What Are These Lesions?

(Answer on next page.)

ANSWER:
These circular, erythematous lesions of varying sizes on a 45-year-old woman’s dorsal right hand and extensor surface of the right forearm are grease burns. The injury occurred when the patient lifted a pan that contained hot cooking oil in which she had been searing meat.

Second only to hot water burns, grease burns represent 10.4% of all major burns and 8.2% of all minor burns seen in the emergency department.¹ The most common scenario is when hot grease splatters onto the hand of a cook who moves a pan in which grease has ignited. The burn is usually full-thickness (third-degree) because of the high temperature of the grease. Water at atmospheric pressure can be heated to 100°C, whereas grease can attain temperatures above 200°C. In addition, the greater viscosity of grease allows it to cling to skin and cause significant tissue damage. The splatter pattern of the lesions represents the clinging grease droplets.²

Most patients who present with full-thickness grease burns are treated by debridement or excision, followed by the application of wound dressings and a graft, if necessary.³ Although this patient’s lack of sensation at the burn site indicated a full-thickness burn, the affected skin involved a small surface area; thus treatment with a wound dressing was sufficient. The injury healed with minimal scarring.


 

References:

REFERENCES:

1.

Bill TJ, Bentrem DJ, Drake DB, Edlich RF. Grease burns of the hand: preventable injuries.

J Emerg Med.

1996;14:351-355.

2.

Klein MB, Gibran NS, Emerson D, et al. Patterns of grease burn injury: development of a classification system.

Burns.

2005;31:765-767.

3.

Fiebiger B, Whitmire F, Law E, Still JM. Causes and treatment of burns from grease.

J Burn Care Rehabil.

2004;25:374-376.