Chronic Dermal Isopropanol Exposure Resulting in Central Nervous System Depression in a Hemodialysis Patient

Isopropanol is a volatile alcohol that is easily accessed but generally not thought to cause significant toxicity. It has been shown to be dermally absorbed in the past, but typically not to a significant extent.

We present a case of chronic dermal isopropanol exposure in a hemodialysis (HD) dependent patient that resulted in central nervous system depression due to chronic accumulation of acetone. Symptoms resolved following 3 hours of HD. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Given that isopropanol and acetone are primarily renally cleared, patients with poor intrinsic renal function are at risk for developing significant toxicity beyond what would typically be expected from an isopropanol exposure.