Contact Burn with Blister Formation in Children Treated with Sennosides

Abstract

Eight children treated for severe constipation with sennosides unexpectedly developed contact burns with blisters secondary to the use of these laxatives. All patients wore diapers, and the injuries occurred overnight. To avoid this side effect, we recommend that patients treated with sennosides, especially those in diapers, receive the medication at a time that allows for bowel movements to occur during the day and not overnight.

When “the runs” also burns: Case reports of severe diaper dermatitis in children with acute gastroenteritis mimicking scald burns

“…The type of diaper dermatitis described in our two patients resembles a chemical partial thickness burn and can be associated with vesicles, bulla, and skin sloughing 5 . The majority of reported cases in the literature have been associated with senna‐based laxative consumption 1,2,5 .…”

“…Wound care is essential for the improvement of diaper dermatitis. Most commonly, zinc oxide is used as a physical barrier in conjunction with occlusive moisturizers (i.e., petroleum jelly) or dressings (i.e., petrolatum gauze) 1,5 . Topical corticosteroids may also be considered for their anti‐inflammatory properties depending on the clinical scenario 5 .…”

“…Most commonly, zinc oxide is used as a physical barrier in conjunction with occlusive moisturizers (i.e., petroleum jelly) or dressings (i.e., petrolatum gauze) 1,5 . Topical corticosteroids may also be considered for their anti‐inflammatory properties depending on the clinical scenario 5 . If there is concern for wound infection topical antibiotics or antifungals may be added to the wound care regimen 5 …”

“…The type of diaper dermatitis described in our two patients resembles a chemical partial thickness burn and can be associated with vesicles, bulla, and skin sloughing. 5 The majority of reported cases in the literature have been associated with senna-based laxative consumption. 1,2,5 We posit that prolonged exposure to stool containing a high concentration of digestive enzymes and bile acids secondary to intestinal villi blunting and malabsorption, often found in diarrheal illness, may cause an irritant contact dermatitis.…”

“…5 The majority of reported cases in the literature have been associated with senna-based laxative consumption. 1,2,5 We posit that prolonged exposure to stool containing a high concentration of digestive enzymes and bile acids secondary to intestinal villi blunting and malabsorption, often found in diarrheal illness, may cause an irritant contact dermatitis.…”