Features suggestive of occupational scleroderma:
(1) history of prolonged exposure to a chemical
(2) onset of scleroderma after the exposure
Supportive findings:
(1) skin involvement in a distribution corresponding to dermal exposure to the chemicals
(2) improvement on discontinuation of chemical exposure
Exposures associated with scleroderma:
(1) vinyl chloride
(2) chlorinated organic solvents (trichloroethane, trichloroethylene, trichlomethane, others)
(3) other organic solvents (benzene)
(4) silica
(5) epoxy resins
(6) herbicides
Type of scleroderma that may occur:
(1) limited to skin
(2) systemic which may include renal, pulmonary and esophageal involvement
In many cases it is impossible to determine if the chemical exposure causes the scleroderma or if it is coincidental. However, it is prudent to screen workers with occupational exposure to these chemicals for evidence of scleroderma and to discontinue further exposure when possible.
