is the one human effect universally linked to dioxin exposure. The presence of
chloracne is considered a clinical sign of exposure.
severity and abrupt onset of chloracne follows a dose response curve. The
lesions are remarkably persistent, and resistant to usual acne treatment
regimens. One study of workers in an industrial accident revealed the mean
duration of residual chloracne to be 26 years. Chloracne was still present in
some workers 30 years after the original exposure. (Moses, 1984)
is an acne-like eruption of comedones, cysts, and postules that usually
involve the malar area of the face. Cysts are frequently coalescent, and
filled with straw colored fluid.
It has been our experience that skin conditions are one of the most common
health problems reported by Vietnam veterans. Most of these conditions are not
chloracne, although diagnosis is often inconclusive. We suspect that the
frequency and persistence of these skin conditions may be related to parasitic
or other infections the veteran acquired in Vietnam, but they are widely
varied. To our knowledge, no significant study of this problem has ever been
is a skin condition that looks like common forms of acne that affect
teenagers. At present, chloracne is the only well established long-term effect
of exposure to TCDD or dioxin, the contaminant found in one of the ingredients
of Agent Orange.
is important to note that skin disorders are among the most common health
problems experienced by combat forces. Because of the environment and living
conditions in Vietnam, veterans developed a variety of skin problems, ranging
from bacterial and fungal infections to a condition known as "tropical
acne." However, the only skin disorder consistently reported to be
associated with Agent Orange and other herbicides is chloracne.
does chloracne look like and where does it appear?
first sign of chloracne may be excessive oiliness of the skin. This is
accompanied or followed by the appearance of numerous blackheads. In mild
cases the blackheads may be limited to the area around the eyes extending
along the temples to the ears. In more severe cases blackheads may appear in
many places on the body, especially over the malar (or cheek bone) area, other
facial areas, behind the ears, and along the arms. The blackheads are usually
accompanied by fluid-filled cysts and by an increased or darker growth of body
hair. The skin may become thicker and flake or peel. In severe cases, the acne
may result in open sores and permanent scars. The condition fades slowly after
exposure. Minor cases may disappear altogether, but more severe cases may
persist for years after the exposure.
even dermatologists, sometimes have difficulty in distinguishing chloracne
from other more common skin disorders. While chloracne may be a sensitive
indicator of exposure to dioxins in some people, it may not be in other
individuals who had equal or greater exposure to dioxins.
absence of chloracne is not necessarily a reliable basis for concluding that a
person has not been exposed to a chemical which is known to cause chloracne.
chloracne been a problem for a large number of Vietnam veterans?
it has not. Of course, many veterans have complained of skin problems. Skin
ailments are the most common medical problem in veteran and non-veteran
populations. After traumatic injuries, skin disorders are among the most
common health problems encountered in combat.
did Public Law 102-4, the Agent Orange Act of 1991, do for Vietnam veterans
2, Public Law 102-4, enacted February 6, 1991, established by statute the
presumption of service connection for certain diseases including chloracne or
another acneform disease consistent with chloracne manifested to a degree of
disability of 10 percent or more within a year after military service in
Vietnam -- associated with exposure to certain herbicide agents.
July 1992, a proposed rule implementing the presumptions established by this
law was published in the Federal Register for public comment. (See 57 Fed.
Reg. 30707, July 10, 1992). In May 1993, the ru1e was finalized and published
in the Federal Register. (See 58 Fed. Reg. 29107, May 19, 1993).
had recognized chloracne as service connected for Vietnam veterans based on
exposure to Agent Orange for many years prior to the enactment of this
did the National Academy of Sciences conclude about chloracne in its 1993
report, entitled Veterans and Agent Orange - Health Effects of Herbicides Used
832-page report included the following statements:
summary, chloracne has been linked to TCDD exposure in numerous epidemiologic
studies of occupationally and environmentally exposed populations. The data on
Vietnam veterans potentially exposed to Agent Orange and other herbicides are
is sufficient to conclude that there is a positive association between
exposure to herbicides (2,4-D; 2,4,5-T and its contaminant TCDD; cacodylic
acid; and picloram) and chloracne
TCDD-associated chloracne becomes evident shortly after exposure, there is no
risk of new cases occurring long after service in Vietnam.
did the NAS conclude about chloracne in its 1996 update?
NAS reviewers essentially reached the same conclusion in 1996 they had in the
should a Vietnam veteran do if he or she thinks his or her skin condition may
the nearest VA medical center for a medical examination and possible treatment
and file a claim for disability compensation at the nearest VA medical center
or regional office. For many years, VA has recognized chloracne as a
service-connected disability based on the results of scientific research that
links this condition with exposure to dioxin.
Chloracne, a chemically induced skin
condition, is the only completely established effect on human beings of the
chemicals known as dioxins. The best-known dioxin is a contaminant of a
herbicide, but others occur in various chemicals that humans manufacture.
These chemicals include some paints and varnishes and some oils used as
lubricants in cutting tools.
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