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An uncommon burn

2008; Oxford University Press; Volume: 160; Issue: 1 Linguagem: Inglês

10.1111/j.1365-2133.2008.08877.x

1365-2133

B. Arun, Joanne S Jacob, James P. Byrne,

Inhalation and Respiratory Drug Delivery

Conflicts of interest: none declared. Sir, We report a rare case of inhaler‐induced burn in a 13‐year‐old boy caused by applying the nozzle of the inhaler to his hand and discharging the inhaler. A 13‐year‐old boy presented with a 4‐day history of blisters around the edge of an erythematous patch on the dorsum of his left hand, which had been present for a year. His sister suffered from asthma. On examination, there was a well‐demarcated erythematous patch on the dorsum of his left hand with crusts from ruptured blisters around the edge of the patch (Fig. 1). On further questioning, he admitted having developed this red patch 1 year previously after he had applied the nozzle of his sister’s salbutamol inhaler onto his hand and discharged it a few times playfully. The repetition of this practice had resulted in the inhaler‐induced burns we see in this picture. Inhaler‐induced burn is very rare, and to our knowledge there are only three cases reported in the literature.1 2–3 All three patients were asthmatic. Chemical burn from the pharmaceutical/preservative/propellant aerosol, cold injury to the skin or mechanical abrasive effect of the aerosol blasts were the suggested mechanisms of injury. Burge et al. suggested that the physical signs of inhaler‐induced burn are similar to those seen after a standardized cryotherapy freeze injury to the skin.4 Children who gain access to inhalers may find them to be interesting toys. They could then sustain chemical burns due to inappropriate discharge onto the skin. We need to be aware of this effect of commonly used inhalers and warn parents, teachers and children in order to avoid these injuries.