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Accidental percutaneous hexachlorophane intoxication in children
Insights
Accidental hexachlorophene poisoning in children from talc caused severe neurological damage, including intracranial hypertension and spinal cord injury. Some cases resulted in death or permanent paralysis due to massive edema.
Area of Science:
- Toxicology
- Pediatric Neurology
- Dermatology
Background:
- Talcum powder is commonly used for cosmetic and hygiene purposes.
- Hexachlorophene is an antiseptic agent that can be toxic if ingested or absorbed in large quantities.
Purpose of the Study:
- To describe the clinical presentation and outcomes of children accidentally intoxicated with hexachlorophene-containing talc.
- To investigate the neuropathological basis of hexachlorophene toxicity.
Main Methods:
- Retrospective case series of 18 children with documented hexachlorophene poisoning from talc.
- Clinical data collection including neurological examination and outcomes.
- Pathological examination of affected tissues (implied).
Main Results:
- Four out of 18 children died.
- Two children developed permanent paraplegia.
- Intracranial hypertension and signs of spinal cord damage were observed in multiple patients.
- Massive intramyelinic edema was identified as the likely cause of neurological deficits.
- Vascular disturbances secondary to edema may lead to permanent sequelae.
Conclusions:
- High-concentration hexachlorophene in talc poses a significant risk of severe neurological toxicity in children.
- Intramyelinic edema is a critical factor in the pathogenesis of hexachlorophene-induced neurotoxicity.
- Prompt recognition and management are crucial to prevent potentially fatal or permanently disabling outcomes.
Abstract:
Eighteen children with normal skin were accidentally intoxicated by a talc powder containing 6% hexachlorophane. Four died and two remained paraplegic. The clinical picture was intracranial hypertension, eight patients developing signs of spinal cord damage. The condition seemed to result from massive intramyelinic oedema. In the spinal cord vascular disturbances may occur as mechanical complications of oedema, giving rise to permanent sequelae.