Atopic dermatitis-associated protein interaction network lead to new insights in chronic sulfur mustard skin lesion mechanisms.

Chronic sulfur mustard skin lesions (CSMSLs) are the most common complications of sulfur mustard exposure; however, its mechanism is not completely understood.According to clinical signs, there are similarities between CSMSL and atopic dermatitis (AD). In this study, proteomic results of AD were reviewed and the AD-associated protein-protein interaction network (PIN) was analyzed. According to centrality measurements, 16 proteins were designated as pivotal elements in AD mechanisms. Interestingly, most of these proteins had been reported in some sulfur mustard-related studies in late and acute phases separately. Based on the gene enrichment analysis, aging, cell response to stress, cancer, Toll- and NOD-like receptor and apoptosis signaling pathways have the greatest impact on the disease. By the analysis of directed protein interaction networks, it is concluded that TNF, IL-6, AKT1, NOS3 and CDKN1A are the most important proteins. It is possible that these proteins play role in the shared complications of AD and CSMSL including xerosis and itching.

External urethral stenosis: a latent effect of sulfur mustard two decades post-exposure.

BACKGROUND: Sulfur mustard (SM), a chemical weapon used widely during World War I and against Iranians during the Iran-Iraq War of the 1980s, causes massive inflammatory tissue damage in the immediate post-exposure period, resulting in debilitating chronic disease in years to decades following contact with the agent. These syndromes most often are pathologies of the lungs, eyes, and skin, the primary target organs of SM. Typically, they are characterized by severe and increasingly painful inflammation, often accompanied by fibrosis and constriction of the anatomic channels needed for normal life, such as the small airways of the lungs and, in the present report, the urethra. METHODS: The present case study is a 43-year-old man with a history of heavy SM exposure to the groin in 1984. RESULT: Within 1 year after exposure, the patient was found to have developed meatal stricture, occlusion of the external urethral meatus, and difficulty in urination. Two years post-exposure, he underwent ventral meatotomy and meatoplasty. CONCLUSION: This case presents a unique example of the latent effects of SM exposure to the groin, and will be of value in the prevention of similar injury and complications to persons at risk of SM exposure in the future.

Mustard gas scarring with specific pigmentary, trophic and vascular charactristics (case report, 16-year post-exposure).

Sulfur mustard (mustard gas) is an alkylating agent used widely against Iranians during the 8-year Iraq-Iran war. This agent causes various late-occurring respiratory, skin and eye complications. A 37-year-old Iranian man exposed to the agent in vapor form 16 years prior to the date of this writing was given a clinical and pathological evaluation for late-occurring skin lesions. Hypo and hyperpigmentation, atrophic, and vascular changes (cherry angiomas) were observed at the site of mustard scarring on the left anterior thigh. Histological studies showed mild papillomatosis and acanthosis changes along with pigmentation of basal layer in epidermis and atrophy of adnexal structures along with fibrosis and sclerosis in dermis.

Comparison of hydroxyzine and doxepin in treatment of pruritus due to sulfur mustard.

OBJECTIVE: To compare the safety and efficacy of doxepin and hydroxyzine in the treatment of chronic pruritus due to exposure to sulfur mustard. METHODS: In a randomized, double-blind safety and efficacy study, 50 patients with chronic pruritus were given either doxepin 10 mg/d or hydroxyzine 25 mg/d for 4 weeks. Pruritic score was calculated for each patient before treatment and 1 month after. RESULTS: After treatment, the mean pruritic scores +/- SD of the hydroxyzine and doxepin groups were 16.7+/-2.3 and 17.8+/-2.5, respectively. The severity of pruritus was decreased in 80% of patients in the hydroxyzine group and 75% in the doxepin group (P=.786). Eighteen patients in the hydroxyzine group and 14 patients in the doxepin group reported sedation. CONCLUSIONS: Both hydroxyzine and doxepin are effective and have equivalent results in controlling the symptoms of patients with chronic pruritus due to exposure to sulfur mustard.