Saada V, Patarin M, Sans S, Saiag P
Service de Dermatologie, CHU Ambroise-Paré, Boulogne-Billancourt.
Ann Dermatol Venereol. 1995;122(8):512-3.
Hydrofluoric acid is a fluoride-substituted compound used in the chemical industry. Burns and hypocalcaemia result from ingestion or contact with the skin or mucosal membranes. We observed burns and skin necrosis on the hands after home use of low-concentration hydrofluoric acid.
A 57-year-old woman consulted in February 1994 for oedema, erythema and very painful burns of the palms of both hands. The day before, she had used a home-made furniture cleanser containing 5 p. 100 hydrofluoric acid. At admission, calcium and radiography of the two hands were normal. She was given a topical application of 5 p. 100 calcium chloride. The clinical course was favourable with squamation of both palms then necrotic lesions of the pulp on the 1st, 2nd and 3rd fingers.
Such exposure in a household situation is unusual. Hydrofluoric acid has two dangerous mechanisms of action. First it is a caustic substance producing late-onset burns and secondly hypocalcaemia results from precipitation of insoluble calcium fluoride. The risk of hypocalcaemia is greatest when a large area of the skin is exposed. Prognosis depends on early treatment based on prevention of hypocalcaemia by abundant washing of the teguments and permanent application of a 5 p. 100 calcium gluconate solution associated with local skin treatments. Careful follow-up is required with regular calcium chemistries.
氢氟酸是一种用于化学工业的氟取代化合物。摄入或接触皮肤或粘膜会导致烧伤和低钙血症。我们观察到在家中使用低浓度氢氟酸后手部出现烧伤和皮肤坏死。
一名57岁女性于1994年2月因双手掌水肿、红斑和剧痛性烧伤前来就诊。前一天，她使用了一种自制的含有5%氢氟酸的家具清洁剂。入院时，双手的钙含量和X光检查均正常。她接受了5%氯化钙的局部应用。临床过程顺利，双手掌出现鳞屑，然后第1、2和3指的指腹出现坏死性病变。
在家用环境中发生这种接触情况并不常见。氢氟酸有两种危险的作用机制。首先，它是一种腐蚀性物质，会导致迟发性烧伤；其次，不溶性氟化钙的沉淀会导致低钙血症。当大面积皮肤暴露时，低钙血症的风险最大。预后取决于早期治疗，即通过大量冲洗皮肤和持续应用5%葡萄糖酸钙溶液预防低钙血症，并结合局部皮肤治疗。需要进行仔细的随访，并定期检测血钙。
