Percutaneous alcohol absorption and skin necrosis in a preterm infant

A 27-week gestation infant developed severe haemorrhagic skin necrosis on the back and buttocks after umbilical arterial catheterisation. Before catheterisation the skin was cleaned with methylated spirits. A blood alcohol level taken 18 hours after catheterisation showed a blood ethanol level of 259 mg/100 ml and a blood methanol level of 26 mg/100 ml. We conclude that the methylated spirits caused this extensive skin damage and that percutaneous absorption via the readily permeable skin of this immature baby resulted in the dangerously high alcohol levels.