Cutaneous burns

Berkow, S. G. and Amboy, P., Value of surface area proportions in the prognosis of cutaneous burns and scalds, Amer. Jour, of Surgery, 1931, 1 1, 315. 

Bond SJ, Schnier GC, Sundine MJ, et al. Cutaneous burns caused by sulfuric acid drain cleaner. J Trauma 1998 44(3) 523 6. 

A 32-year-old man with a history of nephrolithiasis developed fever, severe hypotension, renal failure, hepatotoxicity, and severe cutaneous burns on the face after ingestion of homemade "funiper oxycedrus tar." No information on dose or further details on the product consumed was reported (Koruk et al. 2005). 

To date, the precise pathophysiology of the relationship between severe cutaneous burns and the development of peptic ulceration still remains unclear, although the association is important. 

The major adverse effect of niacin treatment is intense cutaneous flushing (vasodilation), which manifests as an uncomfortable burning sensation and itchiness of the face and upper body, thereby limiting patient compliance to therapy [13]. Moreover, a short half-life, dyspepsia, hyperuricemia, and modest hyperglycemia were also reported [14-16]. 

Contact with the eye by the gas or liquid resulted in transient irritation and conjunctivitis. Minor skin exposure to the liquid produced erythema and edema." Prolonged or repeated contact resulted in deeper burns with delayed vesiculation." It is doubtful that significant cutaneous absorption occurs. Although victims of skin exposure may show symptoms of neurotoxicity, inhalation is considered the likely cause."... 

Little Is known about possible long-term effects of CS Inhalation. This is due In part to the fact that short-term experiments with experimental animals, carried out for from several days to a month and using much higher (In some cases, nearly lethal) concentrations of CS, showed that ocular, respiratory, and cutaneous alte-. rations were mild and readily reversible, whereas necropsy findings failed to reveal any evidence of systemic alterations. Retrospective studies performed by the Hlmsworth committee at the request of the British Parliament after the extensive use of CS in Northern Ireland showed that no adverse effects of CS use were observed, with respect to eye burns, residual respiratory tract injury, Increased death rate in the elderly, exacerbations of mental Illness, increased Incidence of strokes or heart attacks, or incidence of tuberculosis. At exposure concentrations reported by the Hlmsworth committee (about 90 mg-min/m ), no persistent or notably adverse health effects were observed. 

Tinea pedis, tinea cruris, tinea corporis, cutaneous candidiasis, tinea versicolor, tinea rubrum Action Antifungal antibiotic cellular depletion of essential substrates /or ions Dose Adults Peds >10 y. Massage into affected area bid Onychomycosis Apply to nails daily, w/ removal q7d Caution [B, ] Contra Component sensitivity Disp Cream, gel, topical susp, shampoo, nail lacquer SE Pruritus, local irritation, burning Interactions None noted EMS None OD Not likely, no info available if large amt ingested... 

Blister fluid obtained from patients with cutaneous thermal injury had TAC 24% lower than that of blood serum. This may reflect oxidative stress and consumption of antioxidants in the blister site (H8). However, TAC of blood serum of severely burned patients was increased in 42% of the patients (mean value of TAC was elevated by 11% in the whole group of burned patients) (F2). 

In humans, brief contact of hydrogen peroxide with the skin leads to irritation and whitening (cutaneous emphysema), the severity of which depends on the concentration of the hydrogen peroxide solution. Longer contact or higher concentration can lead to burns. Contact with the eyes can lead to serious... 

Although burns are cutaneous injuries, the effects can influence nearly all systems of the body. The overall morbidity associated with a burn injury will be determined by burn depth, percentage total body surface area (TBSA) involved, patient age, and presence of inhalation injury. Children and older adults have thinner skin and are more likely to sustain a deeper burn injury. Patients at the age extremes are also less likely to tolerate the stress of burn shock. The presence of an inhalation in-... 

That same year, 19 children (11.3% of the 168 fatalities) died in the bombing of the Alfred P. Murrah Federal Building in Oklahoma City on April 19, 1995 (Quintana et al., 1997). Sixteen of the children who died were seated by the window of the day care center at the time of the explosion. Among the 19 dead children, 90% sustained skull fractures, with 79% sustaining cerebral evisceration 37% suffered abdominal or thoracic injuries 31% had amputations 47% had arm and 26% had leg fractures 21% were burned and 100% had extensive cutaneous contusions, avulsions, and lacerations (Quintana et al., 1997). Forty-seven children sustained nonfatal injuries, with seven requiring hospitalization (Quintana et al., 1997). Again, hospitalized children sustained severe skull and brain injuries, extremity fractures, amputations, and burns (Quintana et al., 1997). 

Amorolfine top. ind. most cutaneous mycoses nail lacquer for onychomycosis local irritation (burning, itch etc.) -... 

Graham, J.S., Schomacker, K.T, Glatter, R.D., Briscoe, C.M., Braue, E.H., Jr., Squibb, K.S. (2002a). Efficacy of laser debridement with autologous split-thickness skin grafting in promoting improved healing of deep cutaneous sulfur mustard hums. Burns 28 719-30. 

Graham, J.S., Chilcott, R.P., Rice, P., Milner, S.M., Hurst, C.G., Maliner, B.I. (2005). Wound healing of cutaneous sulfur mustard injuries strategies for the development of improved therapies. J. Burns Wounds 4 el. 

Berard P, Quesne B, Auriol B, et al. 1994. Cutaneous contamination after a uranyl nitrate skin burn incident report. Radiat Prot Dosim 53(l-4) 269-272. 

The initial clinical review should include a search for known consequences of poisoning, which include impaired consciousness with flacddity (benzodiazepines, alcohol, trichloroethanol) or with hypertonia (tricyclic antidepressants, antimuscaiinic agents), hypotension, shock, cardiac arrhythmia, evidence of convulsions, behavioural disturbances (psychotropic drugs), hypothermia, aspiration pneumonia and cutaneous blisters, burns in the mouth (corrosives). 

Other cutaneous sjmptoms, such as burning, pruritus, dermatitis, and skin redness, have also been reported (1). In trials in the USA, 14% of 1500 patients had shght transient rises in liver function tests, the significance of which is unclear (SEDA-13, 79). Headache, dizziness, gastrointestinal discomfort, and dysuria have also been described (1). Asthma can be precipitated in aspirin-sensitive patients. 

Short-term reactions are not uncommon. They include erythema, burns, nausea, pruritus, headache, and dizziness. Hypersensitivity reactions, which are uncommon, include drug fever, skin rashes, and bronchial asthma. Long-term treatment increases the risk of non-melanoma skin cancers and possibly of cutaneous melanoma. 

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