Urinary and cutaneous complications of sulphur mustard poisoning preceding pulmonary and ocular involvement: an unusual sequence of symptoms

Sulphur mustard was used as a disabling chemical warfare agent during World War I, and, in more recent times, the Iran-Iraq conflict. Various chronic and acute complications have been documented in almost 100 000 Iranian victims to date. Several individual and environmental factors affect the severity and persistency of the complications. The most common adverse effects occur in the respiratory system, skin and eyes, with ocular and respiratory features usually preceding cutaneous lesions. In this paper, we present the unusual case of a chemical victim presenting with characteristic mustard scar leading to stenosis of the external meatus. In this case, initial cutaneous involvement of the injured external genitalia and thighs preceded the ocular and respiratory symptoms. We discuss the possible aetiologies.