A Rash and Chemical Burns in a Cowboy Exposed to Permethrin

Abstract

Permethrin is a semisynthetic pyrethoid used in agriculture as an insecticide and acaricide. It is especially effective on ectoparasites. When used correctly, it can be safe but when diluted incorrectly, it can cause a rash inconsistent with a toxic dermatitis and chemical burns. The case presented in this article demonstrates the necessity of obtaining an adequate history of chemical exposure and the problem of obtaining the history from cantankerous individuals. It also demonstrates the range of skin lesions that results from using permethrin incorrectly. Once the diagnosis was made, the rash cleared with topical and oral steroids and antibiotics. The physician was able to intervene in a positive manner after establishing rapport with the patient by cautioning the patient not to misuse the pesticide.