We report a case of accidental cutaneous
burns caused by
salbutamol metered dose inhaler. A 9-year-old boy underwent dental extraction at a children's hospital and was incidentally noted to have
burn injuries on dorsum of both hands. On questioning, the boy revealed that a few days ago his 14-year-old brother, who is an asthmatic, playfully sprayed his
salbutamol metered dose inhaler on the back of both his hands with the
inhaler's mouth piece being in direct contact with the patient's skin. On examination, there was a rectangular area of
erythema with superficial peeling on the dorsum of both hands, the dimensions of which exactly matched those of the
inhaler's mouthpiece. It is possible that the injury could have been a
chemical burn from the
pharmaceutical/preservative/propellant
aerosol or due to the physical effect of severe cooling of the skin or mechanical abrasive effect of the
aerosol blasts or a combination of some or all the above mechanisms. This case highlights the importance of informing children and parents of the potentially hazardous consequences of misusing a
metered dose inhaler.