Eldad et al studied the systemic effects of phosphorus poisoning in white rats. Dermal toxicity can lead to a chemical burn, which may be part of multi-organ failure. The authors are from Hadassah University Hospital in Jerusalem and the Israel Defense Force Medical Corps.
NOTE: Although described in white rats, the histologic changes would be the same in a human exposed to phosphorus.
Parameters:
(1) depth of injury
(2) regeneration of epidermis in from the edges of the wound
(3) infiltration by neutrophils
(4) vascularization
(5) adherence of skin flap over the burn
|
Parameter |
Finding |
Points |
|
depth of injury |
superficial |
2 |
|
|
partial thickness (second degree) |
1 |
|
|
complete necrosis (third degree) |
0 |
|
regeneration of epidermis from the edges |
complete |
2 |
|
|
some ("beginning") |
1 |
|
|
none |
0 |
|
neutrophil response |
absent to mild |
2 |
|
|
moderate |
1 |
|
|
marked |
0 |
|
vascularization |
present throughout (well-vascularized) |
2 |
|
|
only at the edges of the wound |
1 |
|
|
none |
0 |
|
adherence of skin flap |
complete |
2 |
|
|
partial |
1 |
|
|
none |
0 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The lower the score the more severe the dermal injury.
Specialty: Toxicology, Emergency Medicine, Critical Care
