title: Adverse clinical sequelae after skin branding: a case series.
abstract: BACKGROUND
  Branding refers to a process whereby third degree burns are inflicted on the skin with a hot iron rod or metallic object. Branding employs the phenomenon of "counter irritation," and is widely used by faith healers in developing countries for therapeutic purposes. Some methods, which are very crude and inhuman, carry a large risk of complications. The purpose of this study is to present a series of complications and to familiarize clinicians with this dangerous method of treatment.
  
  
  METHODS
  Four Pakistani patients, three male and one female, ranging from 25 to 60 years of age "branded" with a red hot iron rod for various medical reasons presented with severe medical complications to our tertiary care hospital. The mean duration between the procedure and presentation to the hospital was 6 days. At the time of admission, two patients had septic shock, one patient had cavernous sinus thrombosis and one patient had multiple splenic abscesses. All patients received standard care for wound management and systemic infections. Two patients eventually died during the course of treatment.
  
  
  CONCLUSIONS
  Severe complications from branding are troublesome and the potential risks of this treatment outweigh its benefits. Globally, there is a great need for heightened awareness about the dangers of branding among patients and physicians, as this will have an important effect on patients who seek branding for various medical conditions.
authors.affiliation: Department of Oncology, New York University, NY, USA. shahzad.raza@nyumc.org.
authors.forename: Shahzad
authors.initials: S
authors.lastname: Raza
authors.forename: Khalid
authors.initials: K
authors.lastname: Mahmood
authors.forename: Abdul
authors.initials: A
authors.lastname: Hakeem
authors.forename: Sylvie
authors.initials: S
authors.lastname: Polsky
authors.forename: Anna
authors.initials: A
authors.lastname: Haemel
authors.forename: Soniya
authors.initials: S
authors.lastname: Rai
authors.forename: Mahadi
authors.initials: M
authors.lastname: Ali Baig