Journal List > Allergy Asthma Respir Dis > v.4(2) > 1059170

Lee, Oh, Choi, Choi, Han, Lee, and Kim: Late-onset trichloroethylene-induced hypersensitivity syndrome after intermittent exposure to low-dose trichloroethylene

Abstract

Occupational exposure to trichloroethylene (TCE) can occasionally induce severe cutaneous disorders, including hypersensitivity syndrome and Stevens-Johnson syndrome. The clinical manifestation of TCE hypersensitivity syndrome is quite similar to that of drug-induced hypersensitivity syndrome and includes skin lesions, hepatitis, fever, and lymphadenopathy. Almost all cases of TCE hypersensitivity syndrome developed within 2–8 weeks after the first exposure to TCE in an occupational setting. This typical course and clinical feature of hypersensitivity syndrome together with occupational history of TCE contact may lead to prompt diagnosis and treatment of this potentially fatal disease. This report describes a 32-year-old man who has been intermittently engaged in cleaning work using TCE for about 3 years, and then developed TCE hypersensitivity syndrome. To the best of our knowledge, this is the first case of TCE hypersensitivity syndrome with a long duration of symptom onset due to intermittent exposure to TCE. Thus, physicians should take thorough occupational history when seeing a patient with hypersensitivity syndrome has neither history of drug intake nor regular exposure to TCE.

Figures and Tables

Fig. 1

Skin lesions with erythematous patches on anterior trunk (A) and pustule on axillary area (B).

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Fig. 2

Skin biopsy shows spongiotic dermatitis with exocytosis of lymphocytes and some neutrophils. Superficial dermal edema and lymphocytes infiltration are present with scattered eosinophils (A: H&E, ×200). Spongiotic dermatitis with large intraepidermal pustule formation was also noted (B: H&E, ×100).

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Fig. 3

Treatment and clinical course of trichloroethylene hypersensitivity syndrome. ALT, aspartate aminotransferase.

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