Cutaneous manifestations of tetrachlorodibenzo-p-dioxin in children and adolescents

Caputo, Ruggero; Monti, Marco; Ermacora, E.; Carminati, G.; Gelmetti, Carlo; Gianotti, Raffaele; Giannì, E; Puccinelli, V

doi:10.1016/s0190-9622(88)70238-8

Cited by 90 publications

(43 citation statements)

References 7 publications

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“…The histological pattern of chloracne/MADISH has been reported [11] based on fully constituted lesions in a patient highly exposed to an AhR agonist; this had confirmed and extended previous observations [13,14,15]. In order to introduce a focused analysis of a histological slide from a ‘routine acne patient' aimed at identifying a pattern associated with AhR activation, we thought [G. Kaya, unpubl.…”

Section: Methodssupporting

confidence: 76%

“…The key histological pattern indicating AhR activation includes (i) disappearance of the sebaceous glands (fully seen in major AhR agonist exposure, and a reduction in milder exposure) and (ii) epidermal cysts with mantle-like epithelial projections [11,13,14,15]. Consensus amongst dermatopathologists in weighing these signs in mild cases is in progress.…”

Section: Introductionmentioning

confidence: 99%

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Aryl Hydrocarbon Receptor Activation in Acne Vulgaris Skin: A Case Series from the Region of Naples, Italy

Fabbrocini

Kaya²,

Silverio³

et al. 2015

Dermatology

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Background: Dioxins are persistent organic pollutants present in the environment. They exert their biological effects by binding to an intracellular receptor, the aryl hydrocarbon receptor (AhR). Activation of AhR leads to the induction of cytochrome p450 1A1 (CYP1A1). Expression of CYP1A1 in human skin is a key marker for AhR activation, and it may induce comedogenesis resulting in acne-like lesions known as chloracne/metabolising acquired dioxin-induced skin hamartomas (MADISH). The contribution of this pathway in patients seen in a busy acne clinic is unknown. Materials and Methods: We explored the expression of CYP1A1 by immunohistochemistry in the acne lesions of 16 patients living in the region of Naples, Italy, where epidemiological studies have suggested a possibly increased exposure to environmental dioxins. A composite score to outline potential components of the chloracne/MADISH histological pattern was used. Results: CYP1A1 expression was observed in 11 lesions (69%) and was distributed in sebaceous glands, follicular epithelium, cystic wall and endothelial cells. The histological score for chloracne/MADISH was ‘likely' in 3 cases and ‘possible' in 11 cases. Compared to current data on CYP1A1 expression in the skin of 67 patients with proven exposure to AhR agonists, these data indicate a high incidence of AhR activation in this series. Conclusion: This is the first study analysing AhR activation in skin in a series of patients from a hospital-based acne clinic. It provides information for future controlled prospective studies. The significance of CYP1A1 expression in terms of AhR ligand exposure is discussed.

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Section: Methodssupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Aryl Hydrocarbon Receptor Activation in Acne Vulgaris Skin: A Case Series from the Region of Naples, Italy

Fabbrocini

Kaya²,

Silverio³

et al. 2015

Dermatology

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“…Another study, of 115 Seveso residents, found that 84% had urine porphyrin patterns consistent with coproporphyrinuria or CHP Type A, with the greatest prevalence and degree of abnormality in residents from areas of highest contamination (122). A later study, however, reported chloracne but no PCT attributable to TCDDs among Seveso children and adolescen (123,124). In two studies of Missouri communities where TCDD-contaminated waste oil had been sprayed for dust control over several years, there were no cases of PCT, but one study found significantly higher mean uroporphyrin levels in urine and higher prevalence of elevated urine uroporphyrin values (> 13 pg/g creatinine (cre) in 16%, vs 7% controls) among 154 residents of a contaminated mobile home park compared to matched control subjects (125,126).…”

Section: Biochemistry Of Porphyriasmentioning

confidence: 89%

Environmental Chemical Exposures and Disturbances of Heme Synthesis

Daniell¹,

Stockbridge²,

Labbé³

et al. 1997

Environmental Health Perspectives

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“…One worker in a TCDD-contaminated workplace developed PCT, sarcoma, and probable chloracne; the combined occurrence of these rare conditions suggested an etiological relation to the TCDD exposure (116,117 (122). A later study, however, reported chloracne but no PCT attributable to TCDDs among Seveso children and adolescents (123,124). In two studies of Missouri communities where TCDD-contaminated waste oil had been sprayed for dust control over several years, there were no cases of PCT, but one study found significantly higher mean uroporphyrin levels in urine and higher prevalence of elevated urine uroporphyrin values (> 13 pg/g creatinine (cre) in 16%, vs 7% controls) among 154 residents of a contaminated mobile home park compared to matched control subjects (125,126).…”

Section: Dioxinmentioning

confidence: 89%