Oil and Tar Acne: This acne like eruption occurs in areas of skin exposed to and directly in contact with oil and crude tars. It is not common now but out break still occurs. Many patients presents with periorbital (around orbit or eye ball) comedones. People with acne vulgaris are more prone to develop, but it is not proven.
Men are more commonly involved then women . The skin shows comedones and rarely inflammatory lesions. If inflammatory lesion are present they are superficial. Thighs and lower arms are more prone to develop lesion, which occurs within 6 weeks of exposure. The commonest oil involved are impure paraffin mixture used in engineering industry. DDT (dichlorodiphenyltrichlorethane), asbestos and heavy water (D2O) distillate can cause occupational acne. Petroleum products can also effects workers of oil field and refineries. Workers exposed to coal-tar distillates like pitch and creosols can develop acne.
Oil and Tar Acne treatment is mainly removing the patient from the particular working environment and topical retinoids. Oral isotretinoin is also used with success. If acne is severe than oral antibiotics can be used.
Chloracne: This type of acne is due to exposure to toxic chlorinated hydrocarbons. Chloracne lesions contain multiple comedones and blackheads, but inflammatory lesions are uncommon. Commonly comedones are concentrated in both the checks. But severe form can be seen on the other part of the body. Other skin lesion like pigmentation, hyper trichosis & palmer and plantar lesions can be seen. Ophthalmic (eye) chloracne may occur due to involvement of Meibomian glands. Systemic disturbances like fatigue, neuropathy, anorexia, impotence are less frequent.
Chloraene has been reported following exposure to poly chlorinated dibenzofurans, chlornaphthalins, pyrazole derivatives and chlorbenzenes. Some time contamination with the above mentioned chemicals are due to explosion in the industries which deal with them and results in prolonged and uncontrolled liberation of harmful chemicals mentioned above.
Chloracnegens have been identified in blood but not in the pilosebaceous duct. The skin lesions are persistent and resistant to treatment. Chloracne treatment consists of an oral antibiotic and topical retinoids like tretinoin and adapalan. Oral isotretinoin is of no use, because sebaceuous glands have already undergone atrophy. Best treatment for chlorache is gentle cautery under antiseptic cream EMLA applied for one hour. This gives excellent result.
