OCCUPATIONAL LEUCODERMA (VITILIGO) Definition: Occupationally leucoderma, refers to depigmentation of the skin caused by occupational exposure to chemicals. Diagnostic Criteria: Clinical Appearance: Hypopigmented and depigmented patches appear at the site of the skin contact. These are usually on the exposed areas of the hands and forearms, although covered areas may be affected in some cases. Neither facial leucoderma nor depigmentation due to steroids, hydroxyquinoline, sulfate, or butyl hydroxyanisole are normally associated with occupational exposure. The depigmentation may be mottled and patchy or confluent and symmetrical. There may be some inflammation. There is a tendency, except for chemicals like monobenzyl ether of hydroxyquinone, for spontaneous, for spontaneous but slow repigmentation after discontinuation of exposure. History: Occupational exposure to a substance known for its depigmenting properties. Agents: Phenols - p-tert-butyl phenol (PTBP) - p-tert-amyl phenol (PTAP) - p-phenyl phenol - chloro-2 amino-4 phenol cathechols catechol (pyrocatechol) p-methyl catechol 4-isopropyl catechol 4-tert-butyl catechol hydroquinone, monobenzylether and monomethylether of hydroquinone Differential Diagnosis post-inflammatory hypopigmentation and vitiligo (non occupational) Exposure Criteria: Intensity of exposure: From a few days to a few months, depending on concentration of the agent and its nature. Maximal acceptable latent period from exposure to disease development is two years. Leucoderma normally appears after direct and repeated skin contact, although similar effects have been reported following inhalation.
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