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Visintainer Melo P, Fortes Escobar G. An Exuberant Case of Retentional Acne: Chloracne. Dermatol Pract Concept 2022; 12:e2022128. [PMID: 36159117 PMCID: PMC9464560 DOI: 10.5826/dpc.1203a128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/21/2022] Open
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Chessa MA, La Placa M, Patrizi A, Virdi A, Misciali C, Fedrizzi G, Filippi F, Saurat JH, Sorg O, Fontao F, Kaya G, Neri I. Chloracne: a case series on cutaneous expression of CYP1A1 as diagnostic biomarker. Clin Exp Dermatol 2021; 46:896-900. [PMID: 33638914 DOI: 10.1111/ced.14617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/24/2021] [Indexed: 11/29/2022]
Abstract
Chloracne, also known as metabolizing acquired dioxin-induced skin hamartomas (MADISH), is a rare disfiguring disease related to dioxin exposure. There is a paucity of literature on the clinical manifestations and pathogenesis of chloracne/MADISH. The aim of this study was to assess the clinical features of this very unusual acneiform eruption and to explore the pathogenesis of the disease. This was a retrospective, observational report study was conducted on five patients belonging to the same nuclear family (father, mother and three children) and a relative (father's brother) living in the same house. Histopathological, immunohistochemical, laboratory and toxicological analyses were performed for all patients. The results suggest that CYP1A1 in human skin is a diagnostic biomarker in chloracne, and was positive for all the patients in our sample. Tetrachlorodibenzo-p-dioxin is the most investigated dioxin responsible for chloracne; however, several other agonists, whether dioxin-like or not, can activate the aryl hydrocarbon receptor. To our knowledge, this Italian case series is the first study to suggest polychlorinated biphenyls as a possible cause of an overstimulation of aryl hydrocarbons causing the consequent acneiform eruption.
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Affiliation(s)
- M A Chessa
- Dermatology Unit, IRCCS Sant'Orsola Policlinic, University of Bologna, Bologna, Italy
| | - M La Placa
- Dermatology Unit, IRCCS Sant'Orsola Policlinic, University of Bologna, Bologna, Italy
| | - A Patrizi
- Dermatology Unit, IRCCS Sant'Orsola Policlinic, University of Bologna, Bologna, Italy
| | - A Virdi
- Dermatology Unit, IRCCS Sant'Orsola Policlinic, University of Bologna, Bologna, Italy
| | - C Misciali
- Dermatology Unit, IRCCS Sant'Orsola Policlinic, University of Bologna, Bologna, Italy
| | - G Fedrizzi
- Chemical Department, Istituto Zooprofilattico Sperimentale Lombardia Emilia Romagna, Bologna, Italy
| | - F Filippi
- Dermatology Unit, IRCCS Sant'Orsola Policlinic, University of Bologna, Bologna, Italy
| | - J-H Saurat
- Dermatotoxicology Unit, Swiss Centre for Applied Human Toxicology, University of Geneva, Geneva, Switzerland
| | - O Sorg
- Dermatotoxicology Unit, Swiss Centre for Applied Human Toxicology, University of Geneva, Geneva, Switzerland
| | - F Fontao
- Dermatotoxicology Unit, Swiss Centre for Applied Human Toxicology, University of Geneva, Geneva, Switzerland
| | - G Kaya
- Departments of, Dermatology, University Hospital of Geneva, Geneva, Switzerland.,Clinical Pathology, University Hospital of Geneva, Geneva, Switzerland
| | - I Neri
- Dermatology Unit, IRCCS Sant'Orsola Policlinic, University of Bologna, Bologna, Italy
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