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Salicylate intoxication using a skin ointment

A Chiaretti1, D Schembri Wismayer, L Tortorolo

  • 1Paediatric Intensive Care Unit, Catholic University of Rome, Italy.

Acta Paediatrica (Oslo, Norway : 1992)
|March 1, 1997
PubMed
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Acute salicylate poisoning can occur in children with skin conditions like lamellar ichthyosis when using salicylic acid ointments. Monitoring plasma salicylate levels is crucial to prevent toxicity in these vulnerable patients.

Area of Science:

  • Pediatrics
  • Dermatology
  • Toxicology

Background:

  • Salicylate intoxication via skin absorption is rare in children.
  • Keratolytic ointments containing salicylic acid are used for skin conditions.
  • Extensive skin diseases can increase transcutaneous absorption.

Observation:

  • A 5-year-old girl with lamellar ichthyosis presented with acute salicylate intoxication.
  • Symptoms included fever, hyperpnea with respiratory alkalosis, coma, and oculogyric crisis.
  • Intoxication followed the application of a salicylic acid-based skin ointment.

Findings:

  • Transcutaneous absorption of salicylic acid through diseased skin can lead to systemic toxicity.
  • The case highlights a severe presentation of salicylate poisoning in a pediatric patient with a dermatosis.

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  • Clinical manifestations were consistent with significant salicylate overdose.

    • Implications:

    • Clinicians should exercise caution when prescribing salicylic acid preparations for children with extensive skin conditions.
    • Routine monitoring of plasma salicylate levels is recommended for children with dermatoses treated with topical salicylates.
    • Early recognition and intervention are vital to manage salicylate toxicity and prevent severe outcomes.