Coal Ash Poultice: An Unusual Cause of a Chemical Burn

Abstract

Burns from seemingly innocuous substances are rare, probably underrecognized and typically present late. We describe a case of a child who sustained a full-thickness burn after an application of a coal ash poultice for ankle pain. This case report highlights a rare cause of a chemical burn that may become more common with increasing use of traditional remedies worldwide.

Erythroderma in an infant from a traditional alternative remedy

“…Cutaneous burns from wood ash in adults are reported a few minutes to 12 h after exposure, and course with third-degree burns requiring surgical management. [7][8][9][10][11] In a report of chemical burns from wood ash in a 2-year-old child, the reaction was immediate, as in our case. 5 The preexisting atopic dermatitis in our patient may have accelerated the irritative response, leading to severe, extensive irritation and erythroderma.…”

“…Erythroderma in our patient developed even though the skin was only in contact with the ash dissolved in water for a few seconds. Cutaneous burns from wood ash in adults are reported a few minutes to 12 h after exposure, and course with third‐degree burns requiring surgical management 7–11 . In a report of chemical burns from wood ash in a 2‐year‐old child, the reaction was immediate, as in our case 5 .…”

Unusual burn injury due to application of white vinegar and aspirin mixture

“…Household vinegar is a sour‐tasting liquid containing 4% to 5% acetic acid and is used as a condiment, salad dressing, preservative, mild disinfectant, medicinal tonic and ‘softener’ or ‘deodorant’ in cooking. Although this weak acid can cause corrosive and ulcerative injury of the upper digestive tract, the complication reported here has rarely been reported in the medical literature .…”

“…Although pH value of the applied mixture is unknown, the burn was consistent with very low pH levels. Direct contact with acids causes acidic chemical burns of varying severities depending on the type of acid, the length of exposure and initial management .…”

“…Increased use of chemical materials augments the rate of exposure to dangerous chemicals . These exposures are mostly accidental.…”