Hefazi Mehrdad, Maleki Masoud, Mahmoudi Mahmoud, Tabatabaee Abbas, Balali-Mood Mahdi
Department of Dermatology, Imam Reza Hospital, Mashhad, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Int J Dermatol. 2006 Sep;45(9):1025-31. doi: 10.1111/j.1365-4632.2006.03020.x.
Extensive cutaneous burns caused by alkylating chemical warfare agent sulfur mustard (SM) have been associated with the severe suppression of the immune system in humans. We aimed to study the association between late cutaneous and immunological complications of SM poisoning.
Skin examination was performed on all SM-poisoned Iranian veterans in the province of Khorasan, Iran, who had significant clinical complications, and their SM intoxication was confirmed by toxicological analysis. Light microscopy was performed on eight skin biopsies. Blood cell counts, serum immunoglobulin and complement factor, as well as flow cytometric, analyses were performed on all the patients. The severity of cutaneous complications were classified into four grades and compared with hematological and immunological parameters, using Spearman's rank correlation test.
Forty male subjects, confirmed with SM poisoning 16-20 years earlier, were studied. The main objective findings were hyperpigmentation (55%), dry skin (40%), multiple cherry angiomas (37.5%), atrophy (27.5%), and hypopigmentation (25%). Histopathologic findings were nonspecific and compatible with hyperpigmented old atrophic scars. Except for the hematocrit and C4 levels, hematological and immunological parameters revealed no significant correlation with the severity grades of cutaneous complications.
Sulfur mustard is an alkylating agent with prolonged adverse effects on both the skin and the immune system. Although skin is a major transporting system for SM's systemic absorption, there is probably no correlation between the severity of late cutaneous and immunological complications of SM poisoning.
烷基化化学战剂硫芥（SM）导致的大面积皮肤烧伤与人类免疫系统的严重抑制有关。我们旨在研究硫芥中毒后期皮肤和免疫并发症之间的关联。
对伊朗霍拉桑省所有有明显临床并发症且经毒理学分析确诊为硫芥中毒的伊朗退伍军人进行皮肤检查。对八份皮肤活检样本进行了光学显微镜检查。对所有患者进行了血细胞计数、血清免疫球蛋白和补体因子检测以及流式细胞术分析。皮肤并发症的严重程度分为四个等级，并使用Spearman等级相关检验与血液学和免疫学参数进行比较。
研究了40名男性受试者，他们在16 - 20年前被确诊为硫芥中毒。主要客观发现为色素沉着过度（55%）、皮肤干燥（40%）、多发性樱桃状血管瘤（37.5%）、萎缩（27.5%）和色素减退（25%）。组织病理学发现无特异性，与色素沉着过度的陈旧萎缩性瘢痕相符。除了血细胞比容和C4水平外，血液学和免疫学参数与皮肤并发症的严重程度等级之间无显著相关性。
硫芥是一种烷基化剂，对皮肤和免疫系统都有长期的不良影响。虽然皮肤是硫芥全身吸收的主要转运系统，但硫芥中毒后期皮肤和免疫并发症的严重程度之间可能没有相关性。
