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Persistent Chloracne in a Tank Mechanic

Chloracne is characterized by acquired dioxin-induced skin hamartomas (MADISH), often involving the post-auricular skin. Chloracne classically occurs in individuals exposed to Agent Orange and dioxin-containing oils used in machinery.  Since new-onset acne vulgaris is unusual in adults, a thorough occupational history must be elicited in this patient population. The herein patient is a retired tank mechanic with no known exposure to Agent Orange and presents with persistent acneiform eruptions.