Journal of

Background and Aim: As a blistering agent, mustard gas causes a variety of disorders in different body organs, including the skin, such as altrations in DNA and clinical manifestations like pruritus. TGF-β1 molecule is a cytokine with anti-cell growth and inflammation suppression effects in skin inflammation. The aim of this study was to determine TGF-β1 gene exprtession in victims exposed to mustard gas and the correlation with the severity of their pruritus.
Methods: 17 victims exposed to mustard gas, 17 patients with chronic contact dermatitis and 10 healthy individuals were included in the study. The assessment of TGF-β1 expression in their skin samples was conducted by semi-quantitative RT-PCR followed by immunohistochemistry and classification of patients was done by pruritus severity scoring system (0-3).
Results: There was a significant decrease in TGF-β1 gene expression in mustard gas exposed victims comparing to chronic contact dermatitis group and the control group (P<0.05). In addition, in the absence of TGF-β1 expression, the severity of pruritus in the patient group significantly increased (P<0.05).
Conclusion: TGF-β1 has a significant role in chronic inflammatory skin lesions caused by mustard gas.

Sulfur mustard (SM) or mustard gas is a chemical weapon which for the first time was employed during world war I later on it was used by Iraqi military forces against Iranian army and civilians (1980-88). This agent injured over 100000 Iranians and one-third of them are still suffering from its complications. SM is an alkylating agent with cytotoxic, mutagenic and vesicating properties, which targets the skin, eyes and respiratory systems. In this study we review the acute and chronic effects of SM on the skin. We obtained information of this paper from a search of PubMed. Google, Iran Medex, Irandoc and SID until beginning of 2011. The most common acute effects of SM on skin were: pruritus and burning (26%-96.8%), pain (25%-77.4%), erythema (20.6%-83.9%), hyperpigmentation (20%-83.9%), and vesicle and bulla (15.4%-80.6%). The most common chronic effects were: pruritus (24.7%-94.7%), burning (9.9%-52.1%), scar (4.5%-70%), hyperpigmentation (5.9%-55%), hypopigmentation (3.2%-40%), xerosis (2.1%-43.7%) and cherry angioma (12.2%-70.5%). After passing more than 20 years of the end of the Iraq-Iran war, the victims still suffer from many skin complications of SM and some of them such as itching and dry skin have negative effects on the performance and quality of their life. Up to now, serious skin complications like malignant skin tumors have been rare and a longer time may be required to establish. Therefore further follow-up is needed to detect and treat any kind of skin cancers promptly.