An 11-year-old girl was referred to the Pediatric Emergency Department due to suspicion of hand dermatitis.
He has an erythematous, painful lesion in his left hand.
The physical examination revealed a vesicular lesion of 10 days old (old wound) on the back of the hand, and an erythematous zone x 3 cm) at the distal head of the second local temperature, with no external signs of recent inflammation.
No other significant findings were found in the rest of the physical examination.
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The patient manifests that the wound was produced by cutting with the crystal of a mercury thermometer.
With this background, mercury toxicity in tissue is suspected, which is confirmed by the presence of radiopaque material in radiographs of the second and third located metaphalangeal subcutaneous tissue.
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The patient underwent emergency surgery for cleaning and removing mercury, previously locating the area under radioscopy and delimiting the margins with needles.
A block excision of skin and subcutaneous wedge-shaped cellular tissue was performed. Intraoperative radioscopy confirmed the absence of mercury in the area, resulting in surgical closure.
The anatomopathological study of the excised tissue showed the presence of droplets of refracting material with intense atonecrosis and acute inflammation successively around these drops.
Blood mercury levels (3 μ/L) and urine (16 μ/g creatinine) were requested, with normal values < 15 μ/L and < 35 μ/g, respectively.
The postoperative evolution was favorable with disappearance of the local toxicodermic reaction.
