Background The etiology of systemic sclerosis (SSc) is unknown, but there is evidence of environmental factors playing a part in disease development in a number of cases. Silica is a common mineral that is part of sand, rock and mineral ores like quartz. Research evidence has shown that exposure to silica dust might contribute to SSc causation. Erasmus syndrome consists of the association of systemic sclerosis following exposure to silica with or without silicosis
Objectives To study features of systemic sclerosis in patients exposed to silica
Methods Clinical records of 200 systemic sclerosis patients fulfilled the American college of rheumatology classification criteria and/or Leroy and Medsger classification criteria, and admitted to rheumatology department between 1986 and 2014, were reviewed. Nine patients had a history of occupational exposure to silica.
Results All patients were male, with a median age of 30 years and a disease duration (first non-Raynaud symptom) of 2 years. 6 patients had a diffuse scleroderma, 3 patients had a limited scleroderma. The mean exposure time to silica was 5.5 years. All patients had Raynaud's phenomenon, 7 had digital ulcers. Thoracic high-resolution computed tomography detected a silicotic pattern in nine patients. Seven had restrictive spirographic patterns. 3 patients had pulmonary hypertension. Antitopoisomerase I antibodies was positive in 6 patients. All patients are stone masons in sandstone careers in the region of Tkout (eastern Algeria). They Work unprotected in confined structures, and use chain saw to cut stones. Mineralogical stone study showed significant presence of quartz (more than 95%).
Conclusions Our patients have severe systemic sclerosis and accelerated silicosis, wich occurs after exposure to large amounts of silica over a shorter period of time. Employers must give their workers, equipment and clothing to protect themselves.
Disclosure of Interest None declared