The solution to pollution may not be dilution: A paediatric burn from accidental fingernail glue spillage

Abstract

The use of fingernail glue in cosmetics is widespread, but the serious effects of spillage directly onto skin causing a burn have not been previously reported. We describe a 2-year-old male suffering full-thickness burns to the dorsum of his left foot 9 days after direct contact with cyanoacrylate-containing nail glue. Conservative management failed and formal surgical excision with skin grafting was needed. First aid advice from product safety and medical literature is ambiguous, as despite timely intervention with recommended measures, a serious burn injury resulted. Review of the literature revealed two other cases of indirect nail glue burns, both requiring surgery, with clothing acting as an interface between glue and skin, distinguishing it from our case. We propose possible mechanisms of injury and present this case to increase awareness of the consequences of contact with a seemingly trivial cosmetic chemical, recommend its better labelling and hope to educate medical professionals about this unusual, but serious mechanism of burn injury. This would obviate additional psychological stress on child and parents due to unnecessary referral to social services for investigation of a possible non-accidental injury.