A 45-year-old male presents to the emergency department with chemical burns to his hands and forearms. He reports that he was cleaning with a strong cleaner but is unsure of the exact substance. On inspection, his burns display coagulation necrosis with a dry, leathery appearance. Which type of agent is most likely responsible for this injury?
The presentation of coagulation necrosis and a dry, leathery appearance of the burns is typical of an acid burn. Acids cause protein denaturation, leading to coagulative necrosis, which often results in a more 'dry' appearance. Alkali burns, on the other hand, typically result in liquefactive necrosis due to saponification, causing the affected tissue to appear more 'wet' or 'damp'. Bleach (sodium hypochlorite), while a common cleaning agent, also causes irritation and burns but is less likely to cause the coagulative necrosis seen in acid burns. Ethanol primarily causes systemic effects such as intoxication and dehydration rather than localized coagulative necrosis on the skin.
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BCEN CEN
Environment and Toxicology Emergencies, and Communicable Diseases
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