A 16-year-old female with psoriasis presented to our Plastic Surgery Department with a significant CHEMICAL BURN to the neck, upper torso and left cheek (TBSA 6%). She applied a concoction of cream prescribed by her dermatologist in her native country, Poland when she returned to the United Kingdom. A few hours after application she developed a BURN with pH of 5. A review of the cream revealed a mixture of 19% dithranol and 5% salicylic acid. This combination is recognized for managing psoriasis, however the strength of dithranol in the combination given is of a high concentration (normally <3%). This alone can cause a BURN to the skin if left for a prolonged period of time. Salicylic acid is an enhancer which augments the stability of dithranol and increases its penetration and efficacy. The concentration of 5% is also on the higher end. Our patient was admitted for pain relief and further irrigation till normalization of the pH which was achieved after 3 days. A worrying aspect in our patients’,case is that she was given the cream to commence at home. High concentration preparation is normally commenced in a controlled setting under medical supervision.

This retrospective, cross-sectional and descriptive study was performed on 599 BURNed patients who referred to Mottahari Hospital during one year (20.3.2002-20.3.2003) to determine the incidence of different kinds of BURNs in children and adolescents. The age of 15 years old or less was the basis of selection. Studied variables were patients' age. and sex, cause of BURNing, duration of hospitalization, BURNed surface percentage and mortality rate of patients. Of these 599 patients (mean age: 5.8), 167 were hospitalized and 432 were outpatient. In hospitalized group, 97.6% of patients had thermal BURN, 2.4% had electrical BURN, but nobody had CHEMICAL BURN. In outpatient group, 98.8% had thermal BURN, 0.9% had electrical BURN and 0.3% had CHEMICAL BURN. This study showed that BURNing occurred in male patients more than females (58.6% vs. 41.4%). Children younger than 5 years old were the most affected group. Most of the patients had BURNed surface area (BSA) less than 10% and a few patients had BSA more than 90%. The mortality rate was 4.8%.

This study was conducted to determine the causes and outcomes of BURN in patients referred to Shahid Mohammadi Hospital in Bandar Abbass, southern Iran, in which 212 BURNed patients were assessed from March 2007 to March 2008 .Mean age of patients was 22.14 yr. Heat contact was the main cause of BURN with 92.5%. 49.1% of total BURNs occurred among less than 20 yr old people. Mortality rate was 10.4%. Most of BURNs occurred at home. An educational program is necessary to prevent thermal BURNing at home.

Purpose: To evaluate result of Corneal graft (PKP) after cultivated oral mucosal epithelial transplantation (COMET) in patients with CHEMICAL BURN.Methods: In this prospective interventional nonrandomized case series, optical PKP was performed after successful COMET for visual rehabilitation in patients with severe stromal opacity. Main outcome measures were clarity of the corneal graft, visual acuity improvement, and corneal graft survival.Results: Fourteen eyes of 14 patients with successful COMET were included. Overall, PKP was performed 7.6±1.3 months (6-9 months) after COMET. The mean follow-up period was 28.2±8 months (14-40 months, median 30 months). The time for complete epithelial healing was 7 days in all eyes. There was no epithelial defect in 13 eyes at the final examination. The corneal surface had been covered by a transparent epithelium without significant neovascularization. Bacterial keratitis developed in 1 eye due to persistent epithelial defect, which was healed with vascularization. Best-corrected visual acuity increased from 2.67±0.08 LogMAR preoperatively to 0.64±0.27 LogMAR after PKP (P<0.001). Four patients had Endothelial rejection that successfully managed by systemic and topical steroids. Overall and rejection-free graft survival rates were 92.9 and 69.2%, respectively.Conclusion: PKP is a good choice for visual rehabilitation in CHEMICAL BURN with bilateral total LSCD and severe stromal opacity that underwent successful COMET.

Purpose: To evaluate the effect of topical phenytoin 1 % on corneal epithelial defects healing in a rabbit model.Methods: One eye of 20 albino rabbits in the animal house of Al-Zahra Ophthalmology Hospital was studied. A single corneal epithelial defect was created. The rabbits were randomly assigned into two groups (Ten animals in each group). After creating a CHEMICAL BURN in rabbits, one group was treated by soluble phenytoin 1% eye drops and the other group with normal saline eye drops. Daily examination was performed to determine the maximum diameter of corneal epithelial defects during 14 days. Data was analyzed using statistical tests including independent T Test and ANOVA on repeated observations.Results: The difference between the first and the last day of follow up in each group was significant (P<0.05). Topical phenytoin 1%, as compared with the control group, significantly improved epithelial defect healing (P<0.05).Conclusion: Topical phenytoin 1% as a supplement treatment can help in the improvement of epithelial defect caused by alkaline BURNs.

Thermal BURN, which is the most common cause of BURNs, leads to the destruction of tissues via heat conduction. The heat leads to cellular damage. The depth and severity of BURN is determined by the temperature and the duration of contact.In CHEMICAL BURNs with acid, the depth of injury is more than what can be seen initially and the exact evaluation of the depth of the wound needs complete debridement. Here we report about the cases of two pastry workers who had mixed BURNs: thermal and CHEMICAL (acid). The termal BURN was due to the ignition of gasoline and CHEMICAL BURN was due to the contact with acid that was used for cleaning of the floor.We report on the type of the wound and the follow up and the final results of the treatments of these two patients.

Here we reported a one-year-old infant with tissue damage in the scrotum area, in which a small button cell battery had been found in his diaper. Evidence suggested that the lesion was caused by contact with the leaky battery with the scrotal skin. The treatment procedure was prescribed by a dermatologist. The healing process was tracked over the examination times. After two months, the site of the lesion showed complete remission. The findings suggested that in such cases, after removing the CHEMICAL agent, blisters, and necrotic tissues, therapeutic measures should be performed similarly to the thermal BURNs.

Purpose: To report visual rehabilitation with a native Pintucci keratoprosthesis (KPro) after a severe ocular surface CHEMICAL BURN in a male patient. Case Report: A 41‑ year‑ old man experienced a bilateral severe CHEMICAL BURN 5 years previously. Earlier penetrating keratoplasty and keratolimbal allografts were unsuccessful in both eyes, and neither of the eyes had vision better than light perception. Both corneas were opaque and conjunctivalized. Because of severe dry eye and total limbal stem cell deficiency, the left eye was considered for a Pintucci‑ type KPro. In the first stage, the ocular surface was reconstructed with an oral mucus membrane graft, and a KPro was placed under the skin and orbicularis oculi muscle. Three months later, the KPro was removed and implanted in the left eye. During seven months after the KPro implantation, the anatomical position was acceptable, and his best corrected visual acuity was 2/10. Conclusion: Bearing in mind the successful results of the native Pintucci KPro in this case of severe acid BURN, using this type of keratoprosthesis in patients with total limbal stem cell deficiency and severe dry eye is recommended.