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Blister agents are named for their ability to cause large, painful water blisters on the bodies of those affected

Soldier with moderate mustard gas burns sustained during World War I showing characteristic bullae on neck, armpit and hands

A blister agent, or vesicant, is a chemical compound that causes severe skin, eye and mucosal pain and irritation. They are named for their ability to cause severe chemical burns, resulting in painful water blisters on the bodies of those affected. Although the term is often used in connection with large-scale burns caused by chemical spills or chemical warfare agents,^[1] some naturally occurring substances such as cantharidin are also blister-producing agents (vesicants).^[2] Furanocoumarin, another naturally occurring substance, causes vesicant-like effects indirectly, for example, by increasing skin photosensitivity greatly. Vesicants have medical uses including wart removal but can be fatal if even small amounts are ingested.^[2]

Blister agents used in warfare

Most blister agents fall into one of three groups:

Sulfur mustards – A family of sulfur-based agents, including mustard gas.
Nitrogen mustards – A family of agents similar to the sulfur mustards, but based on nitrogen instead of sulfur.
Lewisite – An early blister agent that was developed, but not used, during World War I. It was effectively rendered obsolete with the development of British anti-Lewisite in the 1940s.

Occasionally, phosgene oxime is included among the blister agents, although it is more properly termed a nettle agent (urticant).

Effects

Exposure to a weaponized blister agent can cause a number of life-threatening symptoms, including:

Severe skin, eye and mucosal pain and irritation
Skin erythema with large fluid blisters that heal slowly and may become infected
Tearing, conjunctivitis, corneal damage
Mild respiratory distress to marked airway damage

All blister agents currently known are denser than air, and are readily absorbed through the eyes, lungs, and skin. Effects of the two mustard agents are typically delayed: exposure to vapors becomes evident in 4 to 6 hours, and skin exposure in 2 to 48 hours. The effects of Lewisite are immediate.

References

^ Center for Disease Control Archived January 22, 2005, at the Wayback Machine
^ ^a ^b Cantharidin and Meloids: a review of classical history, biosynthesis, and function Archived September 3, 2005, at the Wayback Machine

External links

Medterms.com
Medical Aspects of Biological and Chemical Warfare, Chapter 7: Vesicants

UpToDate Contents

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1. 化学テロ：早急な認識および初回薬物治療マネージメントchemical terrorism rapid recognition and initial medical management [show details]
…specifically formulated to neutralize the toxicity of the liquid nerve agent VX and blister agents such as sulfur mustard and Lewisite. It acts within seconds of being applied to the skin and is the preferred spot …
2. 反応性気道機能障害症候群および刺激に誘発された喘息reactive airways dysfunction syndrome and irritant induced asthma [show details]
…assessed . In a 10-year follow-up of 197 veterans of the Iran-Iraq war with acute poisoning with sulfur mustard gas, asthma symptoms, reversible airflow obstruction, and excessive diurnal peak expiratory flow…
3. 帰国高齢者に対する医療medical care of the returning veteran [show details]
…with the conflicts in Afghanistan or Iraq. These hazards include Agent Orange (dioxin) , sulfur mustards (mustard gas) , other toxic nerve agents (eg, sarin, cyclosarin) , and heavy metals . The herbicide…
4. ヒ素曝露と中毒arsenic exposure and poisoning [show details]
…recommend its use . Two chelating agents are available in the United States: dimercaprol (British Anti-Lewisite [BAL]) and meso-2,3-dimercaptosuccinic acid (DMSA, succimer). A third drug, unithiol (sodium 2, …
5. 表皮水疱症の診断diagnosis of epidermolysis bullosa [show details]

English Journal

A quantitative method to detect human exposure to sulfur and nitrogen mustards via protein adducts.

Pantazides BG, Quiñones-González J, Rivera Nazario DM, Crow BS, Perez JW, Blake TA, Johnson RC.
Journal of chromatography. B, Analytical technologies in the biomedical and life sciences. 2019 May;1121()9-17.
Sulfur and nitrogen mustards are internationally banned vesicants listed as Schedule 1 chemical agents in the Chemical Weapons Convention. These compounds are highly reactive electrophiles that form stable adducts to a variety of available amino acid residues on proteins upon exposure. We present a
PMID 31082684

The natural anticancer agent cantharidin alters GPI-anchored protein sorting by targeting Cdc1-mediated remodeling in endoplasmic reticulum.

Sahu PK, Tomar RS.
The Journal of biological chemistry. 2019 03;294(11)3837-3852.
Cantharidin (CTD) is a potent anticancer small molecule produced by several species of blister beetle. It has been a traditional medicine for the management of warts and tumors for many decades. CTD suppresses tumor growth by inducing apoptosis, cell cycle arrest, and DNA damage and inhibits protein
PMID 30659098

Uptake and Release of Polyvinyl Alcohol from Hydrogel Daily Disposable Contact Lenses.

Phan CM, Subbaraman LN, Jones LW.
Optometry and vision science : official publication of the American Academy of Optometry. 2019 Mar;96(3)180-186.
Polyvinyl alcohol is a wetting agent that could reduce the symptoms of dry eye and contact lens discomfort. Currently, only one lens type, nelfilcon A (DAILIES AquaComfort Plus), releases polyvinyl alcohol. The concept of releasing this agent from contact lenses could be applied to other lens materi
PMID 30801502

Japanese Journal

ポータブルラマン分光計による化学兵器用剤の分析

佐藤貴史,關岡亮二,瀬戸康雄,松宮宏幸,中川秀樹
分析化学 65(9), 539-545, 2016
… The Raman spectra (300–2000 cm<sup>−1</sup>) of five nerve gases, one nerve gas precursor, five blister agents, three lachrymators, one vomit agent and one choking agent and seven chemical warfare agents (CWAs) simulants as liquid or solid state were measured using portable Raman spectrometer (Delta Nu Co., RAPID ID, excitation wavelength: 785 nm). …
NAID 130005420893

フルオロウラシル内服薬のPTPシート汚染原因の検討

川本英子,小川壮寛,江川孝,島田憲一,浜原安奈,兼光朝子,髙見陽一郎,森山圭,花田貴惠,井上結夏,長瀨彩花,山本温子
医療薬学 41(9), 630-635, 2015
… We recently reported that various amounts of cyclophosphamide (CP) had contaminated both the inside and outside of the blister pack, and refrigerated storage of CP oral tablets can protect healthcare workers and patients from contact CP exposure. … However, the contamination from a non-volatile agent, fluorouracil (FU), and its preventive procedures are not elucidated. … Here we showed high levels of FU were detected from inside the blister pack. …
NAID 130006855777