Author Interviews, Dermatology, Toxin Research / 27.07.2015

Andrew T. Patterson, MD The Ohio State University College of Medicine The Ohio State University Wexner Medical Center Columbus, Interview with: Andrew T. Patterson, MD The Ohio State University College of Medicine The Ohio State University Wexner Medical Center Columbus, Ohio Medical Research: What is the background for this study? What are the main findings? Dr. Patterson: The utilization of Agent Orange (AO) and other herbicides by the United States during the Vietnam War was controversial at the time and remains a prominent topic of scrutiny even today due to the potential long-term health effects facing exposed military and civilian personnel. The Institute of Medicine (IOM) in accordance with the National Academy of Sciences publishes a semi-annual review of the scientific and medical data regarding the resultant medical effects of Agent Orange and other organochlorine chemical exposures, however, skin diseases are no longer comprehensively assessed. This represents an important practice gap, as in our experience, we had encountered a significant number of patients inquiring whether their cutaneous ailment could be the result of Agent Orange exposure. Our goal was to perform a systematic review of the literature and produce a practical summary of the current evidence regarding cutaneous manifestations of organochlorine exposures that could be utilized by military and non-military dermatologists alike when responding to questions related to prior Agent Orange contact. After examining the literature, there appears to be an increased risk for chloracne, porphyria cutanea tarda, cutaneous lymphoma, and soft-tissue sarcomas including dermatofibrosarcoma protuberans and leiomyosarcomas in organochlorine-exposed patients. Some evidence exists for a possible increased incidence of melanomas, non-melanoma skin cancers, milia, eczema, dyschromias, dysesthesias, and rashes not otherwise specified, but the data is not conclusive. Even less support exists for an association with psoriasis, seborrheic dermatitis, neurodermatitis, and hypertrichosis (more…)
Author Interviews, Cancer Research, JAMA, Surgical Research, Toxin Research / 24.11.2014 Interview with: Naveed Nosrati MD Indiana University School of Medicine Staff Surgeon, Roudebush VAMC Medical Research: What is the background for this study? Dr. Nosrati: We originally began this study as a broader project investigating the effect of trauma induced by biopsies on the spontaneous clearance of a non-melanoma skin cancer. As part of that, we created a large database with many patient variables. Since we undertook this project at our local VA hospital, one of the variables available to us was Agent Orange exposure. Shortly after completing the study, Clemens et al published their study linking Agent Orange exposure to higher rates of invasive non-melanoma skin cancer. Their study was a pilot study of only 100 patients. As we had well over 1,000 patients, we decided to pursue a side project of how Agent Orange specifically affects our results. Our study was operating under the hypothesis that trauma induced by biopsies led to an inflammatory response that often led to the immunologic clearance of the remaining skin cancer. We actually coined the term “SCORCH” lesion, or spontaneous clearance of residual carcinoma histologically, for this phenomenon. With that mind, we would expect patients exposed to Agent Orange to theoretically have a more invasive form of malignancy and thus have lower rates of spontaneous clearance. (more…)