Skin, Eyes, and Mucous Membranes
Current Medical Countermeasures
Pretreatment
Sulfur mustard is an oily liquid and is considered a “persistent” chemical agent, that is, it does not evaporate quickly and remains active for an extended time. Clothing, skin, and hair may remain contaminated with sulfur mustard for hours, presenting a challenge to health care providers. The military and first responders rely heavily on individual physical protection (e.g., protective masks and suits) to prevent exposure to vesicants. No pretreatment drugs are yet available.
Post-Exposure Treatment
Current treatment of vesicant-induced injuries is largely symptomatic and supportive. Eye injuries require the use of special eye drops, antibiotics, and other drugs to prevent secondary infection, and steroids are used to limit the inflammatory response and speed the healing process. Skin wounds, especially when severe with blister formation, require specific medical attention to reduce pain, prevent infection, and reduce inflammation. Debridement (removal) of a layer of the injured skin may be necessary to speed the healing process.
Diagnosis
At this time, diagnosis of vesicant injury is based on clinical signs and symptoms and the detection of specific agents in the environment. There are no FDA-approved clinical laboratory tests for sulfur mustard in blood or tissue. However, compounds such as thiodiglycol are produced in the body after exposure to sulfur mustard and can be detected in blood, urine, and tissue. Analysis of these compounds requires the use of complex technologies, such as gas chromatography-mass spectrometry.
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