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2016 ; 3
(ä): 679-684
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Skin manifestations in sulfur mustard exposed victims with ophthalmologic
complications: Association between early and late phase
#MMPMID28959592
Hejazi S
; Soroush M
; Moradi A
; Khalilazar S
; Mousavi B
; Firooz A
; Younespour S
Toxicol Rep
2016[]; 3
(ä): 679-684
PMID28959592
show ga
CONTEXT: Sulfur mustard (SM) was used during the Iraq-Iran war (1980-1988).
Exposed veterans continue to suffer from its ocular, skin, and respiratory
complications. OBJECTIVE: We aimed to evaluate associations between early (at the
time of acute exposure) and decades later skin manifestations in individuals with
severe ophthalmologic complications secondary to sulfur mustard exposure.
MATERIALS AND METHODS: One hundred forty-nine veterans with severe ocular
injuries were evaluated for acute and chronic skin complications. Logistic
regression models were used to examine the associations between early and late
skin manifestations. RESULTS: Late skin complaints were observed in nearly all
survivors who had early skin lesions (131 out of 137; 95.62%). Seven out of 12
patients (58.33%) who did not have early skin lesions ultimately developed late
skin complications. There was a significant relationship between the presence of
lesions at the time of exposure and developing late skin complaints (two-sided
Fisher's exact test, OR = 15.59, p < 0.001). There was an association between
having at least one early skin lesion and occurrence of late skin complications.
Survivors with blisters at the time of chemical exposure were more likely to
complain of itching (95% CI: 3.63-25.97, p < 0.001), burning (OR = 11.16; 95% CI:
2.97-41.89, p < 0.001), pigmentation changes (OR = 10.17; 95% CI: 2.54-40.75,
p = 0.001), dryness (OR = 6.71, 95% CI: 1.22-37.01, p = 0.03) or cherry angioma
(OR = 2.59; 95% CI:1.21-5.55, p = 0.01) during the late phase. Using multivariate
logistic models, early blisters remained significantly associated with latent
skin complaints. Of note, the genitalia and great flexure areas were the most
involved anatomical sites for both early and late skin lesions in SM exposed
survivors. CONCLUSION: According to this study, the presence of blisters at the
time of exposure to SM is the most important predictor of developing dermatologic
complications decades later in patients with severe ophthalmologic complications
from sulfur mustard exposure.