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Chloracne: a case series on cutaneous expression of CYP1A1 as diagnostic biomarker
Author(s) -
Chessa M. A.,
La Placa M.,
Patrizi A.,
Virdi A.,
Misciali C.,
Fedrizzi G.,
Filippi F.,
Saurat J.H.,
Sorg O.,
Fontao F.,
Kaya G.,
Neri I.
Publication year - 2021
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.14617
Subject(s) - biomarker , medicine , dermatology , series (stratigraphy) , expression (computer science) , pathology , biology , computer science , genetics , paleontology , programming language
Summary 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.