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Occupational Connective Tissue Disorders

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Kanerva’s Occupational Dermatology

Abstract

Systemic sclerosis (SSc) can be induced by long-term silica exposure.

In terms of clinical and laboratory features, this silica-induced scleroderma is indistinguishable from idiopathic scleroderma.

Silica is able to trigger the immune system, vasculature, as well as fibroblasts on the basis of an increased genetic susceptibility.

Silica can also contribute to the pathogenesis of other autoimmune diseases such as (systemic) lupus erythematosus, dermatomyositis, rheumatoid arthritis, overlap syndromes, and Sjögren’s syndrome.

If silica exposure has been long enough and its concentration high enough under occupational conditions, SSc should be acknowledged as an occupational disease and financially compensated.

Silicon (breast augmentation) does not induce the so-called adjuvant disease.

Organic solvents such as (chlorinated) aliphatic and aromatic hydrocarbons can trigger scleroderma-like diseases (SLDs) characterized by scleroderma and, in addition, toxic effects to liver, kidney, nervous system, sometimes absence of autoantibodies and to some extent reversibility of the disease.

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References

  • Adamson IYR, Letourneau HL, Bowden DH (1989) Enhanced macrophage fibroblast interactions in the pulmonary interstitium increases fibrosis after silica injection to monocyte-depleted mice. Am J Pathol 134:411–418

    PubMed  PubMed Central  CAS  Google Scholar 

  • Al-Mogairen SM (2010) Role of sodium silicate in induction of scleroderma-related autoantibodies in brown Norway rats through oral and subcutaneous administration. Rheumatol Int. https://doi.org/10.1007/s00296-009-1327-3

  • American Thoracic Society (1997) Adverse effects of crystalline silica exposure. Am J Respir Crit Care Med 155:761–765

    Article  Google Scholar 

  • Anderegg U, Vorberg S, Herrmann K, Haustein UF (1996) Increased expression of interstitial collagenase in silica-treated fibroblasts. Eur J Dermatol 6:51–55

    CAS  Google Scholar 

  • Anderegg U, Vorberg S, Herrmann K, Haustein UF (1997) Silica directly induces intercellular adhesion molecule 1 (ICAM-1) expression in cultured endothelial cells. Eur J Dermatol 7:27–31

    CAS  Google Scholar 

  • Arnett FC, Fritzler MJ, Ahn C, Holian A (2000) Urinary mercury levels in patients with autoantibodies to U3-RNP (fibrillarin). J Rheumatol 27:405–410

    PubMed  CAS  Google Scholar 

  • Aryal BK, Khuder SA, Schaub EA (2001) Meta-analysis of systemic sclerosis and exposure to solvents. Am J Ind Med 40:271–274

    Article  PubMed  CAS  Google Scholar 

  • Bachner U, Etzel F, Lange CE, Marsteller HJ, Veltman G (1974) Haemostaseologische Aspekte bei der Vinylchlorid-Krankheit. Dtsch Med Wochenschr 99:2409–2410

    Article  PubMed  CAS  Google Scholar 

  • Baer RL, Harber LC (1965) Photobiology of lupus erythematosus. Arch Dermatol 92:124–128

    Article  PubMed  Google Scholar 

  • Barnes J, Mayes MD (2001) Epidemiology of systemic sclerosis incidence, prevalence, survival, risk factors, malignancy and environmental triggers. Curr Opin Rheumatol 24:165–170

    Article  Google Scholar 

  • Barragán-Martínez C, Speck-Hernández CA, Montoya-Ortiz G, Mantilla RD, Anaya JM, Rojas-Villarraga A (2012) Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis. PLoS One 7(12):e51506. https://doi.org/10.1371/journal.pone.0051506. Epub 2012 Dec 19

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Bauer M, Rabens SF (1977) Trichloroethylene toxicity. Int J Dermatol 16:113–116

    Article  PubMed  CAS  Google Scholar 

  • Baur X (1994) Systemische Sklerodermie im Uranerzbergbau der ehemaligen SDAG Wismut. Arbeitsmed Sozialmed Umweltmed Sonderheft 22:5–7

    Google Scholar 

  • Baur X, Rihs HP, Altmeyer P, Degens P, Conrad K, Mehlhorn J, Weber K, Wiebe V (1996) Systemic sclerosis in German uranium miners under special consideration of autoantibody subsets and HLA class II alleles. Respiration 63:368–375

    Article  PubMed  CAS  Google Scholar 

  • Beck B, Irmscher G (1974) Silikosen durch weniger bekannte Expositionsarten. Z Erkr Atmungsorgane 140:282–293

    PubMed  CAS  Google Scholar 

  • Beck B, Irmscher G, Zschunke E (1976) Sklerodermie und Silikose – Versuch einer Synopsis. Z Gesamte Inn Med 31:493–496

    PubMed  CAS  Google Scholar 

  • Beer KR, Lorincz AL, Medenica MM, Albertini J, Baron J, Drinkard L, Swartz T (1994) Insecticide-induced lupus erythematosus. Int J Dermatol 33:860–862

    Article  PubMed  CAS  Google Scholar 

  • Black CM, Welsh KI, Walker AE, Bernstein RM, Catoggio LJ, McGregor AR, Jones JK (1983) Genetic susceptibility to scleroderma-like syndrome induced by vinyl chloride. Lancet 1:53–55

    Article  PubMed  CAS  Google Scholar 

  • Blair HM, Headington JT, Lynch PJ (1974) Occupational trauma, Raynaud’s phenomenon and sclerodactylia. Arch Environ Health 28:80–81

    Article  PubMed  Google Scholar 

  • Bolt HM, Laib RJ, Filser JG (1982) Reactive metabolites and carcinogenicity of halogenated ethylenes. Biochem Pharmacol 31:1–4

    Article  PubMed  CAS  Google Scholar 

  • Bottomley WW, Sheehan-Dare RA, Hughes P, Cuncliffe WJ (1993) A sclerodermatous syndrome with unusual features following prolonged occupational exposure to organic solvents. Br J Dermatol 128:203–206

    Article  PubMed  CAS  Google Scholar 

  • Bovenci M, Barbone F, Pisa FE, Betta A, Romeo L (2001) Scleroderma and occupational exposure to hand-transmitted vibration. Int Arch Occup Environ Health 74:579–582

    Article  CAS  Google Scholar 

  • Bovenzi M, Barbone F, Betta A, Tommasini M, Versini W (1995) Scleroderma and occupational exposure. Scand J Work Environ Health 21:289–292

    Article  PubMed  CAS  Google Scholar 

  • Bovenzi M, Barbone F, Pia FE, Betta A, Romeo L, Tonello A, Biasi D, Caramaschi P (2004) A case-control study of occupational exposures and systemic sclerosis. Int Arch Occup Environ Health 77:10–16

    Article  PubMed  Google Scholar 

  • Bramwell B (1914) Diffuse sclerodermia: its frequency; its occurrence in stone-masons; its treatment by fibrolysin injections – elevations of temperature due to fibrolysin. Edinburgh J Med 12:387–401

    Google Scholar 

  • Brasington RD, Thorpe-Swenson AJ (1991) Systemic sclerosis associated with cutaneous exposure to solvent: case report and review of the literature. Arthritis Rheum 34:631–633

    Article  PubMed  Google Scholar 

  • Brinton LA, Buckley LM, Dvorkina O, Lubin JH, Colton T, Murray MC, Hoover RN (2003) Risk of connective tissue disorders among breast implant patients. Am J Epidemiol 160:619–627

    Article  Google Scholar 

  • Brown JM, Archer AJ, Pfau JC, Holian A (2003) Silica accelerated systemic autoimmune disease in lupus-prone New Zealand mixed mice. Clin Exp Immunol 131:415–421

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Brown JM, Pfau JC, Holian A (2004a) Immunoglobulin and lymphocyte responses following silica exposure in New Zealand mixed mice. Inhalat Toxicol 16:133–139

    Article  CAS  Google Scholar 

  • Brown JM, Pfau JC, Pershouse MA, Holian A (2004b) Silica, apoptosis, and autoimmunity. J Immunotoxicol 1:177–187

    Article  CAS  Google Scholar 

  • Burns CJ, Laing TJ, Gillespie BW, Heeringa SG, Alcser KH, Mayes MD, Wasko MCM, Cooper BC, Garabrant DH, Schottenfeld D (1996) The epidemiology of scleroderma among women: assessment of risk from exposure to silicone and silica. J Rheumatol 23:1904–1911

    PubMed  CAS  Google Scholar 

  • Calvert GM, Rice FL, Boiano JM, Sheehy JW, Sanderson WT (2003) Occupational silica exposure and risk of various diseases: an analysis using death certificates from 27 states of the United States. Occup Environ Med 60:122–129

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Choudat D (1994) Occupational lung diseases among dental technicians. Tuber Lung Dis 75:99–104

    Article  PubMed  CAS  Google Scholar 

  • Christy WC, Rodnan GP (1984) Conjugal progressive systemic sclerosis (scleroderma): report of the disease in husband and wife. Arthritis Rheum 27:1180–1182

    Article  PubMed  CAS  Google Scholar 

  • Conrad K, Mehlhorn J, Lüthke K, Dörner T, Frank KH (1996) Systemic lupus erythematosus after heavy exposure to quartz dust in uranium mines: clinical and serological characteristics. Lupus 5:62–69

    Article  PubMed  CAS  Google Scholar 

  • Conrad K, Humbel RL, Tan EM, Shoenfeld Y (1997) Autoantibodies – diagnostic, pathogenetic and prognostic relevance. Clin Exp Rheumatol 15:457–465

    PubMed  CAS  Google Scholar 

  • Cooper GS, Makris SL, Nietert PJ, Jinot J (2009) Evidence of autoimmune-related effects of trichloroethylene exposure from studies in mice and humans. Environ Health Perspect 117:696–702

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Cooper GS, Wither J, Bernatsky S, Claudio JO, Clarke A, Rioux JD, CaNIOS GenES Investigators, Fortin PR (2010) Occupational and environmental exposures and risk of systemic lupus erythematosus: silica, sunlight, solvents. Rheumatology 49:2172–2180

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Cordier JH, Fieviez C, Lefevre MJ, Sevrin A (1966) Acroosteolyse et lesions cutanees chez deux ouvriers affectees au nettoyage d’autoclaves. Can Med Travail 4:3

    Google Scholar 

  • Cowie RL (1987) Silica-dust-exposed mine workers with scleroderma (systemic sclerosis). Chest 92:260–262

    Article  PubMed  CAS  Google Scholar 

  • Czernielewski A, Swierczynska-Kiec M, Gluszcz M (1979) Dermatological aspects of so called vinyl chloride monomer disease. Derm Beruf Umwelt 27:108–112

    PubMed  CAS  Google Scholar 

  • Czirjak L, Kumanovics G (2002) Exposure to solvents in female patients with scleroderma. Clin Rheumatol 21:114–118

    Article  PubMed  CAS  Google Scholar 

  • Czirjak L, Danko K, Schlammadinger J, Suranyi P, Tamasi L, Szegedi GY (1987) Progressive systemic sclerosis occurring in patients exposed to chemicals. Int J Dermatol 26:374–378

    Article  PubMed  CAS  Google Scholar 

  • Czirjak L, Bokk A, Csontos G, Lörincz G, Szegedi G (1989) Clinical findings in 61 patients with progressive systemic sclerosis. Acta Derm Venereol 69:533–536

    PubMed  CAS  Google Scholar 

  • Czirjak L, Schlammadinger J, Szegedi G (1993) Systemic sclerosis and exposure to trichloroethylene. Dermatology 186:236–237

    Article  PubMed  CAS  Google Scholar 

  • Czirjak L, Pocs E, Szegedi G (1994) Localized scleroderma after exposure to organic solvents. Dermatology 189:399–401

    Article  PubMed  CAS  Google Scholar 

  • DeMartinis M, Ciccarelli F, Sirufo MM, Ginaldi L (2016) An overview of environmental risk factors in systemic sclerosis. Expert Rev Clin Immunol 12:465–478

    Article  CAS  Google Scholar 

  • Diezel W, Meffert H, Günther W, Huse K, Sönnichsen N (1977) Exazerbation des Lupus erythematodes visceralis infolge UV-Bestrahlung. Dermatol Monatsschr 163:290–295

    PubMed  CAS  Google Scholar 

  • Dinman BD, Cook WA, Whitehouse WM, Magnuson HJ, Ditcheck T (1971) Occupational acroosteolysis: an epidemiological study. Arch Environ Health 22:61–65

    Article  PubMed  CAS  Google Scholar 

  • Diot E, Guilmot JL, Metzger MD, Pilore R, Rogier S, Stadler M, Diot P, Lemarie E, Lasfargues G (2002) Systemic sclerosis and occupational risk factors: a case-control study. Occup Environ Med 59:545–549

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Dowd PM, Ziegler V (1987) Endothelial cell cultures in silica induced systemic sclerosis. In: Abstr Sympos Aktuel Probl Arbeitsderm, Leipzig, p 51

    Google Scholar 

  • Dunnill MG, Black MM (1994) Sclerodermatous syndrome after occupational exposure to herbicides-response to systemic steroids. Clin Exp Dermatol 19:518–520

    Article  PubMed  CAS  Google Scholar 

  • Ebihara I, Kawami M (1985) Health hazards of mineral dust with special reference to the causation of immuno-pathologic systemic diseases. J Sci Labour 61:1–31

    Google Scholar 

  • Englert H, Small-McMahon J, Davis K, O’Connor H, Chambers P, Brooks P (2000) Male systemic sclerosis and occupational silica exposure – a population-based study. Aust NZ J Med 30:215–220

    Article  CAS  Google Scholar 

  • Epstein IH, Tuffanelli DL, Dubois EL (1965) Light sensitivity and lupus erythematosus. Arch Dermatol 91:483–485

    Article  PubMed  CAS  Google Scholar 

  • Erasmus LD (1957) Scleroderma in gold-miners on the Witwatersrand with particular reference to pulmonary manifestations. S Afr J Lab Clin Med 3:209–231

    PubMed  CAS  Google Scholar 

  • Evans DJ, Posner E (1971) Pneumoconiosis in laundry workers. Environ Res 4:127–128

    Article  Google Scholar 

  • Finckh A, Cooper GS, Chibnik LB, Costenbader KH, Watts J, Pankey H, Fraser PA, Karlson EW (2006) Occupational silica and solvent exposures and risk of systemic lupus erythematosus in urban women. Arthritis Rheum 54:3648–3654

    Article  PubMed  Google Scholar 

  • Fleischmajer R, Perlish IS, Duncan M (1983) Scleroderma: a model for fibrosis. Arch Dermatol 119:957–962

    Article  PubMed  CAS  Google Scholar 

  • Flindt-Hansen H, Isager H (1987) Scleroderma after occupational exposure to _ssociazione_lene and trichlorethane. Acta Derm Venereol 67:263–264

    PubMed  CAS  Google Scholar 

  • Forkert PG, Forkert L (1994) Trichloroethylene induces pulmonary fibrosis in mice. Can J Physiol Pharmacol 72:205–210

    Article  PubMed  CAS  Google Scholar 

  • Fox AJ, Collier PF (1977) Mortality experience of workers exposed to vinyl chloride monomer in the manufacture of polyvinyl chloride in Great Britain. Br J Ind Med 34:1–10

    PubMed  PubMed Central  CAS  Google Scholar 

  • Francia A, Monarca A, Cavallot A (1959) Osservazioni clinico-roentgenologiche soll _ssociazione silicosi-sclerodermia. Med Lav 50:523

    PubMed  CAS  Google Scholar 

  • Frank R, Giese T, Dummer R, Walther T, Rytter M, Ziegler V, Haustein UF (1993) Silica-induced cytokine release in human monocyte cultures and its possible involvement in the pathophysiology of silica-associated scleroderma. Eur J Dermatol 3:304–309

    CAS  Google Scholar 

  • Freire M, Alonso M, Rivera A, Sousa A, Soto A, Gomez-Sousa M, Baroja A, Vazques-Trinanes C, Sopena P (2015) Clinical peculiarities of patients with scleroderma exposed to silica: a systemic review of the literature. Sem Arthritis Rheumatism 45:294–300

    Article  CAS  Google Scholar 

  • Gabay C, Kahn MF (1992) Les sclerodermies masculines role de l’exposition professionelle. Schweiz Med Wochenschr 122:1746–1752

    PubMed  CAS  Google Scholar 

  • Garabrant DH, Lacey JV, Laing TJ, Gillespie BW, Mayes MD, Cooper BC, Schottenfeld D (2002) Scleroderma and solvent exposure among woman. Am J Epidemiol 157:493–500

    Article  Google Scholar 

  • Garcia-Zamalloa AM, Ojeda E, Gonzalez-Beneitez C, Goni J, Garrido A (1994) Systemic sclerosis and organic solvents: early diagnosis in industry. Ann Rheum Dis 53:618

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Goldman JA (1996) Connective tissue diseases in peoble exposed to organic chemical solvents. Systemic sclerosis (scleroderma) in dry cleaning plants and aircraft industry workers. J Clin Rheumatol 2:185–190

    Article  PubMed  CAS  Google Scholar 

  • Griffin JM, Blossom SJ, Jackson SK, Gilbert KM, Pumford NR (2002) Trichlorethylene accelates an autoimmune response by Th1 T cell activation in MRL +/+ mice. Immunopharmacology 46:123–137

    Article  Google Scholar 

  • Hanson M, Abedi-Valugerdi M (2002) Mercury chloride induces a strong immune activation, but does not accelerate the development of dermal fibrosis in tight skin 1 mice. Scand J Immunol 59:469–477

    Article  Google Scholar 

  • Harris DK, Adams WGF (1967) Acroosteolysis occurring in men engaged in the polymerisation of vinyl chloride. BMJ 3:712–714

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Hatron PY, Plouvier B, Francois M (1982) Assoziation von systemischem Lupus erythematodes und Silikose. Kasuistik (5 Pat.). Rev Med Intern 3:245–246

    Article  CAS  Google Scholar 

  • Haustein UF (1998) Silica-induced lupus erythematosus. Acta Derm Venereol 78:73–74

    Article  PubMed  CAS  Google Scholar 

  • Haustein UF, Albrecht M (1993) Zur Epidemiologie und Klinik der systemischen Sklerodermie. Z Haut Geschlechtskr 68:651–658

    Google Scholar 

  • Haustein UF, Albrecht M (1996) Berufsbedingte progressive Sklerodermie, Pseudosklerodermie und systemischer Lupus erythematodes. Derm Beruf Umwelt 44:77–80

    Google Scholar 

  • Haustein UF, Herrmann K (1994) Environmental scleroderma. Clin Dermatol 12:467–473

    Article  PubMed  CAS  Google Scholar 

  • Haustein UF, Klug H (1975) Zur Ultrastruktur der Hautkapillaren bei Lupus eythematodes, Dermatomyositis und progressiver Sklerodermie. Dermatol Monatsschr 161:353–363

    PubMed  CAS  Google Scholar 

  • Haustein UF, Ziegler V (1985) Environmentally induced systemic sclerosis-like disorders. Int J Dermatol 24:147–151

    Article  PubMed  CAS  Google Scholar 

  • Haustein UF, Herrmann K, Boehme HJ (1986) Pathogenesis of progressive systemic sclerosis. Int J Derm 25:286–293

    Article  PubMed  CAS  Google Scholar 

  • Hennekens CH, Lee IM, Cook NR, Hebert PR, Karlson EW, LaMotte F, Manson JE, Buring JE (1996) Self-reported breast implants and connective-tissue diseases in female health professionals. JAMA 275:616–621

    Article  PubMed  CAS  Google Scholar 

  • Hinnen U, Schmid-Grendelmeier P, Muller E, Elsner P (1995) Exposure to solvents in scleroderma: disseminated circumscribed scleroderma (morphea) in a painter exposed to perchloroethylene (in German). Schweiz Med Wochenschr 125:2433–2437

    PubMed  CAS  Google Scholar 

  • Hochberg MC (1993) Cosmetic surgical procedures and connective tissue disease: the Cleopatra syndrome revisited. Ann Intern Med 118:981–983

    Article  PubMed  CAS  Google Scholar 

  • Hochberg MC, Perlmutter DL, Medsger TA, Nguyen K, Steen V, Weisman MH, White B, Wigley FM (1996) Lack of association between augmentation mammoplasty and systemic sclerosis (scleroderma). Arthritis Rheum 39:1125–1131

    Article  PubMed  CAS  Google Scholar 

  • Holt PF (1981) Transport of inhaled dust to extrapulmonary sites. J Pathol 133:123–129

    Article  PubMed  CAS  Google Scholar 

  • Inachi S, Mizutani H, Ando Y, Shimizu M (1996) Progressive systemic sclerosis sine scleroderma which developed after exposure to epoxy resin polymerization. J Dermatol 23:344–346

    Article  PubMed  CAS  Google Scholar 

  • Ishikawa H, Yamakage A, Tamura T et al (1982) Scleroderma induced by epoxy resins with special reference to experimental scleroderma with Bis (4-amino-3-methylcyclohexyl) methane as the probable causative agent. J UOEH 4:225–235

    Google Scholar 

  • Ishikawa O, Warita S, Tamura A, Miyachi Y (1995) Occupational scleroderma. A 17-year follow-up study. Br J Dermatol 133:786–789

    Article  PubMed  CAS  Google Scholar 

  • Janowsky EC, Kupper LL, Hulka BS (2000) Meta-analysis of the relation between silicone breast implants and the risk of connective tissue diseases. New Engl J Med 342:781–790

    Article  PubMed  CAS  Google Scholar 

  • Johnson WM, Busnardo MS (1993) Silicosis following employment in the manufacture of silica flour and industrial sand. J Occup Med 35:716–719

    Article  PubMed  CAS  Google Scholar 

  • Karlson EW, Lee I-M, Cook NR, Buring JE, Hennekens C, Bloch KJ (2001) Serologic evaluation of woman exposed to breast implants. J Rheumatol 28:1523–1530

    PubMed  CAS  Google Scholar 

  • Kettaneh A, Moufti OA, Tiev KP, Chayet C, Toledano C, Fabre B, Fardet L, Cabane J (2007) Occupational exposure to solvents and gender-related risk of systemic sclerosis: meta-analysis of case-control studies. J Rheumatol 34:97–103

    PubMed  CAS  Google Scholar 

  • Kilburn KH, Warshaw RH (1992) Prevalence of symptoms of systemic lupus erythematosus (SLE) and of fluorescent antinuclear antibodies associated with chronic exposure to trichloroethylene and other chemicals in well water. Environ Res 57:1–9

    Article  PubMed  CAS  Google Scholar 

  • Kjoller K, Friis S, Mellenkjaer L, McLaughlin JK, Winther JF, Lipworth L, Blot WJ, Frycek J, Olsen JH (2001) Connective tissue disease and other rheumatic conditions following cosmetic breast implantation in Denmark. Arch Intern Med 161:973–979

    Article  PubMed  CAS  Google Scholar 

  • Knight KR, Gibbons R (1987) Increased collagen synthesis and cross-link formation in the skin of rats exposed to vinyl chloride monomer. Clin Sci (Colch) 72:673–678

    Article  CAS  Google Scholar 

  • Koeger AC, Alcaix D, Rozenberg S, Bourgeois P (1991) Occupational exposure to silicon and dermatopolymyositis. 3 cases (in French). Ann Med Interne 142:409–413

    CAS  Google Scholar 

  • Koeger AC, Marre JP, Rozenberg S, Gutmann L, Bourgeois P (1992) Autoimmune diseases after unusual exposure to silica or silicones. 3 cases. (in French). Ann Med Interne 143:165–170

    CAS  Google Scholar 

  • Koeger AC, Lang T, Alcaix D, Milleron B, Rozenberg S, Chaibi P, Arnaud J, Mayaud C, Camus JP, Bourgeois P (1995) Silica-associated connective tissue disease. A study of 24 cases. Medicine (Baltimore) 74:221–237

    Article  CAS  Google Scholar 

  • Kohanka V (1982) Epidemiologic studies of the delayed-type immunity in workers exposed to vinyl chloride monomers (in German). Boerg Vener Szemle 58:145–149

    Google Scholar 

  • Lange GE, Juehe S, Veltman G (1974) Ueber das Auftreten von Angiosarkomen der Leber bei zwei Arbeitern der PVC-herstellenden Industrie. Dtsch Med Wochenschr 99:1598–1599

    PubMed  CAS  Google Scholar 

  • Lee S, Hayashi H, Maeda M, Chen Y, Matsuzaki H, Takei-Kumagai N, Nishimura Y, Fujimoto W, Otsuki T (2012) Environmental factors producing autoimmune dysregulation–chronic activation of T cells caused by silica exposure. Immunobiology 217:743–748

    Article  PubMed  CAS  Google Scholar 

  • Lelbach WK, Marsteller HJ (1981) Vinyl chloride-associated disease. Ergeb Inn Med Kinderheilkd 47:1–110

    PubMed  CAS  Google Scholar 

  • Lockey JE, Kelly CR, Cannon GW, Colby TV, Aldrich V, Livingston GK (1987) Progressive systemic sclerosis associated with exposure to trichloroethylene. J Occup Med 29:493–496

    PubMed  CAS  Google Scholar 

  • Maitre A, Hours M, Bonneterre V (2004) Systemic sclerosis and occupational risk factors: role of solvents and cleaning products. J Rheumatol 31:2395–2401

    PubMed  CAS  Google Scholar 

  • Makol A, Reilly MJ, Rosenmann KD (2011) Prevalence of connective tissue diseases in silicosis (1985–2006): a report from the state of Michigan surveillance system for silicosis. Am J Ind Med 54:255–262

    Article  PubMed  Google Scholar 

  • Maricq HR (1981) Vinyl chloride disease. In: International conference on progressive systemic sclerosis, Austin, 9 Oct 1981

    Google Scholar 

  • Maricq HR, Johnson MN, Whetstone CL, LeRoy EC (1976) Capillary abnormalities in polyvinyl chloride production workers. Examination by in vivo microscopy. JAMA 236:1368–1371

    Article  PubMed  CAS  Google Scholar 

  • Marie I, Gehano J-F, Bubenheim M, Duval-Modeste AB, Joly P, Dominique S (2014) Prospective study to evaluate the association between systemic sclerosis and occupational exposure and review of the literature. Autoimmune Rev 13:151–156

    Article  CAS  Google Scholar 

  • Marie I, Menard J-F, Duval-Modeste A-B, Joly P, Domenique S (2015) Association of occupational exposure with features of systemic sclerosis. J Am Acad Dermatol 215:456–464

    Article  Google Scholar 

  • Markowitz SS, McDonald CJ, Fethiere W (1972) Occupational acroosteolysis. Arch Dermatol 106:219–233

    Article  PubMed  CAS  Google Scholar 

  • Masi AT (1980) Preliminary criteria for the classification of systemic sclerosis. Arthritis Rheum 23:581–590

    Article  Google Scholar 

  • McCormic ZD, Khuder SS, Aryal BK, Ames AL, Khuder SA (2010) Occupational silica exposure as a risk factor for scleroderma: a meta-analysis. Int Arch Occup Environ Health. https://doi.org/10.1007/s00420-009-0505-7

  • Medsger TA, Masi AT (1971) Epidemiology of systemic sclerosis. Ann Intern Med 74:714–721

    Article  PubMed  Google Scholar 

  • Mehlhorn J (1994) “Qarzinduzierte” Progressive Systemische Sklerodermie – Exposition, Klinische Beobachtungen, Lungenfunktion. Arbeitsmed Sozialmed Umweltmed Sonderheft 22:8–11

    Google Scholar 

  • Mehlhorn J, Gerlach C (1990) Gemeinsames Auftreten von Silikose und Lupus erythematodes. Z Erkr Atmungsorgane 175:38–41

    PubMed  CAS  Google Scholar 

  • Mehlhorn J, Gerlach C, Ziegler V (1990) Berufsbedingte progressive systemische Sklerodermie durch ein quarzhaltiges Scheuermittel. Derm Beruf Umwelt 38:180–184

    PubMed  CAS  Google Scholar 

  • Milford WA (1976) Evidence of an immune complex disorder in vinyl chloride workers. Proc R Soc Med 69:289–291

    Google Scholar 

  • Miyoshi K, Miyaoka T, Kobayashi Y, Itahura T, Nishijo K, Hagashitara M, Shiragami H, Ohno F (1964) Hypergammaglobulinemia by prolonged adjuvanticity in man: disorders developed after augmentation mammoplasty. Ijishimpo 2122:9–14

    Google Scholar 

  • Moseley PL, Monick M, Hunninghake GW (1988) Divergent effects of silica on lymphocyte proliferation and immunoglobulin production. J Appl Physiol 65:350–357

    Article  PubMed  CAS  Google Scholar 

  • Mueller G, Norpoth K, Kusters E (1978) Determination of thiodiglycolic acid in urine specimens of vinyl chloride exposed workers. Int Arch Occup Environ Health 41:199–205

    Article  CAS  Google Scholar 

  • Nagata C, Yoshida H, Mirbod SM, Komura Y, Fujita S, Inaba R, Iwata H, Maeda M, Shikano Y, Ichiki Y et al (1993) Cutaneous signs (Raynaud’s phenomenon, sclerodactylia and edema of the hands) and hand-arm vibration exposure. Int Arch Occup Environ Health 64:587–591

    Article  PubMed  CAS  Google Scholar 

  • Nario RC, Hubbard AK (1996) Silica exposure increases expression of pulmonary intercellular adhesion molecule-1 (ICAM-1) in C57BI/6 mice. J Toxicol Environ Health 49:599–617

    Article  PubMed  CAS  Google Scholar 

  • Nebe H, Lenz U (1971) Untersuchungen ueber berufliche Noxen beim Lupus erythematodes. Dermatol Monatsschr 157:500–504

    PubMed  CAS  Google Scholar 

  • Nietert PJ, Sutherland SE, Silver RM, Pandey JP, Knapp RG, Hoel DG, Dosemeci M (1998) Is occupational organic solvent exposure a risk factor for scleroderma? Arthritis Rheumatol 41:1111–1118

    Article  CAS  Google Scholar 

  • Oghiso Y, Kubota Y (1986) Enhanced interleukin 1 production by alveolar macrophages and increase in Ia-positive lung cells in silica-exposed rats. Microbiol Immunol 30:1189–1198

    Article  PubMed  CAS  Google Scholar 

  • Olsson AR, Skogh T, Axelson O, Wingren G (2004) Occupations and exposures in the work environment for rheumatoid arthritis. Occup Environ Med 61:233–238

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Ostlere LS, Harris D, Buckley C, Black C, Rustin MH (1992) Atypical systemic sclerosis following exposure to vinyl chloride monomer. A case report and review of the cutaneous aspects of vinyl chloride disease. Clin Exp Dermatol 17:208–210

    Article  PubMed  CAS  Google Scholar 

  • Otsuki T, Sakagchi H, Tomokuni A, Aikoh T, Matsuki T, Isozaki Y, Hyodoh F, Kawakami Y, Kusaka M, Kita S, Ueki A (2000) Detection of alternatively spliced variant messages of Fas gene and mutational screening of Fas and Fas ligand coding regions in peripheral blood mononuclear cells derived from silicosis patients. Immunol Lett 72:137–143

    Article  PubMed  CAS  Google Scholar 

  • Otsuki T, Maeda M, Murakami S, Hayashi H, Miura Y, Kusaka M, Nakano T, Fukuoka K, Kishimoto T, Hyodoh F, Ueki A, Nishimura Y (2007) Immunological effects of silica and asbestosis. Cell Mol Immunol 4:261–268

    PubMed  CAS  Google Scholar 

  • Owens GR, Medsger TA (1988) Systemic sclerosis secondary to occupational exposure. Am J Med 85:114–116

    Article  PubMed  CAS  Google Scholar 

  • Panaszek B, Malolepszy J, Wrzyszcz M, Jutel M, Machaj Z (1993) Mixed connective tissue disease in a male patient chronically exposed to toxic chemicals (in polish). Pol Tyg Lek 48:430–432

    PubMed  CAS  Google Scholar 

  • Parks CG, Cooper GS, Nylander-French LA, Sanderson WT, Dement JM, Cohen PL, Dooley MA, Treadwell EL, StClair EW, Gilkeson GS, Hoppin JA, Savitz DA (2002) Occupational exposure to crystalline silica and risk of systemic lupus erythematosus. Arthritis Rheum 48:1840–1850

    Article  Google Scholar 

  • Parks CG, Cooper GS, Nylander-French LA, Hoppin JA, Sanderson WT, Dement JM (2004) Comparing questionaire-based methods to assess occupational silica exposure. Epidemiology 15:433–441

    Article  PubMed  Google Scholar 

  • Penin H, Sager G, Lange GE et al (1975) Neurologisch-psychiatrische und elektroenzephalographische Befunde bei Patienten mit Vinylchlorid-Krankheit. In: Proceedings of 15. Jahrestagung Dt Gesellschaft Arb Med, Gentner, Stuttgart, pp 299–304

    Google Scholar 

  • Plewig G, Kligman A (1978) Acne. Springer, Berlin/Heidelberg/New York

    Google Scholar 

  • Pollard KM (2016) Silica, silicosis, and autoimmunity. Front Immunol 7(97):1–7

    Google Scholar 

  • Poskitt LB, Duffill MB, Rademaker M (1994) Chloracne, palmoplantar keratoderma and localized scleroderma in a weed sprayer. Clin Exp Dermatol 19:264–267

    Article  PubMed  CAS  Google Scholar 

  • Povey A, Guppy MJ, Wood M, Knight C, Black CM, Silman AJ (2001) Cytochrome P2 polymorphisms and susceptibility to scleroderma following exposure to organic solvents. Arthritis Rheum 44:662–665

    Article  PubMed  CAS  Google Scholar 

  • Puisieux F, Hachulla E, Brouillard M, Hatron PY, Devulder B (1994) Silicosis and primary Gougerot-Sjogren syndrome (in French). Rev Med Intern 15:575–579

    Article  CAS  Google Scholar 

  • Reinl W (1957) Sklerodermie durch Trichloraethyleneinwirkung? Zentralbl Arbeitsmed 7:58–60

    PubMed  CAS  Google Scholar 

  • Rihs HP, Conrad K, Mehlhorn J, May-Taube K, Welticke B, Frank KH, Baur X (1994) Association between HLA-D alleles and scleroderma-specific autoantibodies in quartz dust exposed persons (in German). Z Arztl Fortbild (Jena) 88:513–518

    CAS  Google Scholar 

  • Rihs HP, Conrad K, Mehlhorn J, May-Taube K, Welticke B, Frank KH, Baur X (1996) Molecular analysis of HLA-DPB1 alleles in idiopathic systemic sclerosis patients and uranium miners with systemic sclerosis. Int Arch Allergy Immunol 109:216–222

    Article  PubMed  CAS  Google Scholar 

  • Rocha LF, Luppino Assad AP, Marangoni RG, Del Rio AP, Marques-Neto JF, Sampaio-Barros PD (2016) Systemic sclerosis and silica exposure: a rare association in a large Brazilian cohort. Rheumatol Int 36:697–702

    Article  PubMed  CAS  Google Scholar 

  • Rocha-Parise M, Santos LM, Damoiseaux JG, Bagatin E, Lido AV, Torello CO, Cohen Tervaert JW, Queiroz ML (2014) Lymphocyte activation in silica-exposed workers. Int J Hyg Environ Health 217:586–591

    Article  PubMed  CAS  Google Scholar 

  • Rodnan GP, Benedek TG, Medsger TA, Cammarata RJ (1967) The association of progressive systemic sclerosis (scleroderma) with coal miners pneumoconiosis and other forms of silicosis. Ann Intern Med 66:323–334

    Article  PubMed  CAS  Google Scholar 

  • Rosenman KD, Zhu Z (1995) Pneumoconiosis and associated medical conditions. Am J Ind Med 27:107–113

    Article  PubMed  CAS  Google Scholar 

  • Rustin MHA, Bull HA, Ziegler V, Mehlhorn J, Haustein UF, Maddison PJ, James J, Dowd PM (1990) Silica-associated systemic sclerosis is clinically, serologically indistinguishable from idiopathic systemic sclerosis. Br J Dermatol 123:725–734

    Article  PubMed  CAS  Google Scholar 

  • Saihan EM, Burton JL, Heaton KW (1978) A new syndrome with pigmentation scleroderma, gynaecomastia, Raynaud’s phenomenon and neuropathy. Br J Dermatol 99:437–441

    Article  PubMed  CAS  Google Scholar 

  • Sanchez-Roman J, Wichmann I, Salaberri J, Varela JM, Nunez-Roldan A (1993) Multiple clinical and biological autoimmune manifestations in 50 workers after occupational exposure to silica. Ann Rheum Dis 52:534–538

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Schirren SM (1971) Skin lesions caused by trichloroethylene in a metal working plant. Berufsdermatosen 19:240–245

    PubMed  CAS  Google Scholar 

  • Schmidt JA, Oliver CN, Lepe-Zuniga JL, Green I, Gery I (1984) Silica-stimulated monocytes release fibroblast proliferation factors identical to interleukin 1. J Clin Invest 73:1462–1472

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Siebels M, Schulz V, Andrassy K (1993) Silicosis and systemic diseases (in German). Immun Infekt 21:53–54

    PubMed  Google Scholar 

  • Siebels M, Schulz V, Andrassy K (1995) Systemic lupus erythematosus and silicosis (in German). Dtsch Med Wochenschr 120:214–218

    Article  PubMed  CAS  Google Scholar 

  • Siegel RC (1977) Scleroderma. Med Clin North Am 61:283–296

    Article  PubMed  CAS  Google Scholar 

  • Silman AJ, Jones S (1992) What is the contribution of occupational environmental factors to the occurrence of scleroderma in men? Ann Rheum Dis 51:1322–1324

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Silver RM, Sahn EE, Allen JA, Sahn S, Greene W, Maize JC, Garen PD (1993) Demonstration of silicon in sites of connective tissue disease in patients with silicone-gel breast implants. Arch Dermatol 129:63–68

    Article  PubMed  CAS  Google Scholar 

  • Sluis-Cremer GK, Hessel PA, Hnizdo E, Churchill AR, Zeiss EA (1985) Silica, silicosis and progressive systemic sclerosis. Br J Ind Med 42:838–843

    PubMed  PubMed Central  CAS  Google Scholar 

  • Smith V, Vanthuyne M, Vander Cruissen B, Van Praet J, Vermeiren F, Smets H, Houssiau F, DeKeyser F (2008) Over-representaion of construction-related occupations in male patients with systemic sclerosis. Ann Rheum Dis 67:1448–1450

    Article  PubMed  CAS  Google Scholar 

  • Sparrow GP (1977) A connective tissue disorder similar to vinyl chloride disease in a patient exposed to perchloroethylene. Clin Dermatol 2:17–22

    Article  CAS  Google Scholar 

  • Stachow A, Jablonska S, Skiendzielewska A (1979) Biogenic amines derived from tryptophan in systemic and cutaneous scleroderma. Acta Derm Venereol 59:1–5

    PubMed  CAS  Google Scholar 

  • Steenland K, Brown D (1995) Mortality study of gold miners exposed to silica and nonasbestiform amphibole minerals: an update with 14 more years of follow-up. Am J Ind Med 27:217–229

    Article  PubMed  CAS  Google Scholar 

  • Struhar D, Harbeck RJ (1989) Anti-Ia antibodies inhibit the spontaneous secretion of IL-1 from silicotic rat alveolar macrophages. Immunol Lett 23:31–33

    Article  PubMed  CAS  Google Scholar 

  • Studnicka MJ, Menzinger G, Drlicek M, Maruna H, Neumann MG (1995) Pneumoconiosis and systemic sclerosis following 10 years of exposure to polyvinyl chloride dust. Thorax 50:583–585

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Suciu I, Drejman I, Valaskai M (1963) Contributii la studiul imbolnavirilor produse de clorina de vinil. Med Int 15:967–978

    CAS  Google Scholar 

  • Szeimies RM, Lissner A, Meurer M (1992) Perchlorethylen-induzierte systemische Sklerodermie. Derm Beruf Umwelt 40:66–69

    Google Scholar 

  • Tanaka M, Niizeki H, Shimizu S, Miyakawa S (1993) Scleroderma after exposure to domestic detergent LOC. J Rheumatol 20:1993–1994

    PubMed  CAS  Google Scholar 

  • Tashev TS, Tsonev I (1990) The connective tissue changes in patients with acute poisonings by organophosphate pesticides (in Bulgarian). Vutr Boles 29:83–87

    PubMed  CAS  Google Scholar 

  • Thorgeirsson A, Fregert S, Ramnaes O (1978) Sensitization capacity of epoxy resin oligomers in the Guinea pig. Acta Derm Venereol 58:17–21

    PubMed  CAS  Google Scholar 

  • Tibon-Fisher O, Heller E, Ribak J (1992) Occupational scleroderma due to organic solvent exposure. Harefuah 122(530–532):551

    Google Scholar 

  • Ueki H, Omori K (2001) Dscoid lupus erythematosus developing in areas where fragments of windshield glass had become embedded in the skin. Eur J Dermatol 11:127–130

    PubMed  CAS  Google Scholar 

  • Ueki A, Isozaki Y, Tomakuni A, Ueki H, Kusaka M, Tanaka S, Otsuki T, Sakaguchi H, Hyodoh F (2001) Different distribution of HLA Class II alleles in anti-topoisomerase I autoantibody responders between silicosis and systemic sclerosis patients, with a common distinct amino acid sequence in the HLA-DQB1 domain. Immunobiology 204:458–465

    Article  PubMed  CAS  Google Scholar 

  • Varga J, Schumacher R, Jimenez SA (1989) Systemic sclerosis after augmentation mammoplasty with silicone implants. Ann Intern Med 111:377–383

    Article  PubMed  CAS  Google Scholar 

  • Veltman G (1980) Klinische Befunde und arbeitsmedizinische Aspekte der Vinylchlorid-Krankheit. Dermatol Monatsschr 166:705–712

    PubMed  CAS  Google Scholar 

  • Vincent M, Pouchelle C, Martinon S, Gerard F, Arthaud Y (1996) Connective tissue disease due to intentional inhalation of scouring powder. Eur Respir J 9:2688–2690

    Article  PubMed  CAS  Google Scholar 

  • Walder WB (1983) Do solvents cause scleroderma? Int J Dermatol 22:157–158

    Article  PubMed  CAS  Google Scholar 

  • Waller PA, Clauw D, Cupps T, Metcalf JS, Silver RM, Leroy EC (1994) Fasciitis (not scleroderma) following prolonged exposure to an organic solvent. J Rheumatol 21:1567–1570

    PubMed  CAS  Google Scholar 

  • Warde WB (1903) Lupus erythematosus: some illustrative cases. Br J Dermatol 15:161–168

    Article  Google Scholar 

  • Wichmann I, Sanchez-Roman J, Morales J, Castillo MJ, Ocana C, Nunez-Roldan A (1996) Antimyeloperoxidase antibodies in individuals with occupational exposure to silica. Ann Rheum Dis 55:205–207

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Wilson RH, McCormick WE, Tatum CF, Greech JL (1967) Occupational acroosteolysis: report of 31 cases. JAMA 201:577–580

    Article  PubMed  CAS  Google Scholar 

  • Wu P, Hyodoh F, Hatayama T, Sakaguchi H, Hatada S, Miura Y, Takata-Tomokuni A, Katsuyama H, Otsuki T (2004) Induction of CD 69 antigen expression in peripheral blood mononuclear cells on exposure to silica, but not by asbestos/chrysotile-A. Immunol Lett 98:145–152

    Article  PubMed  CAS  Google Scholar 

  • Xiong M, Arnett FC, Guo X, Zhou X (2008) Differential dynamic properties of scleroderma fibroblasts in response to perturbation of environmental stimuli. PLoS One 3(2):e1693

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Yamakage A, Ishikawa H (1982) Generalized morphea-like scleroderma occurring in people exposed to organic solvents. Dermatologica 165:186–193

    Article  PubMed  CAS  Google Scholar 

  • Yamakage A, Ishikawa H, Saito Y, Hattori A (1980) Occupational scleroderma-like disorder in men engaged in the polymerization of epoxy resins. Dermatologica 161:33–44

    Article  PubMed  CAS  Google Scholar 

  • Yamamoto T, Furuse Y, Katayama I, Nishioka K (1994) Nodular scleroderma in a worker using a silica-containing abrasive. J Dermatol 21:751–754

    Article  PubMed  CAS  Google Scholar 

  • Yanez-Diaz S, Moran M, Unamuno P, Armijo M (1992) Silica and trichloroethylene-induced progressive systemic sclerosis. Dermatology 184:98–102

    Article  PubMed  CAS  Google Scholar 

  • Yang Y, Fujita J, Tokuda M, Bandoh S, Dobashi H, Okada T, Okahara M, Kishimoto T, Ishida T, Takahara J (2001) Clinical features of polymyositis/dermatomyositis associated with silicosis and review of the literature. Rheumatol Int 20:235–238

    Article  PubMed  CAS  Google Scholar 

  • Yoshida S, Gershwin ME (1993) Autoimmunity and selected environmental factors of disease induction. Semin Arthritis Rheum 22:399–419

    Article  PubMed  CAS  Google Scholar 

  • Zachariae H, Bjerring P, Sondergaarrd KH, Halkier-Sorensen L (1997) Arbejdsbetinget systemisk sklerodermi hos maend. Ugeskr Laeger 195:2687–2689

    Google Scholar 

  • Ziegler V, Köpping H, Münzberger H, Haustein UF, Löschke K (1981) Arbeitsmedizinische Aspekte der progressiven Sklerodermie. Wiss Z Karl Marx Univ Leipzig 30:478–482

    Google Scholar 

  • Ziegler V, Pampel W, Zschunke E, Münzberger H, Mährlein W, Köpping H (1982) Kristalliner Quarz – (eine) Ursache der progressiven Sklerodermie? Dermatol Monatsschr 168:398–401

    PubMed  CAS  Google Scholar 

  • Ziegler V, Haustein UF, Mehlhorn J, Münzberger H, Rennau H (1986) Quarzinduzierte Sklerodermie, sklerodermie-aehnliches Syndrom oder echte Sklerodermie? Dermatol Monatsschr 172:86–90

    PubMed  CAS  Google Scholar 

  • Ziegler V, Kipping D, Herrmann K, Haustein UF, Löschke K (1987) Quarz – seine Relevanz für die Dermatologie. Derm Beruf Umwelt 35:199–204

    PubMed  CAS  Google Scholar 

  • Ziegler V, Keyn J, Mehlhorn J, Kipping D, Haustein UF (1988) Qarznachweis in Sklerodermiehaut. Dermatol Monatsschr 174:688–689

    PubMed  CAS  Google Scholar 

  • Ziegler V, Pfeil B, Haustein UF (1991) Berufliche Quarzstaubexposition – Progressive Sklerodermie und Lupus erythematodes. Z Haut Geschlechtskr 66:968–970

    Google Scholar 

  • Zschunke E (1976) Dermatologische Probleme in der Arbeitsmedizin. Dermatol Monatsschr 162:454–458

    Google Scholar 

  • Zschunke E, Ziegler V, Haustein UF (1990) Occupationally induced connective tissue disorders. In: Adams RM (ed) Occupational skin disease. Saunders, Philadelphia

    Google Scholar 

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Authors and Affiliations

  1. Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany

    Uwe-Frithjof Haustein & Bettina Lietzberg

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  1. Uwe-Frithjof Haustein
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  2. Bettina Lietzberg
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Correspondence to Uwe-Frithjof Haustein .

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Editors and Affiliations

  1. Department of Dermatology, University of Osnabrück, Osnabrück, Niedersachsen, Germany

    Swen Malte John

  2. Department of Dermato-allergology, Gentofte Hospital, Hellerup, Denmark

    Jeanne Duus Johansen

  3. Dept. of Dermatology and Allergology, VU University Medical Centre, Amsterdam, The Netherlands

    Thomas Rustemeyer

  4. Dept. of Dermatology and Allergology, Friedrich Schiller University, Jena, Thüringen, Germany

    Peter Elsner

  5. Department of Dermatology, University of California San Francisco, San Francisco, California, USA

    Howard I. Maibach

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Haustein, UF., Lietzberg, B. (2018). Occupational Connective Tissue Disorders. In: John, S., Johansen, J., Rustemeyer, T., Elsner, P., Maibach, H. (eds) Kanerva’s Occupational Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-40221-5_29-2

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