Phenol (also known as carbolic acid) can cause serious chemical burns with the potential for systemic intoxication.
Phenol consists of benzene ring with a single hydroxy group.
Phenol can cause serious dermal burns and binds with dermal proteins.
Skin lesions are initially white, then red, then necrotic.
Because phenol is a local anesthetic serious burns may be painless.
Risk factors for serious exposures:
(1) dilute phenol solution
(2) large body surface area exposure
(3) concurrent ingestion or inhalation
(4) exposure to mixture of phenol and chloroform
(5) pediatric patient
(6) prolonged contact
Initial management involves removal of any phenol from the skin:
(1) Clothing should be removed.
(2) Washing with polyethylene glycol or isopropyl alcohol aids in removal.
(3) The skin should be washed with large amounts of water for 30 minutes or more.
Any patient with a significant cutaneous exposure should be monitored for systemic poisoning. The onset of systemic toxicity may be delayed several hours.
