Silver sulfadiazine therapy in widespread bullous disorders: potential for toxicity.

Silver sulfadiazine (SSD) cream, most known for its use in the treatment of extensive burn wounds, is commonly used in the management of erosions in bullous disorders. The beneficial antibacterial effect of SSD use is not without risk, as silver toxicity has been well documented in burn patients. Renal insufficiency accelerates silver accumulation and thus toxicity. Data on silver toxicity in patients with primary blistering disorders is scarce; however the literature regarding silver toxicity in burn patients may be applicable to patients with bullous diseases. Hence we recommend that clinicians exercise caution when prescribing protracted wound care with SSD for blistering disorders.