A case of burn due to ‘Garlic’ has been reported by Olivia Sharp and associates that has appeared in BMJ Case Reports.
Many herbal medicines are being used lately out of which Garlic is in the forefront for its hypocholesterolemic, fibrinolytic, antidiabetic, and antibiotic actions. It is also supposed to have antiviral, antibacterial, antifungal, larvacidal and diuretic properties. At present, it is being recommended by naturopathic practitioners to treat a variety of conditions by either ingestion or topical use in its crushed form. But it reportedly has unusual adverse effects such as chemical burns and contact dermatitis when used topically.
As the history of the case goes a 45-year-old woman presented with a history of painful blisters and erythema over the dorsum of her left great toe for last 12 hours. The patient had applied freshly sliced raw garlic to the dorsum of her left great toe during the past 4 weeks for up to 4 hours a day for treating a fungal nail infection.
When carrying out local examination it was found that the left great toe was swollen, erythematous and blistering. In addition to this, her great toenail was yellow and slightly lifted from the nail bed. Clinically, she had a partial thickness burn and onychomycosis. The skin on the toe was pH 9. As part of treatment, her toe was irrigated with water until a normal pH was reached, and all the blisters de-roofed.
The adverse effects of raw garlic on the skin are twofold-Firstly it can directly cause a chemical burn and in addition, it can provoke a type IV hypersensitivity reaction in sensitized individuals, resulting in contact dermatitis. The Sulfur-containing compound implicated in these cases is thought to be diallyl disulfide.
The carry home Points are that-
There is diversity in burn aetiology in the general population and it is important to consider somewhat innocuous substances in burn pathogenesis.
The treating clinicians should inquire about the history of Herbal/naturopathic remedies when taking a thorough medical history.
For more details click on the link: doi:10.1136/bcr-2018-226027