Diagnosis: The photograph reveals complications from application of silver nitrate. It demonstrates the minor complications of brownish skin discoloration along with a major complication of partial thickness burn. The infant’s burn resolved after treatment with topical bacitracin.
Silver Nitrate (AgNO3) 75% is commonly used for chemical cauterization of umbilical granulomas. Complications are rarely reported in the literature. Skin discoloration is a common and benign complication. The discoloration in this case is due to deposits of silver nitrate in the epithelium, which may not be evident for several hours following application and eventually resolves over several days.
Chemical burn is a rare but avoidable complication of silver nitrate applications. Burns occur due to spillage of highly concentrated silver nitrate onto the surrounding skin. Therefore, it is important to dry the area after application.
Case presented by Toni Clare Hogencamp, MD, Director, Urgent Care Program, Division of Emergency Medicine, Children’s Hospital Boston, Boston, MA.
