Journal Information
Vol. 100. Issue 10.
Pages 857-860 (December 2009)
Share
Share
Download PDF
More article options
Vol. 100. Issue 10.
Pages 857-860 (December 2009)
ACTAS 1909-2009
Full text access
Skin Manifestations of Toxic Syndrome Due to Denatured Rapeseed Oil
Manifestaciones Cutáneas del Síndrome Tóxico por Aceite de Colza Adulterado
Visits
6389
E. Fonseca
Corresponding author
Eduardo.Fonseca.Capdevila@sergas.es

Correspondence: Servicio de Dermatología. Complejo Hospitalario Universitario de A Coruña. Xubias de Arriba, 84. 15006 A Coruña. Spain.
Servicio de Dermatología, Complejo Hospitalario Universitario de A Coruña, Spain
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Abstract

This article offered an extensive description of the clinical and pathological features and time-course of the skin manifestations of toxic syndrome caused by denatured rapeseed oil, also known as toxic oil syndrome. This new condition occurred in Spain in 1981 and was due to the ingestion of rapeseed oil intended for industrial use that had been denatured with anilines and subsequently refined and sold fraudulently as olive oil.

In total, 20 000 cases and 400 deaths were reported. The disease affected mainly women, particularly in the late stages. In the acute phase, the predominant skin manifestations were toxic-allergic rashes reminiscent of allergic urticaria in the dermatopathologic study. In approximately 25% of cases, the patients’ skin subsequently took on an edematous appearance, with pigmentary abnormalities shown to be related to cutaneous mucinosis. Finally, a characteristic sclerodermatous condition would develop that tended to improve spontaneously. The constant presence of mast cells in all biopsies and the development of mastocytosis in several patients pointed to an important role for these cells in the pathogenesis of the condition. This was subsequently confirmed in other sclerodermatous processes.

In 1989, eosinophilia-myalgia syndrome caused by toxins present in tryptophan food supplements was reported in the United States. This syndrome resembled toxic oil syndrome in many ways and demonstrated that mucinosis and toxic sclerodermatous processes do exist.

Key words:
toxic syndrome caused by denatured rapeseed oil
toxic oil syndrome
rash
mucinosis
toxic mucinosis
sclerodermatous syndrome
scleroderma
eosinophilic fasciitis
eosinophilia-myalgia syndrome
mast cell
mastocytosis
Resumen

En este artículo se efectuó una amplia descripción clínico-patológica y cronológica de las manifestaciones cutáneas del síndrome tóxico por aceite de colza adulterado o síndrome tóxico por aceite. Esta nueva enfermedad se produjo en España en 1981, debida a la ingesta de aceite de colza destinado a uso industrial, que había sido coloreado con anilinas y posteriormente decolorado de forma fraudulenta y vendido como aceite de oliva.

En total se produjeron unos 20.000 casos y unos 400 fallecimientos. Existía un predominio por el sexo femenino, sobre todo en la fase tardía. En la fase aguda las manifestaciones cutáneas predominantes fueron exantemas toxoalérgicos, con un patrón dermatopatológico de erupción alérgica urticariforme. Alrededor de un 25% de los casos desarrolló posteriormente un aspecto edematoso de la piel, con trastornos de la pigmentación, que demostró estar relacionado con mucinosis dérmica. Finalmente se produjo un cuadro esclerodermiforme peculiar, que tendió a mejorar de forma espontánea. La presencia constante de mastocitos en todas las biopsias y el desarrollo de mastocitosis en varios pacientes sugirieron un papel importante del mastocito en la patogenia del cuadro, que luego ha sido ratificada en otros procesos esclerodermiformes.

En 1989 apareció en EE.UU. el síndrome mialgia-eosinofilia, relacionado con sustancias tóxicas presentes en suplementos alimentarios de triptófano y que compartía muchos aspectos con el síndrome tóxico por aceite. Esto corroboró la existencia de mucinosis y cuadros esclerodermiformes de origen tóxico.

Palabras clave:
síndrome tóxico por aceite de colza adulterado
síndrome tóxico por aceite
exantema
mucinosis
mucinosis tóxica
síndrome esclerodermiforme
esclerodermia
fascitis eosinofílica
síndrome mialgiaeosinofilia
mastocito
mastocitosis
Full text is only aviable in PDF
References
[1.]
J.M. Tabuenca.
Toxic-allergic syndrome caused by ingestion of rapeseed oil denatured with aniline.
Lancet, 2 (1981), pp. 567-568
[2.]
G. Greunke, J. Heimbrecht.
El montaje del síndrome tóxico.
Editorial Obelisco, (1988),
[3.]
E. Fonseca Capdevila.
Manifestaciones cutáneas del síndrome tóxico por aceite de colza adulterado.
Actas Dermosifiliogr, 74 (1983), pp. 297-316
[4.]
E. Fonseca Capdevila.
Síndrome tóxico por aceite de colza adulterado: 10 años después.
Piel, 8 (1993), pp. 1-4
[5.]
Toxic epidemic syndrome, Spain, 1981. Toxic Epidemic Syndrome Study Group. Lancet. 1982;2:697-702.
[6.]
E.M. Kilbourne, J.G. Rigau-Pérez, C.W. Heath Jr, M.M. Zack, H. Falk, M. Martín-Marcos, et al.
Clinical epidemiology of toxic-oil syndrome. Manifestations of a new illness.
N Engl J Med, 309 (1983), pp. 1408-1414
[7.]
F.J. Martínez-Tello, J.J. Navas-Palacios, J.R. Ricoy, R. Gil-Martín, J.M. Conde-Zurita, F. Colina-Ruiz Delgado, et al.
Pathology of a new toxic syndrome caused by ingestion of adulterated oil in Spain.
Virchows Arch A Pathol Anat Histol, 397 (1982), pp. 261-285
[8.]
J.L. Díaz Pérez, J. Zubizarreta, J. Gardeazábal, J. Goday.
Fascitis eosinofílica familiar inducida por aceite tóxico.
Med Cutan Iber Lat Am, 16 (1988), pp. 51-58
[9.]
E. Fonseca, J. Solís.
Mast cells in the skin: progressive systemic sclerosis and the toxic oil syndrome.
Ann Intern Med, 102 (1985), pp. 864-865
[10.]
H.N. Claman.
Mast cells and fibrosis. The relevance to scleroderma.
Rheum Dis Clin North Am, 16 (1990), pp. 141-151
[11.]
L.D. Kaufman, R.J. Seidman, M.E. Phillips, B.L. Gruber.
Cutaneous manifestations of the L-tryptophan-associated eosinophilia-myalgia syndrome: a spectrum of sclerodermatous skin disease.
J Am Acad Dermatol, 23 (1990), pp. 1063-1069
[12.]
L.D. Kaufman, L.B. Krupp.
Eosinophilia-myalgia syndrome, toxic-oil syndrome, and diffuse fascitis with eosinophilia.
Curr Opin Rheumatol, 7 (1995), pp. 560-567
[13.]
E. Fonseca, F. Contreras.
Cutaneous mucinosis in the toxic oil syndrome.
J Am Acad Dermatol, 16 (1987), pp. 139-140
[14.]
F. Rongioletti, A. Rebora.
The new cutaneous mucinoses: a review with an up-to-date classification of cutaneous mucinoses.
J Am Acad Dermatol, 24 (1991), pp. 265-270
[15.]
F. Rongioletti, A. Rebora.
Cutaneous toxic mucinoses.
J Am Acad Dermatol, 26 (1992), pp. 789-790
[16.]
M. Posada de la Paz, R.M. Philen, A.I. Borda.
Toxic oil syndrome: the perspective after 20 years.
Epidemiol Rev, 23 (2001), pp. 231-247
[17.]
J.A. Moreno-Romero, S. Segura, J.M. Mascaró Jr, S.E. Cowper, M. Julià, E. Poch, et al.
Nephrogenic systemic fibrosis: a case series suggesting gadolinium as a possible aetiological factor.
Br J Dermatol, 157 (2007), pp. 783-787
Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
Download PDF
Idiomas
Actas Dermo-Sifiliográficas
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?