Chloracne 


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


MADISH


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.


Pathophysiology


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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