Mycosis fungoides two decades after exposure to sulphur mustard: a follow-up of 1100 victims.

BACKGROUND: Sulphur mustard (SM) is an alkylating chemical warfare agent which causes acute and chronic injuries to the eyes, skin, lung and respiratory tract. OBJECTIVE: We aimed to investigate the relationship between SM poisoning and Mycosis fungoides (MF) as a late consequence. MATERIAL AND METHODS: In this retrospective study, the medical files of 1100 Iranian veterans confirmed to have exposure to SM agent during the Iraq-Iran war of the 1980s were reviewed. RESULTS: All 10 cases with MF were confirmed by clinical and histopathological examinations. The mean age of the studied subjects was 43.3 ± 9.8 (years). In comparison to MF incidence rate in Iranian general population (0.39/100 000 person-years), we found an incidence rate of 0.799/100 000 person-years for MF among those who had short-term exposure to SM. The most common sites for SM lesions were flexural and thin skin areas. The main limitation was the retrospective design. CONCLUSION: This study indicates that the risk of MF in those exposed to SM may increase over time. Therefore, their follow-up is recommended.

Urinary and cutaneous complications of sulphur mustard poisoning preceding pulmonary and ocular involvement: an unusual sequence of symptoms.

Sulphur mustard was used as a disabling chemical warfare agent during World War I, and, in more recent times, the Iran-Iraq conflict. Various chronic and acute complications have been documented in almost 100,000 Iranian victims to date. Several individual and environmental factors affect the severity and persistency of the complications. The most common adverse effects occur in the respiratory system, skin and eyes, with ocular and respiratory features usually preceding cutaneous lesions. In this paper, we present the unusual case of a chemical victim presenting with characteristic mustard scar leading to stenosis of the external meatus. In this case, initial cutaneous involvement of the injured external genitalia and thighs preceded the ocular and respiratory symptoms. We discuss the possible aetiologies.