CO2-LASER DEBRIDEMENT OF SULFUR MUSTARD (BIS-2-CHLOROETHYL-SULFIDE) INDUCED CUTANEOUS LESIONS ACCELERATES PRODUCTION OF A NORMAL EPIDERMIS WITH ELIMINATION OF CYTOLOGICAL ATYPIA

Sulphur mustard (bis-2-chloroethyl sulphide; HD) exposure acutely prod uces lesions that vary from mild erythema, to blister formation, to ne crosis, When blisters occur, with or without necrosis, healing of the lesions is delayed. Weanling pigs exposed to a mild erythema-producing dose of HD and to a moderate erythema-producing dose that consistentl y gave microblister formation were treated with CO2 laser (Tru-Pulse) debridement at 6, 24 or 48h after exposure. The histopathological feat ures observed at 14 days after exposure in control skin and skin expos ed to both HD doses were compared with the features observed in CO2 la ser-debrided skin in non-exposed and HD-exposed skin sites, The overly ing epidermis in the non-laser treated lesions was thin, with of cytol ogical atypia and squamoid changes within the basal cell layer, as wel l as scattered apoptoticinecratic keratinocytes. An increased inflamma tory infiltrate and necrobiotic changes in the dermis were seen al the higher HD dose, AU. laser-treated lesions appeared identical, with a thick, differentiated epidermis and a well-formed basal cell layer. Th ere was minimal inflammatory infiltrate. In the papillary dermis there were increased stromal cells. Laser debridement of mild clinical lesi ons induced by HD produced a more functional epidermis by 14 days as w ell as clearing the epidermis of damaged keratinocytes.