[Carboxyhemoglobinemia caused by dichloromethane exposure with dermatologic effects]

In seven winter seasons a young watchmaker was severely disabled by the development of swelling and reddening of the skin, blistering and paraesthesiae affecting his hands. Hospital examination led to a diagnosis of "Raynaud syndrome of undetermined origin". Treatment with corticosteroids was unsuccessful. Not until the young man changed his job did the disorder disappear for good. Investigations at his place of work revealed that the man had inhaled dichloromethane fumes (methylenchloride; CH2Cl2) while cleaning watch parts in a small room that was not ventilated during the winter months. This led to endogenous carboxyneogenesis and subsequently to chronically recurring carboxyhaemoglobinaemia (13%, 10% and 10.7% COHb in three different blood samples). The significance of dichloromethane-induced CO poisoning in the development of dermatological changes is still the subject of controversial discussion.