Hydrofluoric acid (HF) is a colorless
corrosive acid used in different industrial branches. Exposure to HF typically results from spills, and most often the hand or fingers are involved. Tissue damage through cutaneous HF exposure occurs through
corrosive burns due to the free
hydrogen ions and through skin penetration of the
fluoride ions, causing a depletion of
calcium in the deep tissue layers, ultimately leading to cell death and tissue
necrosis. Treatment of HF
burns consists of thoroughly
flushing the exposed area with water and applying
calcium gluconate gel to the skin. If topical treatment does not suffice,
subcutaneous injections, as well as intravascular--both intravenous and intra-arterial--
calcium gluconate therapy, have been advocated. We report for the first time a case of HF
burn of the hand and digits associated with vasospasm.
Pain and vasospasm were successfully treated by repeated intra-arterial
calcium gluconate injection. We conclude that intra-arterial
calcium gluconate injection is a successful and well-tolerated
therapy for HF
burn associated with Raynaud's syndrome.
Intra-arterial injection allows for well-controlled delivery of
therapy as well as assessment of the vascular status.