Comparative Study of Unna's Boot and Betamethasone Cream in the Treatment of Sulfur Mustard–Related Pruritus

Abstract

Pruritus, as a chronic lesion caused by sulfur mustard, is a common problem among chemical weapons veterans. Numerous treatments like antihistamines, local anesthetics, and corticosteroids have been prescribed in order to control pruritus in these patients, while long- term and widespread use of each one of them has its own restrictions. Nowadays different mixtures, including Unna's Boot, are being used. They are effective and have limited adverse effects. So in this study we compared this product with corticosteroids. In this double-blind randomized clinical trial in Baqyiatallah hospital, 90 veterans were included and randomly divided into three groups. Subjects of each group received one of the Betamethasone %1 cream, Unna's Boot cream, or placebo cream for three weeks. They used their medication on an itching area of body, one finger tip unit every night. To evaluate the drugs' efficacy we used pruritus score index and Visual Analysis Score index. From 90 patients, 75 patients completely used the medication and the other 15 subjects were excluded from the study. All three drugs caused significant decrease in both pruritus score and VAS (p < .001). Betamethasone and Unna's Boot were significantly more effective than placebo and despite more efficacy of betamethasone rather than Unna's Boot, they did not have any significant differences (p > .05). Pruritus is a chronic lesion in veterans that needs long-term conservation treatment. Regarding definite side effects of local long-term therapy with corticosteroids and nearly equal efficacy of Unna's Boot and betamethasone, Unna's Boot seems to be a better choice in controlling sulfur mustard–related pruritus compared with betamethason.