Skin hydration and transepidermal water loss in patients with  a history of sulfur mustard contact: a case-control study.
BACKGROUND
Skin lesions are among the most common complications of contact with sulfur mustard.


OBJECTIVE
This study was aimed to measure skin water content and transepidermal water loss (TEWL) in patients with a history of sulfur mustard contact.


METHODS
Three hundred ten male participants were included in this study: 87 (28.1%) sulfur mustard-exposed patients with current skin lesions (group 1), 71 (22.9%) sulfur mustard-exposed patients without skin lesions (group 2), 78 (25.2%) patients with dermatitis (group 3) and 74 (23.8%) normal controls (group 4) The water content and TEWL of skin was measured at four different locations of the body: forehead, suprasternal, palm and dorsum of hand. Nonparametric statistical tests (Kruskal-Wallis) were used to compare the four groups, and P < 0.05 was considered statistically significant.


RESULTS
The mean age of participants were 44.0 +/- 6.7, 41.9 +/- 5.9, 43.8 +/- 9.3 and 44.8 +/- 8.9 years in groups 1 to 4, respectively (P = 0.146). Xerosis, post-lesional hyperpigmentation and lichenification were significantly more common in either sulfur mustard-exposed participants or non-exposed participants with dermatitis (P < 0.05). Skin hydration was higher in subjects with sulfur mustard contact than in non-injured participants (P < 0.05) in the dorsum and palm of hands and forehead. TEWL was significantly higher in participants only in suprasternal area and dorsum of hand.


CONCLUSIONS
Contact with sulfur mustard agent can alter biophysical properties of the skin--especially the function of stratum corneum as a barrier to water loss-several years after exposure.
Davoudi
Seyyed Masoud
SM
Research Center of Chemical Injuries, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Keshavarz
Saeed
S
Sadr
Bardia
B
Shohrati
Majid
M
Naghizadeh
Mohammad Mehdi
MM
Farsinejad
Khalil
K
Rashighi-Firouzabadi
Mehdi
M
Zartab
Hamed
H
Firooz
Alireza
A
D000328:Adult; D016022:Case-Control Studies; D002619:Chemical Warfare Agents / Q000009:adverse effects*; D006391:Hemangioma / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D007492:Iran; D008297:Male; D008875:Middle Aged; D009151:Mustard Gas / Q000009:adverse effects*; D011537:Pruritus / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D012871:Skin Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology*; D012878:Skin Neoplasms / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D012879:Skin Physiological Phenomena; D014870:Water Loss, Insensible / Q000502:physiology*; D014882:Water-Electrolyte Balance / Q000502:physiology*
D002619:Chemical Warfare Agents; D009151:Mustard Gas