Long-Term Risk of Dermatoses Following Sulfur Mustard Exposure: A Retrospective Cohort Study.

IF 3.2 4区医学 Q1 DERMATOLOGY

International Journal of Dermatology Pub Date : 2025-10-04 DOI:10.1111/ijd.70080

Parviz Toossi, SeyedHasan Etemadzadeh, Mohammadreza Sedighimoghadam, Fahimeh Abdollahimajd, Mohammad Roustanezhad Arabani, Aliakbar Babaei, Marziye Asgari, Shahram Ariaeenejad, Nima Sarrafi-Rad, Batool Mousavi

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引用次数: 0

Abstract

Background: Sulfur mustard (SM) was extensively used during the Iraq-Iran War (1983-1988). The study assessed the prevalence of dermatoses in exposed survivors compared to the general population.

Methods: Using a retrospective cohort study, we visited and compared the prevalence of skin complaints and active dermatoses in 1538 SM-exposed survivors and 1425 unexposed controls. All participants underwent clinical evaluations by dermatologists across multiple centers.

Results: The exposed group demonstrated a higher prevalence of chronic diseases (odds ratio [OR]: 4.57, 95% confidence interval [CI]: 3.92-5.34), history of dermatoses (OR: 2.32, 95% CI: 1.97-2.73), need for dermatologic care (OR: 5.91, 95% CI: 4.67-7.50), and corticosteroid use (OR: 10.98, 95% CI: 8.77-13.74) with concurrent use of multiple corticosteroid forms. Dermatologist examinations revealed a higher rate of skin complaints (92.1% vs. 23.4%; OR: 36.47, 95% CI: 29.24-44.5) and dermatoses (86.7% vs. 32.1%; OR: 13.81, 95% CI: 11.48-16.61) in the exposed group. The most prevalent symptom among the exposed group was itching (84.7% vs. 14.5%; OR: 32.46, 95% CI: 26.52-39.74), followed by burning sensation (38% vs. 3.6%; OR: 16.54, 95% CI: 12.28-22.28) and dry skin (36.2% vs. 5.6%; OR: 9.52, 95% CI: 7.43-12.20). Dermatologist visits indicated the highest odds in the exposed group compared to the control group for: blistering disorders (OR: 40.4, 95% CI: 2.4-667.4); persistent warts (OR: 17.7, 95% CI: 1.0-304.5); pruritus (OR: 17.1, 95% CI: 9.5-30.77); xerosis (OR: 11.98, 95% CI: 9.36-15.34); neurodermatitis (OR: 10.28, 95% CI: 5.79-18.56); lichen simplex chronicus (OR: 9.02, 95% CI: 6.13-13.28); and excoriated dermatitis (OR: 7.75, 95% CI: 5.88-10.23). There was no significant rise in the risk of vitiligo, psoriasis, keloids, drug-induced acne, basal cell carcinoma (BCC), morphea, discoid lupus erythematosus (DLE), systemic lupus erythematosus (SLE), squamous cell carcinoma (SCC), or melanoma in the exposed group compared to the control group.

Conclusions: Single-dose SM exposure-regardless of its amount or duration-leads to significantly more long-lasting skin conditions compared to the controls.

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硫芥菜暴露后皮肤病的长期风险：一项回顾性队列研究。

背景：硫磺芥子气（SM）在两伊战争（1983-1988）期间被广泛使用。该研究评估了与普通人群相比，暴露幸存者中皮肤病的患病率。方法：采用回顾性队列研究，我们访问并比较了1538名sm暴露幸存者和1425名未暴露对照者皮肤疾病和活动性皮肤病的患病率。所有参与者都接受了多个中心皮肤科医生的临床评估。结果：暴露组表现出较高的慢性疾病患病率（优势比[OR]: 4.57, 95%可信区间[CI]: 3.92-5.34）、皮肤病史（OR: 2.32, 95% CI: 1.97-2.73）、皮肤科护理需求（OR: 5.91, 95% CI: 4.67-7.50）和皮质类固醇使用（OR: 10.98, 95% CI: 8.77-13.74）并同时使用多种皮质类固醇形式。皮肤科医生检查显示，暴露组皮肤疾病发生率较高（92.1%对23.4%;OR: 36.47, 95% CI: 29.24-44.5）和皮肤病发生率较高（86.7%对32.1%;OR: 13.81, 95% CI: 11.48-16.61）。暴露组中最常见的症状是瘙痒（84.7%比14.5%;OR: 32.46, 95% CI: 26.52-39.74），其次是烧灼感（38%比3.6%;OR: 16.54, 95% CI: 12.28-22.28）和皮肤干燥（36.2%比5.6%;OR: 9.52, 95% CI: 7.43-12.20）。皮肤科医生的访问表明，与对照组相比，暴露组出现水泡疾病的几率最高（OR: 40.4, 95% CI: 2.4-667.4）；持续性疣（OR: 17.7, 95% CI: 1.0-304.5）；瘙痒（OR: 17.1, 95% CI: 9.5 ~ 30.77）；干燥病（OR: 11.98, 95% CI: 9.36-15.34）；神经性皮炎（OR: 10.28, 95% CI: 5.79-18.56）；慢性单纯地衣（OR: 9.02, 95% CI: 6.13-13.28）；和剥脱性皮炎（OR: 7.75, 95% CI: 5.88-10.23）。与对照组相比，暴露组的白癜风、牛皮癣、瘢痕疙瘩、药物性痤疮、基底细胞癌（BCC）、斑疹、盘状红斑狼疮（DLE）、系统性红斑狼疮（SLE）、鳞状细胞癌（SCC）或黑色素瘤的风险没有显著增加。结论：与对照组相比，单剂量SM暴露-无论其量或持续时间-导致更持久的皮肤状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Dermatology 医学-皮肤病学

CiteScore

4.70

自引率

2.80%

发文量

476

审稿时长

3 months

期刊介绍： Published monthly, the International Journal of Dermatology is specifically designed to provide dermatologists around the world with a regular, up-to-date source of information on all aspects of the diagnosis and management of skin diseases. Accepted articles regularly cover clinical trials; education; morphology; pharmacology and therapeutics; case reports, and reviews. Additional features include tropical medical reports, news, correspondence, proceedings and transactions, and education. The International Journal of Dermatology is guided by a distinguished, international editorial board and emphasizes a global approach to continuing medical education for physicians and other providers of health care with a specific interest in problems relating to the skin.