Long-term effects of Sulfur Mustard gas exposure on the skin of Iranian combaters

Background: During imposed war (1980-1988) Iraq frequently used chemical warfare particularly mustard gas. Skin is frequently involved in victims. Objective: Our main objective was to evaluate chronic skin manifestations due to exposure to mustard gas 10-19 years after exposure in a case-control study. Patients and Methods: 101 chemically wounded combators and 121 non-chemically wounded combators were randomly selected and examined by dermatologists. Laboratory tests were done for 30 subjects in each group. Data were analyzed by SPSS/PCT # 5 software using student-t and chi-square tests with Yates correction. Results: Seven itching, burning sensation, skin tightness and dryness, hypo and hyper pigmentation, telangiectasia, melanocytic nevus, cherry angioma, lichenification, alopecia areata, recurrent aphthous stomatitis, tinea versicolor, acute eczema on lower extremities were significantly more common in chemically wounded than the control group. Lymphopenia, lower serum IgM, and higher serum IgG wee also more common in the exposed group. Conclusion: Several skin disorders are more common in chemical gas victims, even several years after exposure. This finding shows that more research on various subjects such as alterations in immune system, adequate training on protective measures, pathophysiology of pruritus and molecular changes are necessary to find better treatment and effective vaccine.