title: Clinical and forensic signs related to chemical burns: a mechanistic approach.
abstract: This manuscript highlights and critically analyses clinical and forensic signs related to chemical burns. Signs that may lead to suspicion of a particular chemical are thoroughly discussed regarding its underlying mechanisms. Burns due to sulfuric, hydrofluoric, nitric, hydrochloric (muriatic) and acetic (including derivatives) acids, hydrogen sulphide, sodium (caustic soda) and calcium (cement) hydroxides, paraquat, burns after inflation and rupture of airbags, povidone-iodine, chlorhexidine/alcohol (in preterm infants), laxatives, and vesicants (warfare agents), will be reviewed since these are the most common agents found in daily practice, for which relevant and timed information may be helpful in formulating an emergency treatment protocols and toxicological analysis.
authors.affiliation: Department of Legal Medicine and Forensic Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, Advanced Institute of Health Sciences - North (ISCS-N), CESPU, CRL, Gandra, Portugal; REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; Center of Forensic Sciences (CENCIFOR), Portugal; CBMA - Centre of Molecular and Environmental Biology, Department of Biology, University of Minho, Braga, Portugal. Electronic address: ricardinis@sapo.pt.
authors.forename: Ricardo Jorge
authors.initials: RJ
authors.lastname: Dinis-Oliveira
authors.affiliation: REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
authors.forename: Félix
authors.initials: F
authors.lastname: Carvalho
authors.affiliation: IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, Advanced Institute of Health Sciences - North (ISCS-N), CESPU, CRL, Gandra, Portugal; CBMA - Centre of Molecular and Environmental Biology, Department of Biology, University of Minho, Braga, Portugal.
authors.forename: Roxana
authors.initials: R
authors.lastname: Moreira
authors.affiliation: IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, Advanced Institute of Health Sciences - North (ISCS-N), CESPU, CRL, Gandra, Portugal.
authors.forename: Jorge Brandão
authors.initials: JB
authors.lastname: Proença
authors.affiliation: Department of Legal Medicine and Forensic Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Center of Forensic Sciences (CENCIFOR), Portugal; National Institute of Legal Medicine and Forensic Sciences, North Branch, I.P., Portugal.
authors.forename: Agostinho
authors.initials: A
authors.lastname: Santos
authors.affiliation: CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal.
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Duarte
authors.affiliation: REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
authors.forename: Maria de Lourdes
authors.initials: Mde L
authors.lastname: Bastos
authors.affiliation: Department of Legal Medicine and Forensic Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Center of Forensic Sciences (CENCIFOR), Portugal; National Institute of Legal Medicine and Forensic Sciences, North Branch, I.P., Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Magalhães
mesh_terms: D019342:Acetic Acid / Q000009:adverse effects; D000143:Acids / Q000009:adverse effects*; D017278:Air Bags / Q000009:adverse effects; D000393:Air Pollutants / Q000009:adverse effects; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D001843:Bone Cements / Q000009:adverse effects; D002057:Burns, Chemical / Q000209:etiology / Q000473:pathology*; D002126:Calcium Hydroxide / Q000009:adverse effects; D002424:Caustics / Q000009:adverse effects*; D002619:Chemical Warfare Agents / Q000009:adverse effects*; D002710:Chlorhexidine / Q000009:adverse effects; D053834:Explosive Agents / Q000009:adverse effects; D005554:Forensic Medicine; D006540:Herbicides / Q000009:adverse effects; D006801:Humans; D006851:Hydrochloric Acid / Q000009:adverse effects; D006862:Hydrogen Sulfide / Q000009:adverse effects; D007509:Irritants / Q000009:adverse effects*; D054368:Laxatives / Q000009:adverse effects; D017942:Nitric Acid / Q000009:adverse effects; D010269:Paraquat / Q000009:adverse effects; D011206:Povidone-Iodine / Q000009:adverse effects; D012972:Sodium Hydroxide / Q000009:adverse effects
chemical_list: D000143:Acids; D000393:Air Pollutants; D000891:Anti-Infective Agents, Local; D001843:Bone Cements; D002424:Caustics; D002619:Chemical Warfare Agents; D053834:Explosive Agents; D006540:Herbicides; D007509:Irritants; D054368:Laxatives; D017942:Nitric Acid; D012972:Sodium Hydroxide; D011206:Povidone-Iodine; D002126:Calcium Hydroxide; D010269:Paraquat; D019342:Acetic Acid; D006851:Hydrochloric Acid; D002710:Chlorhexidine; D006862:Hydrogen Sulfide
keywords: Acetic acid and derivatives; Calcium hydroxide (cement); Chemical burns; Chlorhexidine/alcohol; Hydrochloric acid (muriatic acid); Hydrofluoric acid; Hydrogen sulphide; Inflation and rupture of airbags; Laxatives; Nitric acid; Paraquat; Povidone–iodine; Sodium hydoxide (caustic soda); Sulfuric acid; Vesicants