OCCUPATIONAL LEUCODERMA (VITILIGO) by wg2tB4G4

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									          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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