Sinepõletust

Sinepõletust is an Estonian term for the skin and mucous membrane injuries caused by exposure to mustard agents, also known as sulfur mustard or mustard gas. The name derives from the Estonian words “sinep” meaning mustard and “õletus” meaning inflammation or burn. Mustard agents are blistering chemicals that were used as chemical warfare agents during World War I and later conflicts. They are classified as vesicants because they form painful blisters and cause tissue necrosis.

The pathophysiology of sinepõletust involves alkylation of cellular macromolecules, leading to DNA damage, protein dysfunction, and activation of inflammatory cascades. Initial symptoms typically appear within 24–48 hours of exposure and include itching, burning, erythema, and edema of the skin or conjunctival tissues. From 2–7 days after exposure, vesicles develop, which may rupture to produce crusted erosions. Systemic effects can include respiratory distress, bronchospasm, and mucosal ulceration when inhalation occurs. Long‑term complications may involve scarring, carcinogenesis, or psychosocial impact.

Diagnosis relies on clinical history of exposure, symptom presentation, and, when available, toxicological analysis of a suspected chemical agent. Imaging is rarely required unless complications such as airway obstruction are suspected.

Treatment is supportive and includes decontamination with water and soap, removal of contaminated clothing, and topical measures to soothe skin irritation. For blistering, blister closure and wound care are necessary; systemic pentoxifylline or topical dexamethasone have been used with variable outcomes. Antioxidants, like N‑acetylcysteine, can reduce oxidative stress. Management of respiratory involvement may require bronchodilators, steroids, and, if severe, mechanical ventilation.

Prevention of sinepõletust focuses on chemical weapon stockpile destruction, protective equipment, and rapid decontamination protocols during incidents. In medical settings, training for recognition and immediate referral is essential to improve outcomes.