Document g2jvqLmj2XzbLNOR0BQ53LeOQ

Acc ..ao5unlasps The Cz:l A .OirCaC-l ^fWani- C L` Ol and f fat,, 4 ^, ?r W 'W .Qm ) :1 Ml ACXEFORM DERMATOSIS PRODUCED BY ORTHO (2 CHLOROPHE.YYL) PHENOL SODIUM . AND TETRA-CH LORPHENOL SODIUM MILTON 9. BUTLER, M.D. SAGINAW, MICH. lpirteelrTiamhtueinreacroyenxdrceietpipootnrtthtioes m"bceahdldeoer-sbacecrcinabeue"sde droeefsscetrmhibebeldefsacbtnyotnhPeartodsreseseccrernibWtleydhitthiene. uthsAee ofufngthoeusdriungfesctuionndserincomnasind.eration was recommended for treatment of wasTwseevnetrye-oenneoucgahsestoharveqeubireeentreoabtsmerevnetd.. TIhne sepvaetinetnetesn Htheeateddisowrdeerer awllasyo34u.ng white men.' Most of them were aged from 19 to 23; one The chemicals which I later found to be causative were used in a mixture. The first acnc-likc eruption appeared one month after the pthreoducocntsdiwtieorne mwearneufeamctpulroeydedinian psoawckdienrgfothrme .mAixltlutrhee. mTenheexdhiisboirtdinegr here described developed within the next six months after contact with the chemicals. I have seen four laboratory workers who had a milder, more localized reaction after working with dichlorinatcd phenyl. Their reaction closely resembled the disorder described by Jack Jones, of Atlanta, Ga. In the cases which form the basis of this report the essential lesions were predominantly papulofollicular and were associated with marked hyperkeratosis. Enormous numbers of comedones and numerous seba caesoutos cpyrostdsucweerae bplraecskendti.scoInlorsaotmioen.casSeesccoonmdaerdyonpeusstwuelarer lseosinounms efrrooums the size of a pea to that of a chestnut were observed. The eruption began with a few papules behind the ears; then it spread to the fore . hInevado,lvcehmeeenkst, oclhitnheansdhobualcdkerso,f pthreestneemckn.l rTeghieons,canlpp]xw-rasponrottioinnvooflvtehde. arms and buttocks was seen in five cases. Two patients who had acne of the face previously showed in addition involvement of the abdomen, jtiheenisfo, rsecarromtusm. , Tahneterhiaonrdssuorfracfreest owfertheenothtigahftseralendd. flexor surfaces of *, 1 :: u!s| "i I DEC 011992 252 ARCHIVF.S OV DERMATOLOGY A SD SY PH1L0L*OGY Jn one case the earl}* stage of the disorder was diagnosed as derma titis papillaris capillitii both by me and by a reputable dermatologist who saw the palnil indc|iendeiilly. At that lime we did not suspect an industrial causation. k :::ui?l ffl g athcetiFvlaiegc.ele, s1pi.o--rnssFt.uerllnallenargetahs,vailexwlomshinoawl iwngallthaendwpiedneissprsehaodweidnvsoimlveilmarenstc.arsAbnutetrileovrylyer, itrsoeclooeTsvthhseeeraercdttww.ivoeerTn,ktlbyieu-motopnsrreooencpitechastaspi,neanepfstuispfleetewcseieanarlnleymd riocennomtmthhoesovdesaoedgnoetrf,serobapmtueetrdsnitshwote.nitehpSlhraeaonvsetenrctecogomesnncpcaelrrerratnieynelsydg, 3isl l1 f\V v' BUTLER--ACXEJORM DERMATOSIS 3 ohafvteherepcituterrdenvtarcierotypsseoefn innewordleinsiaornysaantteviasrycoinmgmionnte. rvSaelsv.eraIlnpaatielenwts paastieevnetrse wrehaocthioand.ndeovleelsoipoends awshkenitereams ofvroedm ftrhormeethtoe fsiovuercmeoonfthcsoanftatecrt c e >l t ( *r:>wrleyr, sttfasrhrincseaead.acFrttsmipipoTguaben.hssunatti2utslt.l--fepoyirsrnfoPootleeruyvheneteomhntdatg,oaemgmilanenrgowoeaesdnrpdta.thhadecsi1fma.Ttf9iet,vahicoedeHthnievae,fldeaee,csishgiehnaoahlouniadtttne;n.eedbwbneeoassemionrdnkltoeueesntrdtiitrotohehnwrsaetipeatmahdolntirdenttriwihenesritnmothshdecii*ohubtfehmsemiecghiaicerntau*hnlbs,i*iouoncasdmgculy'oliofin*rsafcd*htaeentochr.iwnnieceeesRddd,leoopsrdteamiiunomprtnaugiislnlle,eao*gns-r' i 'ed exposure. A tintnhiT of tlicse men hnve lost weight and complain of ays, rine WinLgabeaosrialytofraytigteuseud. for jmssihle impurities in the products gave nega tive results. Kx.iuiinatioii of the urine for bromides and iodides revealed l 254 .ARCHIVES OF DERMATOLOGY AXD SYPIULOl.nC.Y nancootntioe.an osPjwxaiicindigf)ictoterestahtscetiwoexnitc.hesstPhaeutfcmhsoixdtetiuustrmse hwpyriodthdrouxtchiedede papunrreesimecnmltt.eeiIdnniianctaetlsh,cisaiu.wsteai.cs, opTpsareprrrhostoefhiecdedsmoiwuuficcrbceee(ldea2ddascyettatchisnhoh.esepnliooatiBsrcsvwaoiniitmpoaticyvhspfe,eeosisnrreaimreymsseala)cpwdcetliteeypviorroihnmednae.ennarnttoeocoTqliesruhditrssehieotse.adabtcfeniyiofuddoonmnrttbchmaulceraetetenarsrrddfpeeabeodfcurtuntcmtsustereaptnadhto-i.aaScttitnh|sKdtloot)penrwrspttolat>hasndesecunoolcnoauneoltsdtltev'csdrodowidunddiietrturuhnomgtiolons.,t su it UARY the 1tahravaecnoebseorrvethdetw"ecnhtlyo-ro-ancencea"sedsesocfriabnedacnbeyfoPrrmosesreurptWiuhnilree.semTbhleinsge ehprahuncpdntlviionl)ngspthohecencfuoinrlriseshdoeddiinupmrpoedrasunocdntsstwehteararne-dclahifnlfogercpathedemn. ioxlTtuhsreoesdeioumfmeo.nrtdhOiodnln(y2otpchehralsnoordnolseor come in contact with any by-products. Other men working in the stdiaeomvneeeldobpueaidgldeinsnetgsvehrraeulmt amnionotendtchosumniaanffgtfeercinteteodx.pdoisrIeuncret scohomandetaccpteaawtsieeidtnh.tsthNtehoeafroderiasecomtriodennesr occurred in persons who had not l>een exposed to the chemicals con ppcerhorenvnMeeoddyl. hsooPebdlsapietufcrumvhlattaebionsutndtssnfticaonittlreatchd-ucetrhsoaeltosicrvhpaeosh.weesnao.innlydsiecopaditideuemtrhmaaatrlcosrectnhasopiatib(z2laeticoohnflo. prorTophdheuerncaivpnlyg) sbeeveurseedacnaesfofnunngeircuidpatilonasgeonntsthuenhtiulmfaunrtshkeirn. inTvehsetsigeadtiroungsresvhoeaullsd tnhoet mechanism whereby they produce this dermatosis. I should like to discover whether the reaction is purely cutaneous or whether there is dreaamctaigoen tios iinnvteorlnvaeld,oragnadnsI. ho1peamthaotf athseolouptiionnionmathyatthraowconssotmituetiloignhalt oexnpethriemeentitoaltoiogny wofithtruaenimacanlse. wi1ll heonpaeblethmate ftuorthmearkeobaselravtaetrionreia*nmd concerning this disorder. I