Background: The purpose of this study was to identify an association between dioxin (Agent Orange) exposure and development of cutaneous T-cell lymphoma (CTCL) in U.S. veterans. Cutaneous lymphomas are cancers characterized by malignant transformation of lymphocytes, or white blood cells, which affect the skin. Definitive causative factors of CTCL have not been identified, although there have been reports linking CTCL to dioxin exposure. However, these studies have been small and unsubstantiated. During military service, many soldiers were exposed to dioxin during the Korean and Vietnam conflicts. Significantly, despite CTCL being a very rare lymphoma, there are 37 veterans diagnosed with CTCL in the VA system, which is probably an underestimation, considering the difficulty in diagnosis.
Methods: We performed a retrospective chart analysis of 37 veterans with cutaneous T-cell lymphoma, identified via the VA Informatics and Computing Infrastructure (VINCI) database, and cross-referenced these individuals with the Agent Orange Registry to characterize extent and duration of dioxin exposure. These patients were compared with Vietnam-era patients with hepatitis C.
Conclusions: The association of CTCL with dioxin exposure allowed for the identification of veterans with dioxin exposure and history of chronic dermatitis such that they can be monitored prospectively for earlier diagnosis of CTCL; early detection of CTCL translates to early treatment and potential prevention of disease progression.
