The effects of sulfur mustard on the skin and their management: reviewing the studies conducted on Iranian chemical victims

Background: The skin is among the main tissues affected by Sulfur Mustard (SM) in chemical attacks. Iranian researchers have performed extensive studies on the exposed victims and have reported a wide spectrum of information in this field. The main objective of this study was to develop a comprehensive revision of data on the pathology, pathogenesis, clinical findings, complications, and treatment of sulfur mustard exposure. Method: This study was part of a systematic search which included all the war related studies on Iranian victims. Among nearly 300 retrieved articles, a total of 193 medical articles were approved in terms of quality and were related to the Iraq-Iran chemical war (1984-1988) out of which 48 were directly related to the dermatologic effects of sulfur mustard. We used known international databases such as ISI, Medline, Scopus, and Iranian databases such as Iranmedex, SID, and Irandoc in this study. Publishing the articles in approved journals was the main criterion for their quality. Result: In this study, the most common symptom in the delayed phase of the exposure to SM was itching which was more frequently seen in women as compared to men. The most common sign was erythema in the skin. One of the chronic complications at the site of exposure was mustard scar. Lipoma and cherry angioma were the most common skin tumors which were reported. Iranian researchers have presented different approaches for the management of exposed victims. Conclusion: In this study, in addition to the effects of SM on the skin, some methods were presented for decontamination, management of itching, vesicles, blisters and treatment of chronic skin lesions.