title: Assessment of the ability of the topical skin protectant (TSP) to protect against contact dermatitis to urushiol (Rhus) antigen.
abstract: BACKGROUND
  Military personnel have a need for effective protection against cutaneous exposure to chemical warfare agents (CWA). Topical Skin Protectant (TSP) is being developed to supplement chemical warfare protective garments. TSP protects against CWA exposure in animals, but does it work for humans? Because humans should not be tested with live CWA, urushiol (poison ivy) extract was used as a surrogate substance in place of CWA for human efficacy testing of TSP.
  
  
  OBJECTIVE
  Determine whether TSP protects human skin against experimentally-induced urushiol dermatitis.
  
  
  METHODS
  Open urushiol patch testing of 50 rhus-sensitive subjects comparing the 96-hour dermatitis severity scores between TSP protected and TSP unprotected sites. There were 4 paired sites (i.e., protected versus unprotected) per subject. Test sites were scored using a 9-point dermatitis scale of 0.0 to 4.0 (using 0.5 increments).
  
  
  RESULTS
  Analysis of variance of the dermatitis scores from 192 paired sites on 48 evaluable subjects showed that TSP protected sites had mean dermatitis scores about 2 points lower than TSP unprotected sites (P <.001).
  
  
  CONCLUSIONS
  Although this study does not provide direct scientific evidence that TSP protects humans against the percutaneous absorption of CWA, it does provide circumstantial evidence that this is the case. The fact that TSP is so highly effective against a lipophilic substance like urushiol and that most common vesicant CWAs are lipophilic and are weaponized in oleaginous vehicles, makes the effectiveness of TSP in preventing absorption and dermatitis from CWA seem likely.
authors.affiliation: Department of Military and Emergency Medicine and Dermatology, Uniformed Services University, Bethesda, MD 20814-4799, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Vidmar
authors.forename: M K
authors.initials: MK
authors.lastname: Iwane
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology* / Q000494:pharmacology; D000941:Antigens / Q000276:immunology; D002396:Catechols / Q000276:immunology* / Q000494:pharmacology; D002618:Chemical Warfare / Q000517:prevention & control; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010328:Patch Tests; D020011:Protective Agents / Q000008:administration & dosage*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D000941:Antigens; D002396:Catechols; D005466:Fluorocarbons; D020011:Protective Agents; C003747:urushiol