Forty-three percent of the veterans had chloracne, a skin condition specifically caused by exposure to dioxins. For this group, the rate of NMISC was more than 80 percent.
Call for More Research on Risks and Treatment
The rate of malignant melanoma, the most serious type of skin cancer, was similar to that expected in men of similar age. However, the article includes two case reports of unusually aggressive NMISCwith numerous recurrences requiring multiple surgeriesoccurring in TCDD-exposed veterans.
Exposure to Agent Orange and TCDD has been linked to a wide range of health problems, including many different cancers. However, its association with the basal cell carcinoma and squamous cell carcinomathe two most common types of skin cancerhas been unclear.
Cases of "aggressive and diffuse" non-melanoma skin cancers in TCDD-exposed veterans were first reported in plastic surgery journals in the mid-1980s. Dr. Clemens and colleagues initiated their study after observing similar patients in their clinic over the last few years. The researchers emphasize that their study has some important limitationsincluding the lack of detailed information on TCDD exposure and the absence of a comparison group of Vietnam-era veterans not exposed to Agent Orange.
Nevertheless, the results strengthen the previously reported association between TCDD exposure and the development of NMISC, even many years after exposure. Certain groups appear to be at particularly high risk, including veterans actively involved in spraying Agent Orange, those with chloracne, and those with lighter skin types. Dr. Clemens and coauthors write, "Further studies are warranted to determine the
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Wolters Kluwer Health