title: Sulfur spring dermatitis.
abstract: Thermal sulfur baths are a form of balneotherapy promoted in many cultures for improvement of skin conditions; however, certain uncommon skin problems may occur after bathing in hot sulfur springs. We report the case of a 65-year-old man who presented with multiple confluent, punched-out, round ulcers with peripheral erythema on the thighs and shins after bathing in a hot sulfur spring. Histopathologic examination revealed homogeneous coagulation necrosis of the epidermis and papillary dermis. Tissue cultures showed no evidence of a microbial infection. The histopathologic findings and clinical course were consistent with a superficial second-degree burn. When patients present with these findings, sulfur spring dermatitis should be considered in the differential diagnosis. Moreover, the patient's clinical history is crucial for correct diagnosis.
authors.forename: Chieh-Chi
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Department of Dermatology, Mackay Memorial Hospital, 92, Sec 2, Zhongshan N Rd, Taipei City 10449, Taiwan. yuhung_wu@yahoo.com.
authors.forename: Yu-Hung
authors.initials: YH
authors.lastname: Wu
mesh_terms: D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D001452:Balneology / Q000379:methods; D003877:Dermatitis, Contact / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D003937:Diagnosis, Differential; D045482:Hot Springs / Q000737:chemistry*; D006801:Humans; D007866:Leg / Q000473:pathology; D008297:Male; D009583:Nitrofurazone / Q000008:administration & dosage*; D012867:Skin / Q000473:pathology*; D013455:Sulfur / Q000009:adverse effects*; D013848:Thigh / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D013455:Sulfur; D009583:Nitrofurazone