iPedia Free Information Center

Information about Chloracne


Classification & external resources
An example of chloracne on Viktor Yushchenko
ICD-10L70.8
DiseasesDB31706
eMedicinetopic/620 
(Acneiform Eruptions)
Chloracne is an acne-like eruption of blackheads, cysts, and pustules associated with over-exposure to certain halogenated aromatic hydrocarbons, such as chlorinated dioxins and dibenzofurans. The lesions are most frequently found on the cheeks, behind the ears, in the armpits and groin region.

The condition was first described in German industrial workers in 1897 by Von Bettman, and was initially believed to be caused by exposure to toxic chlorine (hence the name "chloracne"). It was only in the mid-1950s that chloracne was associated with aromatic hydrocarbons[1]. The substances that may cause chloracne are now collectively known as "chloracnegens".

Chloracne is particularly linked to toxic exposure to dioxins (byproducts of many chemical processes, including the manufacture of herbicides such as Agent Orange) — so much so that it is considered a clinical sign of dioxin exposure. The severity and onset of chloracne may follow a typical asymptotic dose-response relationship curve.

Etiology and progression

Chloracne normally results from direct skin contact with chloracnegens, although ingestion and inhalation are also possible causative routes.

Chloracnegens are fat-soluble, meaning they persist in the body fat for a very long period following exposure. Chloracne is a chronic inflammatory condition that results from this persistence, in combination with the toxin's chemical properties. It is believed, at least from rodent models, that the toxin activates a series of receptors promoting macrophage proliferation, inducing neutrophilia and leading to a generalised inflammatory response in the skin. This process may also be augmented by induction of excess tumor necrosis factor in the blood serum.

The inflammatory processes lead to the formation of keratinous plugs in skin pores, forming yellowish cysts and dark pustules. The skin lesions occur mainly in the face, but in more severe cases they involve the shoulders and chest, the back, and the abdomen. In advanced cases, the lesions appear also on the arms, thighs, legs, hands and feet.

In some instances, chloracne may not appear for three to four weeks after toxic exposure; however in other cases - particularly in events of massive exposure - the symptoms may appear within days [1][2].

Treatment

Once chloracne has been identified, the primary action is to remove the patient and all other individuals from the source of contamination. Further treatment is symptomatic.

Severe or persistent lesions may be treated with oral antibiotics or isotretinoin. However, chloracne may be highly resistant to any treatment.

The course of the disease is highly variable. In some cases the lesions may resolve within two years or so; however, in other cases the lesions may be effectively permanent (mean duration of lesions in one 1984 study was 26 years, with some workers remaining disfigured over three decades after exposure [3]).

Recent research by groups at University of Cincinnati School of Medicine in Ohio and the University of Western Australia indicated that PCB poisoning, including chloracne symptoms, can be treated with fat substitute olestra.

Related conditions

Chloracne is very often seen in combination with hyperhidrosis (clammy, sweaty skin) and porphyria cutanea tarda (a skin condition of increased pigmentation, hair coarsening and blistering).

Notable cases

  • 193 cases of chloracne occurred in Seveso, Italy in 1976 following the Seveso disaster in which several kilograms of TCDD were released into the atmosphere.
  • Hundreds of individuals suffered chloracne after chronic exposure to PCBs and PCDFs in central Taiwan in 1979.
  • Ukrainian President Viktor Yushchenko suffered from extremely prominent facial chloracne after being diagnosed with dioxin poisoning in late 2004. His diagnosis of chloracne was put forth by prominent toxicologist John Henry.

See also

References

1. ^ Williams, D.E.; Wolfe, W.H.; Lustik, M.B. et al. (1995). An Epidemiologic Investigation of Health Effects in Air Force Personnel Following Exposure to Herbicides. Vol. 4.
2. ^ De Marchia, B, and Ravetzb, J.R. (1999). Risk management and governance: a post-normal science approach. Futures 31:743–757.
3. ^ Moses, M. et al. (1984). American Journal of Industrial Medicine 5(3):161-82.

External links

Ukraine

This article is part of the series:
Politics and government of
Ukraine

  • Constitution
  • Parliament
  • President
  • Viktor Yushchenko
  • Cabinet

..... Click the link for more information.
For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
..... Click the link for more information.
List of ICD-10 codes. The version for 2007 is available online at [1]

Chapter Blocks Title
I Certain infectious and parasitic diseases
II Neoplasms
III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
..... Click the link for more information.
The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications.

It directly integrates the Unified Medical Language System.

External links

  • Diseases Database

..... Click the link for more information.
eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely, two medical doctors. It was sold to WebMD in January 2006.
..... Click the link for more information.
Acne
Classification & external resources

Acne of a 14 year old boy during puberty
ICD-10 L 70.0
ICD-9 706.1

DiseasesDB 10765
MedlinePlus 000873
eMedicine derm/2   Acne Vulgaris
..... Click the link for more information.
blackhead (medically known as an open comedo[1] , plural comedones [2]) is a yellowish or blackish bump or plug on the skin. A blackhead is a type of acne vulgaris. It is caused by excess oils that have accumulated in the sebaceous gland's duct.
..... Click the link for more information.
CYST see St. Theresa Point Airport.
For hard-shelled resting stages of some small organisms, see encystment.
A cyst (soft "c", rhymes with "list") is a closed sac having a distinct membrane and division on the nearby tissue.
..... Click the link for more information.
MeSH D000038 An abscess is a collection of pus that has accumulated in a cavity formed by the tissue on the basis of an infectious process (usually caused by bacteria or parasites) or other foreign materials (e.g. splinters or bullet wounds).
..... Click the link for more information.
halogens or halogen elements are a series of nonmetal elements from Group 17 (old-style: VII or VIIA; Group 7 IUPAC Style) of the periodic table, comprising fluorine, F; chlorine, Cl; bromine, Br; iodine, I; and astatine, At.
..... Click the link for more information.
An aromatic hydrocarbon (abbreviated as AH) or arene [1] is a hydrocarbon, the molecular structure of which incorporates one or more planar sets of six carbon atoms that are connected by delocalised electrons numbering the same as if they consisted of alternating
..... Click the link for more information.
1, 3, 5, 7
(strongly acidic oxide)
Electronegativity 3.16 (Pauling scale)
Ionization energies
(more) 1st: 1251.2 kJmol−1
2nd: 2298 kJmol−1
3rd: 3822 kJmol−1

Atomic radius 100 pm
Atomic radius (calc.
..... Click the link for more information.
Dioxin in its original usage denoted the organochemical heterocyclic compound with the general chemical formula C4H4O2 in which two CH groups of a benzene ring were replaced (endocyclic substitution) by oxygen atoms, of which two isomers were
..... Click the link for more information.
Dibenzofuran is a heterocyclic organic compound with the chemical structure shown at right. It is an aromatic compound that has two benzene rings fused to one furan ring in the middle.
..... Click the link for more information.
1, 3, 5, 7
(strongly acidic oxide)
Electronegativity 3.16 (Pauling scale)
Ionization energies
(more) 1st: 1251.2 kJmol−1
2nd: 2298 kJmol−1
3rd: 3822 kJmol−1

Atomic radius 100 pm
Atomic radius (calc.
..... Click the link for more information.
Dioxin in its original usage denoted the organochemical heterocyclic compound with the general chemical formula C4H4O2 in which two CH groups of a benzene ring were replaced (endocyclic substitution) by oxygen atoms, of which two isomers were
..... Click the link for more information.
A herbicide is used to kill unwanted plants. Selective herbicides kill specific targets while leaving the desired crop relatively unharmed. Some of these act by interfering with the growth of the weed and are often based on plant hormones.
..... Click the link for more information.
Agent Orange and "Super Orange" were the nicknames given to a herbicide and defoliant used by the United States Armed Forces in its Herbicidal Warfare program during the Vietnam War.
..... Click the link for more information.
An asymptote is a straight line or curve A to which another curve B (the one being studied) approaches closer and closer as one moves along it. As one moves along B, the distance between it and the asymptote A
..... Click the link for more information.
The Dose-response relationship describes the change in effect on an organism caused by differing levels of exposure (or doses) to a stressor (usually a chemical). This may apply to individuals (eg: a small amount has no observable effect, a large amount is fatal), or to populations
..... Click the link for more information.
In mathematics, the concept of a curve tries to capture the intuitive idea of a geometrical one-dimensional and continuous object. A simple example is the circle.
..... Click the link for more information.
Inflammation (Latin, inflammatio, to set on fire) is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants.
..... Click the link for more information.
Rodentia
Bowdich, 1821

Suborders

Sciuromorpha
Castorimorpha
Myomorpha
Anomaluromorpha
Hystricomorpha
Rodentia is an order of mammals also known as rodents
..... Click the link for more information.
For other uses, see Receptor.


In biochemistry, a receptor is a protein on the cell membrane or within the cytoplasm or cell nucleus that binds to a specific molecule (a ligand), such as a neurotransmitter, hormone, or other substance, and initiates
..... Click the link for more information.
Macrophages (Greek: "big eaters", from makros "large" + phagein "eat") are cells within the tissues that originate from specific white blood cells called monocytes.
..... Click the link for more information.
Neutrophilia (or neutrophil leukocytosis) is a condition where a person has a high number of neutrophil granulocytes in their blood.

Neutrophils are the primary white blood cells that respond to a bacterial infection, so the most common cause of marked neutrophilia is
..... Click the link for more information.
Tumor necrosis factors (or the TNF-family) refers to a group of cytokines family which can cause apoptosis.

Tumor necrosis factor-alpha is the most well known member of this class, and sometimes the term "tumor necrosis factor" is used to refer to this specific form.
..... Click the link for more information.
Blood plasma is the liquid component of blood, in which the blood cells are suspended. It makes up about 55% of total blood volume. Blood plasma is prepared simply by spinning a tube of fresh blood in a centrifuge until the blood cells fall to the bottom of the tube.
..... Click the link for more information.
Keratins are a family of fibrous structural proteins; tough and insoluble, they form the hard but nonmineralized structures found in reptiles, birds, amphibians and mammals. They are rivaled as biological materials in toughness only by chitin.
..... Click the link for more information.
In medicine, a disease is symptomatic when it is at a stage when the patient is experiencing symptoms. It is generally used in counterdistinction of asymptomatic (when the disease is inapparent).
..... Click the link for more information.


This article is copied from an article on Wikipedia.org - the free encyclopedia created and edited by online user community. The text was not checked or edited by anyone on our staff. Although the vast majority of the wikipedia encyclopedia articles provide accurate and timely information please do not assume the accuracy of any particular article. This article is distributed under the terms of GNU Free Documentation License.
Herod_Archelaus


page counter