Mustard gas scarring with specific pigmentary, trophic and vascular charactristics (case report, 16-year post-exposure) ☆

Abstract Sulfur mustard (mustard gas) is an alkylating agent used widely against Iranians during the 8-year Iraq–Iran war. This agent causes various late-occurring respiratory, skin and eye complications. A 37-year-old Iranian man exposed to the agent in vapor form 16 years prior to the date of this writing was given a clinical and pathological evaluation for late-occurring skin lesions. Hypo and hyperpigmentation, atrophic, and vascular changes (cherry angiomas) were observed at the site of mustard scarring on the left anterior thigh. Histological studies showed mild papillomatosis and acanthosis changes along with pigmentation of basal layer in epidermis and atrophy of adnexal structures along with fibrosis and sclerosis in dermis.