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Sulphur Mustard Injuries of the Skin

Pathophysiology and Management

  • Review Article
  • Published:
Toxicological Reviews

Abstract

Sulphur mustard is a vesicant (blistering agent), which produces chemical burns with widespread blistering. It was used extensively as a chemical warfare agent in the First World War, and has allegedly been employed in a number of conflicts since then, most recently by Iraq against Iran (1984–1987). The potential further use of mustard in military conflicts and by terrorists remains a significant threat that if realised in practice would result in a large number of casualties with severely incapacitating, partial thickness burns. Such injuries clearly present a huge potential wound care problem.

The development and healing of mustard-induced cutaneous injuries has not only been observed in human casualties, but has been studied recently at the microscopic and ultrastructural levels in several animal models. Vesication generally begins on the second day after exposure, and may progress for up to 2 weeks. Wound healing is considerably slower than for a comparable thermal burn, and patients often require extended hospital treatment. The current management strategy is essentially symptomatic and supportive. Recently, two techniques for removing damaged tissue and improving wound healing have been investigated. Mechanical dermabrasion and laser debridement (‘lasablation’) both produced an increased rate of wound healing in animal models, and may be of benefit in a clinical context.

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© British Crown copyright 2003/Dstl — published with the permission of the Controller of Her Majesty’s Stationery Office.

No sources of funding were used to assist in the preparation of this manuscript. The author has no conflicts of interest that are directly relevant to the content of this manuscript.

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  1. Biomedical Sciences Department, Dstl Porton Down, Salisbury, Wiltshire, SP4 OJQ, UK

    Paul Rice

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Rice, P. Sulphur Mustard Injuries of the Skin. Toxicol Rev 22, 111–118 (2003). https://doi.org/10.2165/00139709-200322020-00006

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