Cutaneous Inhaler Burn

A 13-year old boy attended the ENT outpatient department for otological review. A rectangular burn mark with surrounding skin peeling on the dorsum of his left hand was incidentally noted. Further history revealed that a week prior to the visit, he was challenged to spray the back of his hands using his friend’s Salbutamol metered dose inhaler. The mouthpiece of the inhaler was placed in direct contact with the dorsum of his hand and sprayed 4 times. There was no immediate discomfort but he noticed that skin changes mainly erythema started to develop over several hours.