A full-thickness chemical burn to the hand using formic acid-based anti-wart treatment: a case report and literature review

Abstract

Lay Abstract[Formula: see text][Formula: see text][Formula: see text]Viral warts to the skins are common and are expected to heal by themselves with time. However, they can be associated with stigma and discomfort, leading many people to seek treatment for their removal. There are many different types of treatment options, the most common being to freeze them (cryotherapy) or using a solution that is painted on to the wart. Recently, there has been a rise in the number of different types of solutions that are used in the treatment of warts, including formic acid. Here we describe a case of an 11-year-old girl who used a formic acid-based solution to treat a wart on her hand. This resulted in a deep chemical burn that required surgery under local anaesthetic. She did not have any immediate complications from her surgery. On reviewing the literature, we identified two other acid-based solutions, salicylic acid and monochloroacetic acid, and a third chemical called other glutaraldehyde, that are commonly found in anti-wart treatments and have been described to cause chemical burns. These anti-wart treatments are widely available over the counter and we would like to highlight the importance of proper patient education when used to minimise the risk of chemical burns.