Clinical features

Local effects:

• blistering and soreness of the skin; cracking, and and shedding of fingernails
• de-epithelialisation of the cornea and conjunctiva
• epistaxis or sore throat following inhalation

Systemic effects:

• abdominal pain, vomiting, diarrhoea
• pulmonary oedema, cardiac and renal failure, hepatic damage

The final outcome depends on the lung lesion which is dose related; this ranges from minimal changes which are reversible, to pronounced pulmonary oedema, leading to pulmonary fibrosis if the patient survives beyond a few days, and long term respiratory impairment.