Pesticide-Induced Scleroderma and Early Intensive Immunosuppressive Treatment

Abstract

The authors report 2 children with generalized cutaneous sclerosis exposed to pesticides containing malathion and diniconazole. Treatment with immunosuppressives resulted in partial improvement in the cutaneous signs, particularly over the face, trunk, and proximal limbs. The considerable exposure to chemicals related with the initiation of symptoms and absence of organ involvement suggested a diagnosis of chemically induced scleroderma-like disorder. Although autoantibodies were negative, previously reported relevant associations of anti-kinetochore and anti-topoisomerase function of active ingredients-diniconazole and phosphorodithioate-and solvents of these pesticides are also discussed. Careful follow-up for systemic involvement is warranted, since these agents may have triggered systemic scleroderma in these patients. Elimination of chemical exposure of children is stressed.

Organophosphate toxicity: updates of malathion potential toxic effects in mammals and potential treatments

“…Moreover, Johnson et al reported an increased antibody production following immunization with a T lymphocytedependent antigen in female mice treated with MAL at doses as low as 0.018 mg/kg, which is below the human allowable daily intake (0.02 mg/kg) (Johnson et al 2002); their results were in agreement with those of Flipo et al (Flipo et al 1992). This may explain the report of Sozeri et al of 2 children with generalized cutaneous sclerosis, with signs correlated to exposure to pesticides containing MAL (Sozeri et al 2012). Another study revealed that weekly administration (> 33 mg/kg) elevated the level of serum rheumatoid factor at 19 weeks of age, and a higher dose (> 100 mg/kg) also increased the level of anti-anti-DNA antibodies in the serum of MRL-lpr mice (mice genetically predisposed to autoimmune disease) (Rodgers 1997).…”

Chemical-induced sclerodermoid disease triggered by pressure washing bleach solution

“…CISD frequently presents with acrosclerosis and morpheaform plaques. 1,2 Histological examination shows lymphocytic infiltration around the dermal vessels and changes in the collagen matrix, closely resembling the findings in scleroderma. 2,3 Commonly implicated chemicals include silica and organic compounds; pesticides have also been reported.…”

“…1,2 Histological examination shows lymphocytic infiltration around the dermal vessels and changes in the collagen matrix, closely resembling the findings in scleroderma. 2,3 Commonly implicated chemicals include silica and organic compounds; pesticides have also been reported. 2 Exposure to Mold Armor, a registered pesticide containing sodium hypochlorite (5.25%) and sodium hydroxide (\1%) or similar bleaching agents has not been previously reported to cause CISD.…”

“…CISD has been well-reported, secondary to aromatic hydrocarbon, vinyl chloride, epoxy resin, and pesticide exposure. 1,2 Cutaneous signs of CISD include acrosclerosis and morpheaform plaques. We report a novel case of CISD attributed to a pressure washing product containing sodium hypochlorite and sodium hydroxide, which are the ingredients found in household bleach.…”

Localized Scleroderma: Predisposing and Triggering Factors

“…Scleroderma can be induced by some chemical agents, for example pesticides containing malathion and diniconazole [54]. Localized scleroderma is occasionally linked with exposure to chemical compounds such as silicone [55].…”