The effects of sulfur mustard on the skin and their management: reviewing the studies conducted on Iranian chemical victims

Background: The skin is among the main tissues affected bySulfur Mustard (SM) in chemical attacks. Iranian researchershave performed extensive studies on the exposed victims andhave reported a wide spectrum of information in this field. Themain objective of this study was to develop a comprehensiverevision of data on the pathology, pathogenesis, clinical findings,complications, and treatment of sulfur mustard exposure.Method: This study was part of a systematic search whichincluded all the war related studies on Iranian victims. Amongnearly 300 retrieved articles, a total of 193 medical articles wereapproved in terms of quality and were related to the Iraq-Iranchemical war (1984-1988) out of which 48 were directly relatedto the dermatologic effects of sulfur mustard. We used knowninternational databases such as ISI, Medline, Scopus, and Iraniandatabases such as Iranmedex, SID, and Irandoc in this study.Publishing the articles in approved journals was the main criterionfor their quality.Result: In this study, the most common symptom in the delayedphase of the exposure to SM was itching which was more frequentlyseen in women as compared to men. The most common sign waserythema in the skin. One of the chronic complications at thesite of exposure was mustard scar. Lipoma and cherry angiomawere the most common skin tumors which were reported.Iranian researchers have presented different approaches for themanagement of exposed victims.Conclusion: In this study, in addition to the effects of SM onthe skin, some methods were presented for decontamination,management of itching, vesicles, blisters and treatment of chronicskin lesions.