Dermatitis, Occupational ; etiology ; Humans ; Trichloroethylene

Dermatitis, Occupational ; etiology ; Humans ; Trichloroethylene ; poisoning

Adult ; Dermatitis, Occupational ; etiology ; Drug Eruptions ; etiology ; Humans ; Male ; Phthalimides ; adverse effects

Trichloroethylene is commonly used as an industrial solvent and degreasing agent. The clinical features of acute and chronic intoxication with trichloroethylene are well-known and have been described in many reports, but hypersensitivity syndrome caused by trichloroethylene is rarely encountered. For managing patients with trichloroethylene hypersensitivity syndrome, avoiding trichloroethylene and initiating glucocorticoid have been generally accepted. Generally, glucocorticoid had been tapered as trichloroethylene hypersensitivity syndrome had ameliorated. However, we encountered a typical case of trichloroethylene hypersensitivity syndrome refractory to high dose glucocorticoid treatment. A 54-year-old Korean man developed jaundice, fever, red sore eyes, and generalized erythematous maculopapular rashes. A detailed history revealed occupational exposure to trichloroethylene. After starting intravenous methylprednisolone, his clinical condition improved remarkably, but we could not reduce prednisolone because his liver enzyme and total bilirubin began to rise within 2 days after reducing prednisolone under 60 mg/day. We recommended an extended admission for complete recovery, but the patient decided to leave the hospital against medical advice. The patient visited the emergency department due to pneumonia and developed asystole, which did not respond to resuscitation.
Dermatitis, Occupational/*etiology ; Fatal Outcome ; Humans ; Hypersensitivity/*etiology ; Male ; Middle Aged ; Occupational Exposure/*adverse effects ; Solvents/*toxicity ; Trichloroethylene/*toxicity

Accidents, Occupational ; prevention & control ; Adolescent ; Dermatitis, Occupational ; etiology ; prevention & control ; Female ; Humans ; Male ; Trichloroethylene ; poisoning ; Young Adult

Adolescent ; Adult ; Dermatitis, Occupational ; etiology ; Female ; Humans ; Male ; Trichloroethylene ; adverse effects

Adolescent ; Adult ; Dermatitis, Occupational ; diagnosis ; Eye Diseases ; diagnosis ; etiology ; Female ; Humans ; Male ; Trichloroethylene ; poisoning ; Young Adult

Aged ; Chlorpyrifos ; Dermatitis, Occupational ; etiology ; Female ; Humans ; Insecticides ; poisoning ; Middle Aged ; Organophosphate Poisoning ; complications

Adolescent ; Adult ; Dermatitis, Occupational ; etiology ; therapy ; Drug Eruptions ; etiology ; therapy ; Female ; Humans ; Male ; Methylprednisolone ; therapeutic use ; Trichloroethylene ; adverse effects

OBJECTIVETo investigate the clinical manifestations, complications and treatment of medicament-like dermatitis due to trichloroethylene (TCE), so as to provide basis for studying its etiology and mechanism.

METHODSFifty patients with dermatitis due to TCE from 1997 to 2000 were analysed retrospectively.

RESULTSThe occurrence of the dermatitis was not parallel to TCE exposure levels, without significant dose-effect relationship. This disease could be caused by both inhalation and skin exposure. The latency period of TCE dermatitis ranged from 5 to 66 days, and the average was 31.5 d (Medium). The major clinical manifestations included skin lesions, fever, superficial lymph node swelling and liver dysfunction. Infection was the major complication. Glucocorticoid was effective for treatment of this disease.

CONCLUSIONThe clinical manifestations due to TCE exposure were similar to dermatitis medicamentosa. The major clinical types of TCE dermatitis included exfoliative dermatitis and erythema multiforme. The dermatitis is considered to be mediated by delayed-type (IV) hypersensitivity. The key factors to treat this disease successfully included the use of glucocorticoid in time with sufficient dose and full course, professional skin care, active treatment to protect the liver and to avoid infection.

Adolescent ; Adult ; Allergens ; adverse effects ; Dermatitis, Exfoliative ; diagnosis ; etiology ; therapy ; Drug Eruptions ; diagnosis ; etiology ; therapy ; Female ; Humans ; Male ; Occupational Exposure ; adverse effects ; Retrospective Studies ; Trichloroethylene ; adverse effects