Lewisite skin damages

The clinical effects of lewisite are similar to those of mustard. However, unlike mustard, lewisite liquid or vapor produces irritation and pain upon contact. As with mustard, immediate decontamination will limit lewisite s damage to skin or eyes. A specific antidote for the systemic effects of the agent exists in the form of British Anti-Lewisite (BAL). BAL must be used under medical supervision owing to its own toxic properties. There is no need to have this antidote far forward, and it can be kept in modest quantities because of the minimum threat from lewisite. 

Lewisite produces immediate clinical effects (unlike mustard gas, which is delayed). Stinging pain is often felt within 10-20 seconds. Skin damage can occur within 5 minutes and blister formation is complete within 12-18 hours. Warm, moist areas of the body are the most vulnerable and it easily penetrates ordinary clothing as well as wood, leather and rubber. Absorption is increased by heat and moisture. Exposure to the liquid agent is more severe than to its vapour. 

Tissue damage occurs within minutes of exposure to vesicants, but clinical effects may not appear for up to 24 hours. Mixtures such as HL (C03-A010) contain lewisite (C04-A002) and will produce an immediate burning sensation on contact with the skin or eyes. Some agents are rapidly absorbed through the skin and extensive skin contamination may cause systemic damage. 

Lewisite, dichloro(2-dichlorovinyl)arsine is a chemical that contains arsenic, which though a liquid is sufficiently volatile to be dispersed among enemy troops. The arsenic atom in the lewisite reacts with proteins and causes terrible blisters on the skin and damage to the eyes and lungs if inhaled. Fortunately, an antidote was devised as a result of the work of the British biochemist Rudolf Peters. The antidote was appropriately named British anti-lewisite (dimercaprol), and abbreviated to BAL. 

Pediatric exposures to vesicants can be quite toxic however, in contrast to nerve agent exposures, HD causes significantly greater morbidity than mortality. While mustard did not cause many deaths in WWI, death from HD exposure is usually due to massive pulmonary damage complicated by infection (bronchopneumonia) and sepsis. Children often show a quicker onset and greater severity of toxicity. Skin and eye toxicity occurs in the form of blisters or irritation that can result in blindness for the most severe cases. Except for lewisite, vesicant exposures must be managed with supportive care and rapid decontamination. 

Lewisite is an oily, colorless liquid that can appear amber to black in its impure form. It has the odor of geraniums. It is more volatile than the mustard agents. Lewisite in the air can cause damage to the eyes, skin, and airways by direct contact. Lewisite in water can lead to exposures from drinking the water or from skin contact, and lewisite-contaminated food can be ingested. Lewisite remains as a liquid under a wide range of environmental conditions, from below freezing to very hot temperatures. 

Lewisite is readily absorbed from the skin, eyes, and respiratory tract, as well as after ingestion and through wounds. It causes blistering on the skin and mucous membranes on contact. After absorption, it causes an increase in capillary permeability, which produces hypovolemia, shock, and organ damage. Unlike the mustard agents, lewisite vapor or liquid causes immediate pain or irritation although lesions require up to 12 h to become full-blown cases. 

Blister agents Also known as vesicants, these are chemical weapon compounds that cause severe blistering of the skin, as well as damage to the eyes, mucous membranes, respiratory tract and internal organs. This class of chemical weapon agent includes the arsenicals/Lewisites (L), phosgene oxime (CX), and sulfur mustards (HD, HN). 

Lewisite (b-chlorovinyldichloroarsine) is an arsenical vesicant but of secondary importance in the vesicant group of agents. It was synthesized in the early twentieth century and has seen little or no battlefield use (Balali-Mood et al., 2005). Lewisite is similar to mustard in that it damages the skin, eyes, and airways however, it differs from mustard because its clinical effects appear within seconds of exposure. An antidote, British anti-Lewisite (BAL), can ameliorate the effects of Lewisite if used soon after exposure. Lewisite has some advantages over mustard but also some disadvantages. 

Lewisite damages skin, eyes, and airways by direct contact and has systemic effects after absorption. Unlike mustard, it does not produce immunosuppression. Data on human exposure are few. Lewisite was applied to human skin in a few studies however, most information on its clinical effects is based on animal studies (Rovida and Lewisite 1929 Wardell, 1940 Dailey et al., 1941 Buscher and Conway, 1944). 

Unfortunately, vesicant exposure creates a huge problem because microscopic cellular damage occurs within very few minutes of exposure, but at a minimum, outward physical signs of that damage does not normally occur for at least 2 or 3 h after exposure, though usually longer. While phosgene oxime produces immediate pain on skin contact and Lewisite produces pain usually within 1 min after skin contact, sulfur mustard produces absolutely no pain on contact with the skin. As much as people do not like pain, pain is an extremely important protective mechanism for... 

Lewisite (L) is a vesicant from the arseitical (vesicant) chemical family. Lewisite causes many of the same types of damage to skin, eyes, and the respiratory system as do the mustard agents. The chemical name is dichloro-(2-chlorovinyl) arsine. It has not knowingly been used on the battlefield, and human exposure data is limited. The major difference between lewisite and mustard is that lewisite causes pain... 

Lewisite is a vesicant and toxic lung-irritant that is absorbed into tissues. If inhaled in high concentrations, it can be fatal in as little as 10 minutes the body is unable to detoxify itself from lewisite exposure. Routes of entry into the body include the eyes, skin absorption, and inhalation. Eye contact results in pain, inflammation, and blepharospasm (spasms of the muscles of the eyelid), which leads to closure of the eyelids, comeal scarring, and iritis (inflammation of the iris). If decontamination of the eyes occurs quickly after exposure, damage may be reversible however, permanent injury or blindness can occur within one minute of exposure. 

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