2004. His case brought significant public attention to the condition and its association with dioxin exposure.

Prevention

Preventing chloracne involves minimizing exposure to dioxins and PCBs. This can be achieved through the use of protective equipment in occupational settings, proper handling and disposal of hazardous materials, and adherence to environmental regulations aimed at reducing emissions of these compounds.

See also

• Dioxin
• Polychlorinated biphenyl
• Acne
• Occupational safety and health