Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
Department of Emergency Medicine, Denver Health and Hospital Authority, 777 Bannock Street, Denver, CO, 80204, USA.
J Med Toxicol. 2021 Apr;17(2):222-226. doi: 10.1007/s13181-020-00818-z. Epub 2021 Jan 5.
Methylene chloride, also known as dichloromethane, is a volatile hydrocarbon used in paint strippers and removers. Toxicity from methylene chloride may include narcosis and elevated carbon monoxide (CO) levels. Significant injury to the skin can occur after prolonged exposure to methylene chloride and other hydrocarbon-based solvents causing a chemical dermal injury.
This case series describes three male patients with prolonged exposure to a methylene chloride-containing paint remover to the bilateral hands with two of the three patients requiring transfer to a tertiary burn center and operative intervention. The clinical significance and impressive resolution of dermal injury from prolonged methylene chloride exposure are highlighted with detailed images and a literature review.
Chemical dermal injury secondary to methylene chloride exposure likely results from destruction of lipids within the epidermis and dermis and direct chemical injury. Prolonged exposure to skin can result in clinically important injury that requires management by a burn specialist and may necessitate operative intervention. The severity of the dermal injury can range from severe to mild and should be considered by a clinician after skin exposure to hydrocarbons.
二氯甲烷，又称甲基氯仿，是一种用于脱漆剂和清洁剂的挥发性碳氢化合物。二氯甲烷中毒可能包括麻醉和一氧化碳（CO）水平升高。长期接触二氯甲烷和其他碳氢化合物基溶剂会导致化学性皮肤损伤，从而对皮肤造成严重损伤。
本病例系列描述了 3 名男性患者，他们的双手长时间接触含有二氯甲烷的油漆去除剂，其中 2 名患者需要转移到三级烧伤中心进行手术干预。通过详细的图像和文献回顾，强调了二氯甲烷暴露引起的皮肤损伤的临床意义和显著的愈合。
二氯甲烷暴露引起的化学性皮肤损伤可能是由于表皮和真皮内的脂质破坏和直接化学损伤所致。皮肤长时间接触可能导致严重的临床损伤，需要烧伤专家进行治疗，可能需要手术干预。皮肤接触碳氢化合物后，临床医生应考虑皮肤损伤的严重程度，从严重到轻度不等。
