title: Doxepin cream vs betamethasone cream for treatment of chronic skin lesions due to sulfur mustard.
abstract: Oral doxepin was shown to reduce chronic pruritus due to sulfur mustard. The present study compared the effects of topical doxepin 5% with betamethasone 1% for the treatment of pruritus in veterans exposed to sulfur mustard. This investigator-blinded, randomized, clinical trial was conducted in an outpatient dermatology clinic. Seventy-five men who were exposed to sulfur mustard 23 to 28 years ago during the Iran-Iraq war who complained of pruritus were randomized to receive doxepin cream 5% (n = 40) or betamethasone cream 0.1% (n = 35) twice a day for 6 weeks. Pruritus severity and Dermatology Life Quality Index (DLQI) were evaluated before and after each treatment. Both groups showed significant improvement regarding pruritus (P < .05), burning sensation, skin dryness (P < .001), and skin scaling (P < 0.05). The lesions of all regions significantly reduced after treatments (P < .05), except those on the head, face, and genitalia. Pruritus, visual analog scores, and DLQI significantly decreased (P < .01, P < .01, and P < .001, respectively) in doxepin- and betamethasone-treated groups, and there was no difference between groups. All DLQI subscores decreased after both type of treatments (P < .01). Equal efficacy of doxepin cream and betamethasone suggest that doxepin is a potential alternative to control pruritus caused by sulfur mustard in exposed veterans.
authors.affiliation: Chemical Injuries Research Center, Baqiyatallah Medical Sciences University, Molla-Sadra Avenue, Vanak Square, PO Box 19945/581, Tehran, Iran. yunespanahi@yahoo.com
authors.forename: Yunes
authors.initials: Y
authors.lastname: Panahi
authors.forename: Seyyed Masoud
authors.initials: SM
authors.lastname: Davoudi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Beiraghdar
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Amiri
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001623:Betamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D002619:Chemical Warfare Agents / Q000633:toxicity; D002908:Chronic Disease; D004316:Doxepin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007492:Iran; D007493:Iraq; D008297:Male; D008875:Middle Aged; D009151:Mustard Gas / Q000633:toxicity*; D011537:Pruritus / Q000139:chemically induced / Q000188:drug therapy; D011788:Quality of Life; D012720:Severity of Illness Index; D016037:Single-Blind Method; D012871:Skin Diseases / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome; D014857:Warfare
chemical_list: D000893:Anti-Inflammatory Agents; D002619:Chemical Warfare Agents; D004316:Doxepin; D001623:Betamethasone; D009151:Mustard Gas