Occupational and Environmental Acne
摘要
Occupational and environmental acne is an acneiform disorder, resulting from various chemical exposures and from a variety of environmental, physical, and mechanical factors, usually encountered in the workplace but occasionally seen in nonoccupational settings. Occupational and environmental acne comprises oil acne, coal-tar and pitch acne, acne cosmetica, acne estivalis (from sun), acne mechanica, tropical acne, drug-induced acne, and chloracne. Chloracne, although rare, is a sensitive indicator of chemical exposure to certain polyaromatic halogenated hydrocarbons and is often associated with systemic involvement that should be recognized by physicians treating occupational skin disease. Diagnosis of occupational and environmental acne requires a detailed medical history including possible physical, chemical, and environmental causative agents, a compatible clinical and histologic picture, and distribution usually beyond the typical locations of acne vulgaris. Putative chloracnegens should be identified by environmental measurements and may be assessed in serum and various tissues by direct chemical analysis or biological assay. Management of occupational and environmental acne involves removing or limiting exposure to the putative chemical agent, wearing chemical protective equipment, worker education, and topical and systemic pharmaceutical therapy as indicated.