Ver el código de «Caustic burn»

==Background==
{{Skin anatomy background images}}
{{Caustics background}}

==Clinical Features==
[[File:1215px-My hand with minor chemical burns.jpg|thumb|Hand with minor chemical burns exposure to commercial-grade dishwasher with concentrated chlorine.]]
[[File:Sodium hydroxide burn.png|thumb|Chemical burn caused by sodium hydroxide solution (lye) 44 hours after exposure.]]
[[File:Chemical burn CaCN2.png|thumb|Lower leg chemical burn caused by calcium cyanamide.]]
[[File:Silbernitrat-Verätzung Collage.jpg|thumb|Water-thinned silver nitrate chemical burn on hand. Left: 7 hours after injury. Right: 26 hours after injury.]]
[[File:Mustard gas burns.jpg|thumb|Caustic burn caused by exposure to [[mustard gas]] (World War I).]]
[[File:HF burned hands.jpg|thumb|Hydrofluoric acid (HF) burns, which were not evident until a day after exposure.]]
*Signs and symptoms are inadequate to predict presence or severity of injury after caustic ingestion <ref>Gaudreault, P. et al. Predictability of esophageal injury from signs and symptoms: a study of caustic ingestion in 378 children. Pediatrics. 1983;71(5):767-770.</ref>
*Exam eyes and skin (splash and dribble injuries may easily be missed)
*GI tract injury
**[[Dysphagia]], odynophagia, [[epigastric pain]], [[vomiting]]
*Laryngotracheal injury
**[[Dysphonia]], [[stridor]], [[respiratory distress]]
**Occurs via aspiration of caustic or vomitus or inhalation of acidic fumes

==Differential Diagnosis==
{{Caustic burn types}}

{{Burn DDX}}

==Evaluation==
*Clinical diagnosis

===Work-up===
Only necessary in patients with significant injury or volume of ingestion

Consider:
*CBC
*Metabolic panel
*[[Lactate]]
*Calcium level (if [[Hydrofluoric acid]] exposure)
*[[ECG]]
**May show QT-prolongation if hypocalcemic secondary to Hydrofluoric acid
*APAP/ASA levels if concerned about coingestion (suicidal patients) 

==Management==
*First prevent personal exposure to the caustic agent by removing all clothing and decontaminating the patient
*Brush any dry chemicals off the patient
*Irrigate all wounds and areas of exposure with copious amounts of water
**Exception: dry lime, phenol, metals such as potassium and sodium, causes harmful exothermic reaction

===Acidic injuries (except [[Hydrofluoric acid]])===
*May also have [[non anion gap acidosis]] (e.g. HCl)
*Respond well to copious saline or water irrigation

===Alkali injuries===
*May appear superficial but often are deeper with ongoing burn
*Treat with copious irrigation and local wound debridement to remove residual compound

==Disposition==
*Admit the following:
**Injuries that cross flexor or extensor surfaces
**Facial injuries
**Perineum injuries
**Partial-thickness injuries >10-15% of [[BSA]]
**All full-thickness burns

==See Also==
*[[Burns]]
*[[Caustic keratoconjunctivitis]]
*[[Caustic ingestion]]

==References==
<references/>

[[Category:Dermatology]]
[[Category:Toxicology]]
[[Category:Trauma]]
[[Category:Symptoms]]