Most distinguishing histopathologic feature of chloracne is the

lack of sebaceous glands

Most significant environmental chloracnegen

Dioxin is recognized as the most significant environmental chloracnegen


Chloracne is also known as MADISH (Metabolizing Acquired Dioxin Induced Skin Hamartomas)

Common sites

Skin lesions appear on the cheeks and postauricular skin and may progress into the axillae and groin.


Toxins accumulate within the sebaceous glands and alter their normal physiology from oil-producing glands into the cyst-like structures (hamartomas) of chloracne.

Activation of aryl hydrocarbon receptor

Pathophysiological changes take place through activation of the aryl hydrocarbon receptor (AHR) which is expressed in keratinocytes and sebocytes, accelerating epidermal terminal differentiation (keratinization) and converting sebocytes toward keratinocyte differentiation.

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