Topical iodine preparation as therapy against sulfur mustard-induced skin lesions

Sulfur mustard (SM) is a powerful vesicant employed as an agent of chemical warfare. This study demonstrates the therapeutic effect of a novel topical iodine preparation as a postexposure treatment against SM-induced lesions in the fur-covered guineapig skin model. Iodine treatment 15 min after SM e xposure resulted in statistically significant reductions of 48, 50, and 55% in dermal acute inflammation, hemorrhage, and necrosis, respectively, wher eas, the epidermal healing markers, hyperkerathosis and acanthosis, were si gnificantly elevated by 72 and 67%, respectively, 2 days after treatment. A t the interval of 30 min between SM exposure and iodine treatment, there wa s a significant degree of healing or recovery, albeit to a lesser extent th an that observed in the shorter interval. Although the epidermal healing ma rkers were not elevated, the parameters indicative of active tissue damage, such as subepidermal microblisters, epidermal ulceration, dermal. acute in flammation, hemorrhage, and necrosis, were significantly reduced by 35, 67, 43, 39, and 45%, respectively. At the 45-min interval between exposure and treatment, there was also a certain degree of healing or recovery expresse d as significant reductions in dermal subacute inflammation, subepidermal m icroblister formation, and epidermal ulceration, whereas, acanthosis was st atistically elevated, indicating an increased healing potential. At the 60- min interval, iodine was less efficacious; nevertheless, a significant redu ction in the incidence of subepidermal microblisters and an expansion of th e acanthotic area were observed. Gross ulceration was significantly decreas ed at intervals of 15 and 30 min between exposure and treatment. The local anesthetic, lidocaine, did not alter the therapeutic effect of iodine. SM w as not affected chemically by iodine as measured by gas chromatography-mass spectrometry (GC-MS) analysis. These findings suggest that the iodine prep aration functions as an antidote against skin lesions induced by SM. (C) 20 00 Academic Press.