Association between Agent Orange Exposure and Nonmelanotic Invasive Skin Cancer

Clemens, Mark W.; Kochuba, Andrew; Carter, Mary Ella; Han, Kevin; Li, Jun; Evans, Karen K.

doi:10.1097/01.prs.0000436859.40151.cf

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…Fifteen years after spraying ceased, numerous studies revealed that dioxin levels had accumulated in higher amounts in the adipose tissue of individuals from Vietnam than in those from other countries 1 2. Particular areas of accumulation of Agent Orange include the liver and adipose tissue; therefore resulting in a slow metabolism and an estimated half-life of 11.3 years 1 3.…”

Section: Discussionmentioning

confidence: 99%

“…Particular areas of accumulation of Agent Orange include the liver and adipose tissue; therefore resulting in a slow metabolism and an estimated half-life of 11.3 years 1 3. Additionally, TCDD has been shown to cause indirect DNA damage through alterations of particular molecular compounds 2. Many reports have also shown that TCDD impacts lipid metabolism and have attributed hyperlipidaemia as a potential consequence of Agent Orange exposure 4.…”

Section: Discussionmentioning

confidence: 99%

“…Operation Ranch Hand led to the deposition (via helicopter, boats and trucks) of 72 million litres of chemicals across the forested and rural areas of Vietnam for this sole purpose 1 2. The bulk of these chemicals was Agent Orange, a mixture of 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,3,7,8-tetrachlorodibenzo- p -dioxin (TCDD), a common contaminant of 2,4,5-T 1.…”

Section: Introductionmentioning

confidence: 99%

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Wartime toxin exposure: recognising the silent killer

Khan¹,

Wozniak

Coleman

et al. 2016

BMJ Case Reports

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Wartime toxin exposures have been implicated in the genesis of malignancy in war veterans. Agent Orange, one toxin among many, has been linked to malignancy and the subcomponent phenoxyacetic acid has been associated with soft tissue sarcomas (STSs). This case demonstrates the association between a wartime toxin exposure (Agent Orange) and subsequent cancer development. Ultimately, we aim to highlight the importance of simple, specific questions in the patient history to account for previous wartime toxin exposures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Wartime toxin exposure: recognising the silent killer

Khan¹,

Wozniak

Coleman

et al. 2016

BMJ Case Reports

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“…34 A recent study showed increased rates of NMSC in fair-skinned male veterans when compared with the general population, encompassing men and women of all pigmentation types, but the study suffered from several methodological flaws. 35 The difference between these 2 distinct risk populations is incorrectly attributed to Agent Orange, but what is more concerning is the statement that 43% of their veterans had chloracne. This is in direct opposition to the AFHS, which was conducted with dermatology confirmation and showed a 0% prevalence of chloracne among Agent Orangeeexposed veterans and was performed years earlier.…”

Section: Melanoma and Nonmelanoma Skin Cancermentioning

confidence: 96%

“…This is in direct opposition to the AFHS, which was conducted with dermatology confirmation and showed a 0% prevalence of chloracne among Agent Orangeeexposed veterans and was performed years earlier. 18,35 Conversely, the dioxinexposed Seveso population has demonstrated no increased susceptibility for melanoma or NMSCs. 36 It is possible that with longer postexposure periods this risk factor may become more conclusive or that other factors involved with military service in Southeast Asia may contribute to the dermatologic cancer risk in this population.…”

Section: Melanoma and Nonmelanoma Skin Cancermentioning

confidence: 99%

Skin diseases associated with Agent Orange and other organochlorine exposures

Patterson

Kaffenberger

Keller

et al. 2016

Journal of the American Academy of Dermatology

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Organochlorine exposure is an important cause of cutaneous and systemic toxicity. Exposure has been associated with industrial accidents, intentional poisoning, and the use of defoliants, such as Agent Orange in the Vietnam War. Although long-term health effects are systematically reviewed by the Institute of Medicine, skin diseases are not comprehensively assessed. This represents an important practice gap as patients can present with cutaneous findings. This article provides a systematic review of the cutaneous manifestations of known mass organochlorine exposures in military and industrial settings with the goal of providing clinically useful recommendations for dermatologists seeing patients inquiring about organochlorine effects. Patients with a new diagnosis of chloracne, porphyria cutanea tarda, cutaneous lymphomas (non-Hodgkin lymphoma), and soft-tissue sarcomas including dermatofibrosarcoma protuberans and leiomyosarcomas should be screened for a history of Vietnam service or industrial exposure. Inconclusive evidence exists for an increased risk of other skin diseases in Vietnam veterans exposed to Agent Orange including benign fatty tumors, melanomas, nonmelanoma skin cancers, milia, eczema, dyschromias, disturbance of skin sensation, and rashes not otherwise specified. Affected veterans should be informed of the uncertain data in those cases. Referral to Department of Veterans Affairs for disability assessment is indicated for conditions with established associations.

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The Effect of Agent Orange on Nonmelanoma Skin Cancer Regression Rates

et al. 2014

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Decades ago, the US military used herbicides, including Agent Orange (2,3,7,8-tetrachlorodibenzodioxin), in conflicts such as the Vietnam War. Agent Orange has since been linked to multiple ailments, including prostate cancer, porphyria, chloracne, Hodgkin disease, and many more. 1 Recently, a pilot study by Clemens et al 2 suggested that exposure to Agent Orange may increase the incidence of nonmelanotic invasive skin cancer (NMSC) among veterans when compared with the general population. They also found a greater risk when the exposure was through more direct means such as spraying the herbicide. Frequently, following a biopsy, NMSCs may regress to the point that no evidence of carcinoma may be found after excision. The observation was first described by Goldwyn and Kasdon in 1978. 3 Since their initial report, several studies 4-6 have found regression rates varying from 24% to 72%. With the pilot study 2 suggesting that Agent Orange increased the incidence of NSMC, we aimed to determine if these NSMC lesions still behaved similarly. We then proceeded to design a study comparing regression rates between veterans with NMSC who were exposed to Agent Orange and veterans with NMSC who were not.

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Association between Agent Orange Exposure and Nonmelanotic Invasive Skin Cancer

Abstract: Risk, II.

Cited by 12 publications

References 20 publications

Wartime toxin exposure: recognising the silent killer

Wartime toxin exposure: recognising the silent killer

Skin diseases associated with Agent Orange and other organochlorine exposures

The Effect of Agent Orange on Nonmelanoma Skin Cancer Regression Rates

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