Published online 23 November 2004 | Nature | doi:10.1038/news041122-8

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Yushchenko's acne points to dioxin poisoning

But experts challenge diagnosis that relies on snapshots of politician.

Viktor Yushchenko, Ukraine's opposition leader, in Kiev on 19 November. A British toxicologist says his skin condition is characterisitic of dioxin poisoning.Viktor Yushchenko, Ukraine's opposition leader, in Kiev on 19 November. A British toxicologist says his skin condition is characterisitic of dioxin poisoning.© AP Photo/Alexander Zemlianichenko

As disputed presidential election results provoke protests in Kiev, a British toxicologist is supporting candidate Viktor Yushchenko's claim that he was poisoned earlier in the campaign.

Yushchenko, the leader of the opposition, was hospitalized with a mystery illness in September and later claimed that he had been poisoned by the government. However, the Austrian doctors who treated him denied having found any evidence of this.

John Henry, a clinical toxicologist at St Mary's Hospital, London, and a consultant for Britain's National Poisons Information Service, points out that current photos of Yushchenko's face show a dramatic transformation compared with a few months ago.

He says that Yushchenko's disfiguring acne is almost certainly 'chloracne', a characteristic symptom of dioxin poisoning.

Dioxin danger

Dioxins are a group of chlorinated organic molecules. They are long-lived and form as a by-product of many industrial processes, such as waste incineration.

Yushchenko looks fit and healthy on 2 August 2004, before his mystery illness.Yushchenko looks fit and healthy on 2 August 2004, before his mystery illness.© AP Photo/Anatoly Medzyk

Exposure to dioxins is known to increase the risk of cancer and can cause severe reproductive and developmental problems.

The most toxic dioxin is a compound called 2,3,7,8-tetrachlorodibenzo-p-dioxin, or TCDD. In 1976, an industrial explosion in Seveso, Italy, released 20 kilograms of dioxins into the atmosphere, causing the highest known exposure of any population to TCDD.

Skin lesions similar to burns appeared on some children a few hours after the accident. Two months later, chloracne broke out on the people most exposed to the cloud.

Snap judgement

Marcello Lotti, an expert in occupational medicine at the University of Padua, Italy, questions the validity of Henry's conclusion. He argues that it is impossible to make such a diagnosis simply by looking at a photo.

Lotti adds that he would be surprised if anyone were to select dioxin as a poison. "Dioxins have only modest toxicity and you would need an extremely high dose to get chloracne," he says. "Only kilos of contaminated food, administered over several days, would give you chloracne."

Henry admits that he does not have any toxicological evidence to back up his claim. "My diagnosis is from the photo and from the medical report of him being normal two months earlier," he says.

"Very few medical conditions give this type of transformation in such a short time," he points out.

Henry also argues that it would be possible to produce the effect seen in Yushchenko's face from a single high dose of dioxin hidden in food. 

St. Mary's Hospital, London