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CO 2 laser debridement of sulphur mustard (bis‐2‐chloroethyl sulphide) induced cutaneous lesions accelerates production of a normal epidermis with elimination of cytological atypia
Author(s) -
SMITH K.J.,
SKELTON H.G.,
MARTIN J.L.,
HURST C.G.,
HACKLEY B.E.
Publication year - 1997
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1997.tb03792.x
Subject(s) - dermis , epidermis (zoology) , erythema , necrosis , blisters , sulfur mustard , pathology , papillary dermis , stratum spinosum , granulation tissue , medicine , desquamation , dermatology , wound healing , anatomy , stratum corneum , toxicity , surgery , immunology
Summary Sulphur mustard (bis‐2‐chloroethyl sulphide: HD) exposure acutely produces lesions that vary from mild erythema, to blister formation, to necrosis. 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 consistently gave microblister formation were treated with CO 2 (Tru‐Pulse) debridement at 6, 24 or 48 h after exposure. The histopathological features observed at 14 days after exposure in control skin and skin exposed to both HD doses were compared with the features observed in CO 2 laser‐debrided skin in non‐exposed and HD‐exposed skin sites. The overlying epidermis in the non‐laser treated lesions was thin, with cytological atypia and squamoid changes within the basal cell layer, as well as scattered apoptotic/necrotic keratinocytes. An increased inflammatory infiltrate and necrobiotic changes in the dermis were seen at the higher HD dose. All laser‐treated lesions appeared identical, with a thick, differentiated epidermis and a well‐formed basal cell layer. There was minimal inflammatory infiltrate. In the papillary dermis there were increased stromal cells. Laser debridement of mild clinical lesions induced by HD produced a more functional epidermis by 14 days as well as clearing the epidermis of damaged keratinocytes. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army, the Department of the Navy, or the Department of Defense.