Skin hydration and transepidermal water loss in patients with a history of sulfur mustard contact: a case-control study

J Eur Acad Dermatol Venereol. 2009 Aug;23(8):940-4. doi: 10.1111/j.1468-3083.2009.03235.x.

Abstract

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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Chemical Warfare Agents / adverse effects*
  • Hemangioma / chemically induced
  • Hemangioma / epidemiology
  • Hemangioma / physiopathology
  • Humans
  • Hyperpigmentation / chemically induced
  • Hyperpigmentation / epidemiology
  • Hyperpigmentation / physiopathology
  • Incidence
  • Iran
  • Male
  • Middle Aged
  • Mustard Gas / adverse effects*
  • Pruritus / chemically induced
  • Pruritus / epidemiology
  • Pruritus / physiopathology
  • Skin Diseases / chemically induced*
  • Skin Diseases / epidemiology
  • Skin Diseases / physiopathology*
  • Skin Neoplasms / chemically induced
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / physiopathology
  • Skin Physiological Phenomena*
  • Water Loss, Insensible / physiology*
  • Water-Electrolyte Balance / physiology*

Substances

  • Chemical Warfare Agents
  • Mustard Gas