|Year : 1991 | Volume
| Issue : 1 | Page : 34-35
K Banerjee, NB Mukharjee, R Paul, D Singh
Source of Support: None, Conflict of Interest: None
A Patient working as sweeper inside Durgapur Steel Plant developed brownish black pigmentation with folliculitis of the entire face and volar aspect of fore arms and hands for last 4 years. Biopsy revealed particles in the corium. The change of his site of working brought about dramatic remission but brownish black pigment persisted as occupational stigma.
Keywords: Miller′s disease, Exogenous siderosis
|How to cite this article:|
Banerjee K, Mukharjee N B, Paul R, Singh D. Exogenous siderosis. Indian J Dermatol Venereol Leprol 1991;57:34-5
| Case Report|| |
A 50 year old male industrial sweeper who had progressive irritating follicular lesions of the entire face.[ Figure 1] volar aspect of both the forearms and hands with brownish black pigmentation was referred for consultation. He had been treated for last 4 years with systemic antibiotics and steroid with periodic remission and subsequent exacerbation of the condition.
Some occupational contact dermatitis was thought off. Patch testing with shaving cream, nylon bristle, alum, and soap showed negative results. Skin biopsy at three sites revealed brownish black material at the upper dermis along with picture of folliculitis and perifollicular reaction. [Figure - 2] `X' Ray defraction confirmed it to be steel particles. Authority was informed and he has been allowed to shift his site of job from inside the plant to the colony area which resulted into dramatic improvement in his condition. Oral sulfa and antihistaminics along with topical steroid were used for 2 months and then discontinued.
| Comments|| |
Jirasek reported red brown tattoo like eruption among welders doing spot welding which he labeled "Exogenous Siderosis" of the skin, referred commonly as "Miller's disease" caused by penetration of minute steel (Iron & Carbon) particles in the exposed part of the mill workers. This particular patient was a sweeper (not miller) employed to remove dust and soot from the floor of the cokeoven plant and also to scrub the floor of gas pipe lines feeding the plant.
Bear and Nater . both reported epidermal hypersensitivity to iron and demonstrated pustular lesion to patch testing. Patch testing with ferric-chloride solution has been done in this case leading to eczematous reaction but it is very difficult to conclude only with patch testing that dark brown .pigmented. material present in the upper dermis is iron particle. X-Ray defraction of the material done with the help of Sindri fertilizer plant confirmed the composition of the particles.
To the best of our knowledge, this type of extremely rare condition is yet to be published from our country.
| References|| |
|1.||Jirasek L : Occupational exogenous siderosis of the skin, Cont, Derm, 1979:5:334 |
|2.||Bear R : Allergic contact sensitization to iron, J Aller clin Immunol, 1973:5:35 |
|3.||Nater JP : Epidermal hydersensitivity to iron, Hautarzt, 1960:11:223. |
[Figure - 1], [Figure - 2]