Sulfur mustard skin lesions: A systematic review on pathomechanisms, treatment options and future research directions

Toxicol Lett. 2018 Sep 1;293:82-90. doi: 10.1016/j.toxlet.2017.11.039. Epub 2017 Dec 2.


Sulfur mustard (SM) is a chemical warfare, which has been used for one hundred years. However, its exact pathomechanisms are still incompletely understood and there is no specific therapy available so far. In this systematic review, studies published between January 2000 and July 2017 involving pathomechanisms and experimental treatments of SM-induced skin lesions were analyzed to summarize current knowledge on SM pathology, to provide an overview on novel treatment options, and to identify promising targets for future research to more effectively counter SM effects. We suggest that future studies should focus on (I) systemic effects of SM intoxication due to its distribution throughout the body, (II) removal of SM depots that continuously release active compound contributing to chronic skin damage, and (III) therapeutic options that counteract the pleiotropic effects of SM.

Keywords: CEES; Cell death; Mustard gas; Oxidative stress; Vesicant; Warfare toxicant.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Antidotes / pharmacology
  • Chemical Warfare Agents / pharmacokinetics
  • Chemical Warfare Agents / toxicity*
  • Humans
  • Mustard Gas / pharmacokinetics
  • Mustard Gas / toxicity*
  • Skin Diseases / chemically induced*
  • Skin Diseases / drug therapy
  • Skin Diseases / pathology


  • Antidotes
  • Chemical Warfare Agents
  • Mustard Gas