Annals of Burns and Fire Disasters - vol. XXVIII - n. 3 - September 2015
HOW FAST CAN A NATUROPATHIC MEDICINE CAUSE SKIN BURN? A CASE REPORT OF GARLIC BURN COMMENT UNE THERAPIE NATURELLE PEUT ETRE RESPONSABLE D’UNE BRÛLURE CUTANEE? CAS D’UNE BRULURE CAUSEE PAR L’AIL
keleş m.k.,* bayram Y., Durmuş m.
Gulhane military medical Academy, Department of Plastic and Reconstructive Surgery, Ankara, Turkey
SUMMARY. This paper presents a case in which a chemical burn resulted from the use of garlic as a naturopathic medicine for knee pain. Keywords: burn, garlic, naturopathic
RÉSUMÉ. Nous présentons une brûlure chimique causée par l’ail utilisé comme une médecine naturopathique antalgique du genou. Mots-clés: brûlure, ail, naturopathie
Introduction
Many different naturotrophic medications can cause chemical burns. Among these naturotrophic medicines, one of the most frequent causes of burns is crushed garlic. Burns caused by garlic were first described in the English literature in 1987.1 Garlic burns have subsequently been reported many times on different parts of the body and at different depths.2-8 In this case report, we present the treatment of a second degree skin burn at the knee region that was caused by the use of crushed garlic over a short time period. Case Report
A 70-year-old male patient was referred to our burn center with a second degree burn in the right knee region (Fig. 1). He had used crushed garlic three days earlier, wrapping it around his knee to treat knee ache. The patient had first wrapped gauze around his skin then put the crushed garlic on it and wrapped the garlic using more gauze. This was the first time that he had used garlic treat-
*
Fig. 1 - Wound located at the knee region of the right lower extremity.
ment. Less than one hour after the application, he had unwrapped the dressing because of severe pain. He had used only two medium-sized garlic cloves. Treatment involved cleaning the necrotic tissues on the wound and administering conventional dressing, using material containing chlorhexidine acetate (Bactigras Tulle
Corresponding author: Musa Kemal KELEŞ, M.D., Gulhane Military Medical Academy, Department of Plastic and Reconstructive Surgery and Burn Center, 06010 Etlik/Ankara, Turkey. Tel.: +90 0312 304 5406; cell.: +90 506 735 3553; fax: +90 0312 304 5404; e-mail: [email protected] Manuscript: submitted 16/05/2015, accepted 23/05/2015.
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Annals of Burns and Fire Disasters - vol. XXVIII - n. 3 - September 2015
Gras Dressings). The patient’s follow-up included dressing changes once every two days. Ten days after this nonsurgical treatment, the wound had totally healed. Discussion
In recent years, western countries have seen an increase in the use of naturopathic medicines, resulting from the greater interaction with and influence of eastern cultures. Creams and pastes are the preferred forms of naturopathic treatments – one of which is ‘crushed garlic’. Garlic has been used for centuries to relieve localized pains in several parts of the body.7 It has also been used in many other areas of medicine.9 However, some systemic and local adverse effects can be seen as a result of garlic treatment.9 One of the most
BIBLIOGRAPHY
1. Al-Qattan MM: Garlic burns: Case reports with an emphasis on associated and underlying pathology. Burns, 35: 300-2, 2009. 2. Dietz DM, Varcelotti JR, Stahlfeld KR: Garlic burns: A not-sorare complication of a naturopathic remedy? Burns, 30: 612-3, 2004. 3. Filobbos G, Chapman T, Gesakis K: Iatrogenic burns from garlic. J Burn Care Res, 33: 21, 2012. 4. Friedman T, Shalom A, Westreich M: Self-inflicted garlic burns: Our experience and literature review. Int J Dermatol, 45: 1161-3, 2006. 5. Karabacak E et al.: An unusual garlic burn occurring on an unexpected area. BMJ Case Rep, 2014.
commonly reported side effects of applying garlic is burns. Indeed, it is known that garlic can cause serious chemical burns. Some chemicals, such as diallyldisulfide, allicin, and allylpropyldisulfide, have been thought to cause skin burns 4,5,9 from raw garlic treatments. Coagulation necrosis occurs with exposure to these chemicals.5 Previous studies reported the exposure times to be not less than two hours.5 In our case, the burn occurred in a very short time period of less than one hour. Severe injuries may occur rapidly as a result of skin sensitivity to the chemicals in garlic, depending on its freshness, concentration, the anatomic area and previous skin disease. It should be kept in mind that naturotherapies such as garlic may cause systemic or local adverse reactions, even with short contact duration.
6. Parish RA, McIntire S, Heimbach DM: Garlic burns: A naturopathic remedy gone awry. Pediatr Emerg Care, 3: 258-60, 1987. 7. Roberge RJ et al.: Garlic burns of the breast. Am J Emerg Med, 15: 548, 1997. 8. Sisson D, Balmer C: A chemical burn from a garlic poultice applied to the face to treat toothache: a case report. Prim Dent J, 3: 28-9, 2014. 9. Xu S et al.: Chemical burn caused by topical application of garlic under occlusion. Dermatol Online J, 20: 21261, 2014. Funding. None
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HOW FAST CAN A NATUROPATHIC MEDICINE CAUSE SKIN BURN? A CASE REPORT OF GARLIC BURN COMMENT UNE THERAPIE NATURELLE PEUT ETRE RESPONSABLE D’UNE BRÛLURE CUTANEE? CAS D’UNE BRULURE CAUSEE PAR L’AIL
keleş m.k.,* bayram Y., Durmuş m.
Gulhane military medical Academy, Department of Plastic and Reconstructive Surgery, Ankara, Turkey
SUMMARY. This paper presents a case in which a chemical burn resulted from the use of garlic as a naturopathic medicine for knee pain. Keywords: burn, garlic, naturopathic
RÉSUMÉ. Nous présentons une brûlure chimique causée par l’ail utilisé comme une médecine naturopathique antalgique du genou. Mots-clés: brûlure, ail, naturopathie
Introduction
Many different naturotrophic medications can cause chemical burns. Among these naturotrophic medicines, one of the most frequent causes of burns is crushed garlic. Burns caused by garlic were first described in the English literature in 1987.1 Garlic burns have subsequently been reported many times on different parts of the body and at different depths.2-8 In this case report, we present the treatment of a second degree skin burn at the knee region that was caused by the use of crushed garlic over a short time period. Case Report
A 70-year-old male patient was referred to our burn center with a second degree burn in the right knee region (Fig. 1). He had used crushed garlic three days earlier, wrapping it around his knee to treat knee ache. The patient had first wrapped gauze around his skin then put the crushed garlic on it and wrapped the garlic using more gauze. This was the first time that he had used garlic treat-
*
Fig. 1 - Wound located at the knee region of the right lower extremity.
ment. Less than one hour after the application, he had unwrapped the dressing because of severe pain. He had used only two medium-sized garlic cloves. Treatment involved cleaning the necrotic tissues on the wound and administering conventional dressing, using material containing chlorhexidine acetate (Bactigras Tulle
Corresponding author: Musa Kemal KELEŞ, M.D., Gulhane Military Medical Academy, Department of Plastic and Reconstructive Surgery and Burn Center, 06010 Etlik/Ankara, Turkey. Tel.: +90 0312 304 5406; cell.: +90 506 735 3553; fax: +90 0312 304 5404; e-mail: [email protected] Manuscript: submitted 16/05/2015, accepted 23/05/2015.
228
Annals of Burns and Fire Disasters - vol. XXVIII - n. 3 - September 2015
Gras Dressings). The patient’s follow-up included dressing changes once every two days. Ten days after this nonsurgical treatment, the wound had totally healed. Discussion
In recent years, western countries have seen an increase in the use of naturopathic medicines, resulting from the greater interaction with and influence of eastern cultures. Creams and pastes are the preferred forms of naturopathic treatments – one of which is ‘crushed garlic’. Garlic has been used for centuries to relieve localized pains in several parts of the body.7 It has also been used in many other areas of medicine.9 However, some systemic and local adverse effects can be seen as a result of garlic treatment.9 One of the most
BIBLIOGRAPHY
1. Al-Qattan MM: Garlic burns: Case reports with an emphasis on associated and underlying pathology. Burns, 35: 300-2, 2009. 2. Dietz DM, Varcelotti JR, Stahlfeld KR: Garlic burns: A not-sorare complication of a naturopathic remedy? Burns, 30: 612-3, 2004. 3. Filobbos G, Chapman T, Gesakis K: Iatrogenic burns from garlic. J Burn Care Res, 33: 21, 2012. 4. Friedman T, Shalom A, Westreich M: Self-inflicted garlic burns: Our experience and literature review. Int J Dermatol, 45: 1161-3, 2006. 5. Karabacak E et al.: An unusual garlic burn occurring on an unexpected area. BMJ Case Rep, 2014.
commonly reported side effects of applying garlic is burns. Indeed, it is known that garlic can cause serious chemical burns. Some chemicals, such as diallyldisulfide, allicin, and allylpropyldisulfide, have been thought to cause skin burns 4,5,9 from raw garlic treatments. Coagulation necrosis occurs with exposure to these chemicals.5 Previous studies reported the exposure times to be not less than two hours.5 In our case, the burn occurred in a very short time period of less than one hour. Severe injuries may occur rapidly as a result of skin sensitivity to the chemicals in garlic, depending on its freshness, concentration, the anatomic area and previous skin disease. It should be kept in mind that naturotherapies such as garlic may cause systemic or local adverse reactions, even with short contact duration.
6. Parish RA, McIntire S, Heimbach DM: Garlic burns: A naturopathic remedy gone awry. Pediatr Emerg Care, 3: 258-60, 1987. 7. Roberge RJ et al.: Garlic burns of the breast. Am J Emerg Med, 15: 548, 1997. 8. Sisson D, Balmer C: A chemical burn from a garlic poultice applied to the face to treat toothache: a case report. Prim Dent J, 3: 28-9, 2014. 9. Xu S et al.: Chemical burn caused by topical application of garlic under occlusion. Dermatol Online J, 20: 21261, 2014. Funding. None
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