Occupational Acne and

 

Chloracne

 

Several different groups of industrial compounds encountered in the workplace may cause acne. These include coal tar derivatives, insoluble cutting oils, and chlorinated hydrocarbons (chlornaphthalenes, chlordiphenyls, and chlordiphenyloxides). Chloracne is the term that is used to describe occupational acne caused from chlorinated hydrocarbons. Occupational acne tends to be quite inflammatory and, in addition to large comedones, is characterized by papules, pustules, large nodules, and true cysts. Tar acne is often accompanied by hyperpigmentation. The lesions of occupational acne are not restricted to the face and, in fact, are more common on covered areas with intimate contact to clothing saturated with the offending compound. Because the cutting oils are so widely used, they are the most common cause of industrial acne. However, the chlorinated hydrocarbons, which cause chloracne, have posed a more difficult problem because of the severity of the disease induced with these compounds. Exposure can cause comedones, cysts, and pigmentary changes of the skin but can also affect the ophthalmic, nervous, and hepatic systems. Many cases have occurred as the result of massive exposure in industrial accidents. Chlorinated hydrocarbons are found in fungicides, insecticides, and wood preservatives. Chloracne classically affects the malar, retroauricular, and mandibular regions of the head and neck , as well as the axillae and scrotum. Pathology demonstrates multiple tiny infundibular cysts. Treatment with topical or oral retinoids and oral antibiotics may be beneficial