HYDROFLUORIC ACID-INDUCED CUTANEOUS NECROSIS

Introduction. Hydrofluoric acid is a fluoride-substituted compound used in the chemical industry. Burns and hypocalcaemia result from ingestion or contact with the skin or mucosal membranes. We observed burns and skin necrosis on the hands after home use of low-concentration hydrofluoric acid. Case report. A 57-year-old woman consulted in February 1994 for oedema, erythema and very painful burns of the palms of both hands. The day before, she had used a home-made furniture cleanser containing 5 p. 100 hydrofluoric acid. At admission, cal calcium and radiography of the two hands were normal. She was given a topical application of 5 p. 100 calcium chloride. The clinical course was favourable with squamation of both palms then necrotic lesions of the pulp on the 1 st, 2 nd and 3 rd fingers. Discussion. Such exposure in a household situation is unusual. Hydrofluoric acid has two dangerous mechanisms of action. First it is a caustic substance producing late-onset burns and secondly hypocalcaemia results from precipitation of insoluble calcium fluoride. The risk of hypocalcaemia is greatest when a large aera of the skin is exposed. Prognosis depends on early treatment based on prevention of hypocalcaemia by abundant washing of the teguments and permanent application of a 5 p. 100 calcium gluconate solution associated with local skin treatments. Careful follow-up is required with regular calcium chemistries.