title: Significance of dermatologic findings in a cohort of depleted uranium-exposed veterans of Iraqi conflicts.
abstract: BACKGROUND
  Depleted uranium (DU)-containing weapons have been used in military operations since 1991. There is interest in following veterans who were occupationally exposed to DU by either inhalation or retention of fragments. A cohort of DU-exposed Gulf War I veterans has been followed longitudinally at the Baltimore Veterans Administration Medical Center since 1993.
  
  
  OBJECTIVE
  The aim was to monitor chronic dermatological findings associated with occupational DU exposure in the 2013 cohort.
  
  
  METHODS
  Thirty-five veterans were evaluated. This study was reviewed and approved by the institutional review board and the Baltimore Veterans Administration Medical Center research service. Depleted uranium exposure was measured using creatinine-adjusted urine uranium concentrations (micrograms of uranium per gram of creatinine [μgU/gCrea]). Detailed medical histories, physical examinations, and exposure histories were performed.
  
  
  RESULTS
  Using a cutoff level of 0.1 μgU/gCrea, 11 veterans were placed in the high-uranium exposure group, whereas 23 veterans were placed in the low-uranium exposure group. Retained fragments were documented in 91% of the high-exposure group versus that in 13% of the low-exposure group (P < 0.001), and fragment-related scarring was significantly increased in the high-exposure group (P = 0.002). Other dermatological findings such as dermatitis were also assessed.
  
  
  CONCLUSIONS
  Fragment retainment and related scarring was significantly increased in veterans exposed to high levels of DU. Continuous monitoring of this cohort will yield interesting dermatological findings related to DU exposure.
authors.affiliation: From the Departments of *Dermatology and †Medicine, University of Maryland School of Medicine; ‡Department of Veterans Affairs and §Managed Care Service, Baltimore VA Medical Center, MD.
authors.forename: Jessica
authors.initials: J
authors.lastname: Shiu
authors.forename: Joanna
authors.initials: J
authors.lastname: Gaitens
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Squibb
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Gucer
authors.forename: Melissa A
authors.initials: MA
authors.lastname: McDiarmid
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Gaspari
mesh_terms: D000328:Adult; D002908:Chronic Disease; D002921:Cicatrix / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D009783:Dermatitis, Occupational / Q000453:epidemiology*; D012628:Dermatitis, Seborrheic / Q000453:epidemiology*; D005547:Foreign Bodies / Q000453:epidemiology*; D047830:Gulf War; D006801:Humans; D055623:Keratosis, Actinic / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008545:Melanoma / Q000453:epidemiology; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D012878:Skin Neoplasms / Q000453:epidemiology; D014501:Uranium / Q000652:urine; D014728:Veterans; D014950:Wounds, Penetrating / Q000150:complications / Q000453:epidemiology
chemical_list: D014501:Uranium