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Caustic burns

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

Intentional caustic burns 2-4,6,9,10

Location of intentional caustic burns:

 

  • Acidic liquid in ear 6
  • Acid dripped on head 9
  • Mouth and pharynx – forced drinking of caustic cleaner 2
  • Acid thrown on face / eye 3
  • In one case the location of injury was not recorded 4
  • Three adolescents had caustic burns to exposed body parts as punishment by employers 10

Unintentional caustic burns 1,5,7,8,11-13

Characteristics of unintentional caustic burns (initially mistaken for abusive burns):

 

  • Appeared without apparent explanation in four cases
  • Mostly deep burns
  • Appeared to be no pain initially, which is consistent with burn type
  • Diagnosis made as result of careful history and, where appropriate, testing clothing for chemicals
  • Traditional remedy involving copper sulphate

  Age range: 0 – 11 years

 

Causes

 

  • Alkaline battery fluid 12
  • Bathed in bleach 11
  • Carried Ca Chloride crystals in pocket 13
  • Topical analgesic with salicylate and menthol, aggravated by hot water, toothpaste and potato puree 8
  • Prescribed potassium permanganate solution with undissolved crystals 1
  • Laundry detergent spilt onto clothes 5
  • Copper sulphate mixed with egg white dripped in circular pattern on dorsum of hands, headache remedy 7

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References

  1. Baron S, Moss C. Images in paediatrics: Caustic burn caused by potassium permanganate. Archives of Disease in Childhood. 2003;88(2):96 [Pubmed citation only]
  2. Gillespie RW. The battered child syndrome: thermal and caustic manifestations. The Journal of Trauma: Injury, Infection, and Critical Care. 1965;5:523-534 [Pubmed citation only]
  3. Gollogly JG, Vath SB, Malmberg A. Acid attacks in Cambodia: serious reminders of personal conflicts. Asian Biomedicine. 2008;2(4):329-334 [Abstract from IMSEAR]
  4. Hicks RA, Stolfi A. Skeletal surveys in children with burns caused by child abuse. Pediatric Emergency Care. 2007;23(5):308-313 [Pubmed]
  5. Howieson AJ, Harley OJH, Tiernan EP. Laundry detergent and possible nonaccidental injury. European Journal of Emergency Medicine. 2007;14(3):163-164 [Pubmed]
  6. Kini N, Lazoritz S, Ott C, Conley SF. Caustic instillation into the ear as a form of child abuse. American Journal of Emergency Medicine. 1997;15(4):442-443 [Pubmed citation only]
  7. Lapid O. Copper sulphate burns to the hands, a complication of traditional medicine. Journal of Burn Care & Research. 2008;29(3):544-547 [Pubmed]
  8. Nunez AE, Taff ML. A chemical burn simulating child abuse. The American Journal of Forensic Medicine and Pathology. 1985;6(2):181-183 [Pubmed citation only]
  9. Petersen HD, Wandall JH. Evidence of physical torture in a series of children. Forensic Science International. 1995;75(1):45-55 [Pubmed]
  10. Ramakrishnan MK, Mathivanan T, Sankar J. Profile of children abused by burning. Annals of Burns and Fire Disasters. 2010;23(1)8-12 [Pubmed]

  11. Telmon N, Allery J-P, Dorandeu A, Rougé D. Concentrated bleach burns in a child. Journal of Forensic Sciences. 2002;47(5):1060-1061 [Pubmed]
  12. Winek CL, Wahba WW, Huston RM. Chemical burn from alkaline batteries — a case report. Forensic Science International. 1999;100(1):101-104 [Pubmed]
  13. Zurbuchen P, LeCoultre C, Calza A-M, Halpérin DS. Cutaneous necrosis after contact with calcium chloride: a mistaken diagnosis of child abuse. Pediatrics. 1996;97(2):257-258 [Pubmed citation only]

 

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