Skip to main content

Occupational and Environmental Acne

  • Reference work entry
Kanerva's Occupational Dermatology

Core messages

Occupational and environmental acne includes oil acne, coal-tar and pitch acne, acne cosmetica, acne aestivalis (from sun), acne mechanica, tropical acne, and chloracne.

Chloracne is a refractory acneiform eruption clinically characterized by comedones and straw-colored cysts. The comedones predominantly affect the malar region of the cheek and the retroauricular areas.

Although chloracne is rare, it is a sensitive indicator of chemical exposure to certain polyaromatic halogenated hydrocarbons and may be associated with internal poisoning that should be recognized by physicians treating occupational skin disease.

Patients with the cutaneous manifestations of chloracne should be carefully investigated for systemic complications (such as hepatic, ophthalmic, neurologic, lipoprotein, and endocrine abnormalities).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adams BB, Chetty VB, Mutasim DF (2000) Periorbital comedones and their relationship to pitch tar: a cross-sectional analysis and a review of the literature. J Am Acad Dermatol 42(4):624–627

    PubMed  CAS  Google Scholar 

  • Agency for Toxic Substances and Disease Registry (1993) Dioxin toxicity. Am Fam Physician 47:855–861

    Google Scholar 

  • Baccarelli A, Pesatori AC, Consonni D et al (2005) Health status and plasma dioxin levels in chloracne cases 20 years after the Seveso, Italy accident. Br J Dermatol 152(3):459–465

    Article  PubMed  CAS  Google Scholar 

  • Bartolini R (1989) Acne. A summary of the occupational health concern. Canadian Centre for Occupational Health and Safety, Hamilton. Report No. F89-1E:I-7

    Google Scholar 

  • Bleiberg I, Wallen M, Brodken R et al (1964) Industrial acquired porphyria. Arch Dermatol 89:793–797

    Article  PubMed  CAS  Google Scholar 

  • Bodner KM, Collins JJ, Bloemen LJ et al (2003) Cancer risk for chemical workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Occup Environ Med 60(9):672–675

    Article  PubMed  CAS  Google Scholar 

  • Brun P, Baran R (1984) A special type of mechanical acne: fiddler’s neck dermatitis. Ann Dermatol Venereol 111(3):241–245

    PubMed  CAS  Google Scholar 

  • Caputo R, Monti M, Ermacora E et al (1988) Cutaneous manifestations of tetrachlorodibenzo-p-dioxin in children and adolescents. J Am Acad Dermatol 19:812–819

    Article  PubMed  CAS  Google Scholar 

  • Chen LC, Berberian I, Koch B et al (1992) Polychlorinated and polybrominated biphenyl congeners and retinoid levels in rat tissues: structure-activity relationships. Toxicol Appl Pharmacol 114:47–55

    Article  PubMed  CAS  Google Scholar 

  • Coenraads PI, Brouwer A, Olie K, Tang N (1994) Chloracne. Some recent issues. Dermatol Clin 12:569–576

    PubMed  CAS  Google Scholar 

  • Cole GW, Stone O, Gates D, Culver D (1986) Chloracne from pentachlorphenol – preserved wood. Contact Dermatitis 15:164–168

    Article  PubMed  CAS  Google Scholar 

  • Crow KD (1981) Chloracne and its potential clinical implications. Clin Exp Dermatol 6:243–257

    Article  PubMed  CAS  Google Scholar 

  • Crow KD, Puhvel MS (1991) Chloracne (halogen acne). In: Manulli FN, Maibach HI (eds) Dermatoxicology. Hemisphere, New York, pp 647–667

    Google Scholar 

  • Cunliffe WJ, Williams M, Edwards JC et al (1975) An explanation for chloracne-an industrial hazard. Acta Derm Venereol (Stockh) 55:211–214

    CAS  Google Scholar 

  • Demirci U, Coskun U, Erdem O, Ozturk B, Yilmaz IB, Benekli M, Buyukberber S (2010) Acne rosacea associated imatinib mesylate in a gastrointestinal stromal tumor patient. J Oncol Pharm Pract [Epub ahead of print]

    Google Scholar 

  • den Besten C, Bennik MHJ, Bruggeman I et al (1993) The role of oxidative metabolism in hexchlorobenzene induced porphyria and thyroid hormone homeostasis: a comparison with pentachlorobenzene in a 13-week feeding study. Toxicol Appl Pharmacol 119:181–194

    Article  Google Scholar 

  • Draelos ZD, DiNardo JC (2006) A re-evaluation of the comedogenicity concept. J Am Acad Dermatol 54(3):507–512

    Article  PubMed  Google Scholar 

  • Fitzgerald EF, Weinstein AL, Youngblood LG et al (1989) Health effects three years after potential exposure to the toxic contaminants of an electrical transformer fire. Arch Environ Health 44:214–221

    Article  PubMed  CAS  Google Scholar 

  • Furness SG, Whelan F (2009) The pleiotropy of dioxin toxicity–xenobiotic misappropriation of the aryl hydrocarbon receptor’s alternative physiological roles. Pharmacol Ther 124(3):336–353

    Article  PubMed  CAS  Google Scholar 

  • Gawkrodger DJ (1991) Chloracne: causation, diagnosis and treatment. J Derm Treat 2:73–76

    Article  Google Scholar 

  • Gawkrodger DJ, Harris G, Bojar RA (2009) Chloracne in seven organic chemists exposed to novel polycyclic halogenated chemical compounds (triazoloquinoxalines). Br J Dermatol 161(4):939–943

    Article  PubMed  CAS  Google Scholar 

  • Geusau A, Tschachler E, Meixner M et al (1999) Olestra increases faecal excretion of 2,3,7,8-tetrachlorodibenzo-p-dioxin. Lancet 354:1266–1269

    Article  PubMed  CAS  Google Scholar 

  • Geusau A, Jurecka W, Nahavandi H et al (2000) Punctate keratoderma-like lesions on the palms and soles in a patient with chloracne: a new clinical manifestation of dioxin intoxication? Br J Dermatol 143(5):1067–1071

    Article  PubMed  CAS  Google Scholar 

  • Gladen BC, Taylor JS, Wu YC, Ragan NB, Rogan WJ, Hsu CC (1990) Dermatologic findings in children exposed transplacentally to heat-degraded polychlorinated biphenyls in Taiwan. Br J Dermatol 122:799–808

    Article  PubMed  CAS  Google Scholar 

  • Hambrick GS (1957) The effects of substituted napthalenes on the pilosebacious apparatus of rabbit and man. J Invest Dermatol 28:29–103

    Google Scholar 

  • Hankinson O (2009) Repression of aryl hydrocarbon receptor transcriptional activity by epidermal growth factor. Mol Interv 9(3):116–118

    Article  PubMed  CAS  Google Scholar 

  • Hardell L, Sandstrom A (1979) Case-control study: soft tissue sarcoma and exposure to phenoxy-acetic acids or chlorophenols. Br J Cancer 39:711–717

    Article  PubMed  CAS  Google Scholar 

  • Herxheimer K (1899) Ueber chlorakne. Munch Med Wochenschr 46:278

    Google Scholar 

  • Hjorth N, Sjolin KE, Sylvest B et al (1972) Acne aestivalis: Mallorca acne. Acta Derm Venereol 52:61–63

    PubMed  CAS  Google Scholar 

  • Hryhorczuk DO, Wallace WH, Persky V et al (1998) A morbidity study of former pentachlorophenol-production workers. Environ Health Perspect 106(7):401–408

    Article  PubMed  CAS  Google Scholar 

  • Hsu MM-L, Mak C-P, Hsu C-C (1995) Follow up of skin manifestations in Yu-Cheng children. Br J Dermatol 122:799–808

    Google Scholar 

  • Jirasek L, Kalensky J, Kubec K (1973) Acne chlorina and porphyria cutanea tarda during the manufacturing of herbicides Part I. Cesk Dermatol 48:306–317

    PubMed  CAS  Google Scholar 

  • Kersevovich J, Langenberg A, Odom RB et al (1992) Dowling-Degos’ disease mimicking chloracne. J Am Acad Dermatol 27:345–348

    Article  Google Scholar 

  • Khanna N, Gupta SD (1999) Acneiform eruptions after facial beauty treatment. Int J Dermatol 38(3):196–199

    Article  PubMed  CAS  Google Scholar 

  • Kligman AM, Mills OH (1972) Acne cosmetica. Arch Dermatol 106:843–850

    Article  PubMed  CAS  Google Scholar 

  • Knox JM, Dinehart SM et al (1986) Acquired perforating disease in oil field workers. J Am Acad Dermatol 14:605–611

    Article  PubMed  CAS  Google Scholar 

  • Kokelj F (1992) Occupational acne. Clin Dermatol 10:213–217

    Article  PubMed  CAS  Google Scholar 

  • Litt JZ (1974) McDonald’s acne. Arch Dermatol 110:956

    Article  PubMed  CAS  Google Scholar 

  • Longnecker MP, Rogan WJ, Lucier G (1997) The human health effects of DDT (dichlorodiphenyltrichloroethane) and PCBs (polychlorinated biphenyls) and overview of organochlorines in public health. Annu Rev Public Health 18:211–244

    Article  PubMed  CAS  Google Scholar 

  • Martín JM, Jordá E, Monteagudo C, Alonso V, García L, Villalón G (2006) Follicular acneiform eruption induced by imatinib. J Eur Acad Dermatol Venereol 20(10):1368–1370

    Article  PubMed  Google Scholar 

  • Masuda Y (2001) Fate of PCDF/PCB congeners and change of clinical symptoms in patients with Yusho PCB poisoning for 30 years. Chemosphere 43(4–7):925–930

    Article  PubMed  CAS  Google Scholar 

  • Mathias CGT (1994) Occupational dermatoses. In: Zenz C, Dickerson OB, Horvath EP (eds) Occupational medicine, 3rd edn. Mosby, St. Louis, pp 93–131

    Google Scholar 

  • McDonough AI, Gawkrodger DJ, Walker AE (1993) Chloracne study of an outbreak with new clinical observations. Clin Exp Dermatol 18:523–525

    Article  Google Scholar 

  • Michot C, Guillot B, Dereure O (2010) Lenalidomide-induced acute acneiform folliculitis of the head and neck: not only the anti-EGF receptor agents. Dermatology 220(1):49–50

    Article  PubMed  Google Scholar 

  • Mills OH, Kligman A (1975) Acne mechanica. Arch Dermatol 111:481–483

    Article  PubMed  Google Scholar 

  • Mukerjee D (1998) Health impact of polychlorinated dibenzo-p-dioxins: a critical review. J Air Waste Manag Assoc 48:157–165

    Article  PubMed  CAS  Google Scholar 

  • Nguyen SH, Dang TP, Maibach HI (2007) Comedogenicity in rabbit: some cosmetic ingredients/vehicles. Cutan Ocul Toxicol 26(4):287–292

    Article  PubMed  CAS  Google Scholar 

  • O’Malley MS, Carpenter AV, Sweeney MH, Fingerhut MA et al (1990) Chloracne associated with employment in the production of pentachlorophenol. Am J Ind Med 17:411–421

    Article  PubMed  Google Scholar 

  • Omohundro C, Taylor JS (1998) Occupational acne. In: English JSC (ed) A colour handbook of occupational dermatology. Manson, London, pp 121–134

    Google Scholar 

  • Osio A, Mateus C, Soria JC, Massard C, Malka D, Boige V, Besse B, Robert C (2009) Cutaneous side-effects in patients on long-term treatment with epidermal growth factor receptor inhibitors. Br J Dermatol 161(3):515–521

    Article  PubMed  CAS  Google Scholar 

  • Panteleyev AA, Bickers DR (2006) Dioxin-induced chloracne – reconstructing the cellular and molecular mechanisms of a classic environmental disease. Exp Dermatol 15:705–730

    Article  PubMed  CAS  Google Scholar 

  • Pelclova D, Urban P, Preiss J et al (2006) Adverse health effects in humans exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Rev Environ Health 21(2):119–138

    Article  PubMed  CAS  Google Scholar 

  • Pesatori AC, Consonni D, Bachetti S et al (2003) Short- and long-term morbidity and mortality in the population exposed to dioxin after the “Seveso accident”. Ind Health 41(3):127–138

    Article  PubMed  CAS  Google Scholar 

  • Pesatori AC, Consonni D, Rubagotti M et al (2009) Cancer incidence in the population exposed to dioxin after the “Seveso accident”: twenty years of follow-up. Environ Health 8:39

    Article  PubMed  Google Scholar 

  • Plewig G, Jansen T (1998) Acneiform dermatoses. Dermatology 196:102–107

    Article  PubMed  CAS  Google Scholar 

  • Pocchiari F, Silano V, Zampieri A (1979) Human health effects from accidental release of tetrachlorodibenzo-p-dioxin (TCDD) at Seveso, Italy. Ann NY Acad Sci 320:311–320

    PubMed  CAS  Google Scholar 

  • Poland A, Glover E, Kende AS (1976) Stereo-specific high affinity binding of 2,3,7,8-tetrachlorodibenzo-p-dioxin by hepatic cytosol. J Biol Chem 251:4936–4946

    PubMed  CAS  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 

  • Proudfoot AT (2003) Pentachlorophenol poisoning. Toxicol Rev 22(1):3–11

    Article  PubMed  CAS  Google Scholar 

  • Rodriguez-Pichardo A, Camacho F, Rappe C, Hansson M, Smith AG, Greig IB (1991) Chloracne caused by ingestion of olive oil contaminated with PCDDs and PCDFs. Hum Exp Toxicol 10:311–322

    Article  PubMed  CAS  Google Scholar 

  • Rogan WJ, Gladen BC, Hung K-L, Koong S-L, Shih L-Y, Taylor JS (1988) Congenital poisoning by polychlorinated biphenyls and their contaminants in Taiwan. Science 241:334–336

    Article  PubMed  CAS  Google Scholar 

  • Ryan JJ, Schecter A (2000) Exposure of Russian phenoxy herbicide producers to dioxins. J Occup Environ Med 42(9):861–870

    Article  PubMed  CAS  Google Scholar 

  • Scerri L, Zaki I, Millard LG (1995) Severe halogen acne due to a trifluoromethylpyrazole derivative and its resistance to isotretinoin. Br J Dermatol 132:l44–l148

    Article  Google Scholar 

  • Sorg O, Zennegg M, Schmid P, Fedosyuk R, Valikhnovskyi R, Gaide O, Kniazevych V, Saurat JH (2009) 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) poisoning in Victor Yushchenko: Identification and measurement of TCDD metabolites. Lancet 374:1179–1185

    Article  PubMed  CAS  Google Scholar 

  • Sperling L (1994) Skin disease associated with excessive heat, humidity, and sunlight. In: Zajtchuk R (ed) Textbook of military medicine, part III. Sergent General, Department of the Army, Washington DC, pp 44–45

    Google Scholar 

  • Sterling JB, Hanke CW (2005) Dioxin toxicity and chloracne in the Ukraine. J Drugs Dermatol 4(2):148–150

    PubMed  Google Scholar 

  • Strik JJ (1979) Porphyrins in urine as an indicator of exposure to chlorinated hydrocarbons. Ann NY Acad Sci 320:308–310

    PubMed  CAS  Google Scholar 

  • Sutter CH, Yin H, Li Y et al (2009) EGF receptor signaling blocks aryl hydrocarbon receptor-mediated transcription and cell differentiation in human epidermal keratinocytes. Proc Natl Acad Sci USA 106(11):4266–4271

    Article  PubMed  Google Scholar 

  • Sweeney MH, Mocarelli P (2000) Human health effects after exposure to 2,3,7,8-TCDD. Food Addit Contam 17(4):303–316

    Article  PubMed  CAS  Google Scholar 

  • Tang NJ, Liu J, Coenraads PJ et al (2008) Expression of AhR, CYP1A1, GSTA1, c-fos and TGF-alpha in skin lesions from dioxin-exposed humans with chloracne. Toxicol Lett 177(3):182–187

    Article  PubMed  CAS  Google Scholar 

  • Taylor JS (1974) Chloracne, a continuing problem. Cutis 13:585–591

    Google Scholar 

  • Taylor JS (1979) Envionmental chloracne: update and overview. Ann NY Acad Sci 320:295–307

    PubMed  CAS  Google Scholar 

  • Taylor JS (1986) Occupational dermatoses. In: Conn HF (ed) Current therapy. Saunders, Philadelphia, pp 686–688

    Google Scholar 

  • Taylor JS (1987) Pilosebaceous unit. In: Maibach HI (ed) Occupational and industrial dermatology. Year Book Medical Publishers, Chicago, pp 105–120

    Google Scholar 

  • Taylor JS, Lloyd KM (1982) Chloracne from 3.3’,4,4’ -tetrachloroazoxybenzene and 3.3’,4,4’-tetrachloroazobenzene: update and review. In: Hutzinger O (ed) Chlorinated dioxins and related compounds. Pergamon, Oxford, pp 535–544

    Google Scholar 

  • Taylor JS, Wuthrich RC, Lloyd KM, Poland A (1977) Chloracne from manufacture of a new herbicide. Arch Dermatol 113:616–619

    Article  PubMed  CAS  Google Scholar 

  • Thomke F, Jung D, Besser R et al (1999) Increased risk of sensory neuropathy in workers with chloracne after exposure to 2,3,7,8-polychlorinated dioxins and furans. Acta Neurol Scand 100(1):1–5

    Article  PubMed  CAS  Google Scholar 

  • Tindall JP (1985) Chloracne and chloracnegens. J Am Acad Dermatol 13:539–558

    Article  PubMed  CAS  Google Scholar 

  • Upreti RK, Das M, Shanker R (1989) Dermal exposure to kerosene. Vet Hum Toxicol 31:16–20

    PubMed  CAS  Google Scholar 

  • Vazquez ER, Macias PC, Tirado IG, Solana CG, Casanova A, Moncada IF (1996) Chloracne in the 1990s. Int J Dermatol 35:643–645

    Article  Google Scholar 

  • Veterans Administration Chloracne Task Force (1984) Guidelines for the Diagnosis of Chloracne. U.S. Veterans Administration, Washington, DC, USA

    Google Scholar 

  • Veysey EC, George S (2005) Actinic folliculitis. Clin Exp Dermatol 30(6):659–661

    Article  PubMed  CAS  Google Scholar 

  • Yip J, Peppall L, Gawkrodger DJ, Cunliff WJ (1993) Light cautery and EMLA in the treatment of chloracne lesions. Br J Dermatol 128:313–316

    Article  PubMed  CAS  Google Scholar 

  • Zaenglein AL, Thiboutot DM (2008) Acne vulgaris. In: Bolognia JL, Jorizzo JL, Rapini RP (eds) Dermatology, 2nd edn. Mosby, London, pp 495–508

    Google Scholar 

  • Zugerman C (1990) Chloracne, chloracnegenesis, and other forms of environmental acne. In: Adams RM (ed) Adams occupational skin disease, 2nd edn. WB Saunders, Philadelphia, pp 127–135

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Penpun Wattanakrai .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Wattanakrai, P., Taylor, J.S. (2012). Occupational and Environmental Acne. In: Rustemeyer, T., Elsner, P., John, SM., Maibach, H.I. (eds) Kanerva's Occupational Dermatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02035-3_31

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-02035-3_31

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-02034-6

  • Online ISBN: 978-3-642-02035-3

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics