Chloracne: Causation, diagnosis and treatment

Abstract

Chloracne is a rare but serious manifestation of systemic poisoning with polyhalogenated aromatic chemicals. It is alrqost invariably due to occupational exposure, often as a result of an industrial accident. Comedones, sometimes with inflammatory lesions, are the principal skin signs and most accurately reflect systemic toxicity. Hepatotoxicity, neuropathy and lipid abnormalities also occur. The skin lesions are resistant to most conventional acne therapies. Topical tretinoin may be of some benefit for comedones. Light cautery of comedones is successful and, although time consuming for the patient, many comedones can be treated in a 15 minute session. Limited experience with oral isotretinoin suggests that it is not very effective in chloracne. An outbreak of chloracne requires detailed investigation of the industrial process responsible to eliminate further exposure. The prognosis for mild cases of chloracne is good provided contact with the chloracnegen ceases.