SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

CIS
RAPID DETERMINATION OF CAUSATIVE AGENT USING DETACHED ROOF OF BULLA IN CHEMICAL BURNS OR
DERMAL EXPOSURE
Yoshio Tsujino' J , Yoko Hieda l , Haruo Takeshita 2 , Eishin Morita' - JDepartment of Dermatology, Shimane University School of
Medicine, Shimane, Japan, 2Department of Legal Medicine, Shimane University School of Medicine, Shimane, Japan
Background and aim: Liquid specimens such as blood or urine are commonly used in forensic examinations, while skin samples are
rarely used. Recently we have been studying the percutaneous absorption of chemicals and have shown that skin analysis is useful in
identil'ying dermal exposure to petroleum products. Only small amounts of skin «0.03 g) are required for analysis since lipophilic
chemicals, such as aliphatic hydrocarbons used to identil'y the petroleum product, remain in the skin (Forensic Sci Int 133, 141-145,
2003). However, most living patients do not agree to have a skin biopsy for chemical analysis. We. present a case ofa patient who was
exposed dermally to some solvents where we determined the causative agent without skin biopsy.
A case: A 73-year-old woman was first aware of slight redness with soreness on her anterior right thigh one evening. When she took off
her trousers 3 h later, the redness had spread over her rigbt thigh up to her abdomen with some erosion. When she visited our hospital
next morning, extensive erythema with bulla and erosion appeared over 10% of her body.. These first- and second-degree bums were
thought to be caused by exposure to some unidentified organic solvents.
Examination: The lesions were first washed thoroughly with saline. To examine the lesions pathologically, and tojdentil'y the causative
agent, a skin biopsy was recommended but not agreed upon with the patient. For an alternative specimen, small pieces of detached roof
ofbulla. which are usually taken off, were collected for analYSis during topical treatment with a steroid ointment. For rapid examination
to estimate the causative agent, a part of the collected bulla (0,01 g) was put into small amount ofn-pentane in a glass tube, sonicated in
an ultrasonic bath for I min, and then I iii oin-pentane was analyzed using a GC-MS system (HP5890)in a scan mode (mlz 30-400)
. equipped with a capillary column (HP-5, 0.25 mm i.d. x 30 m, 0.25 lim thickness), The column temperature was set at 50°C for I min,
then increased I O°C/min up to 280°C and held for 10 min. The temperature ofinjection port and ion source was set at 270°C and 280·C.
respectively.
Results: In the rapid analysis, typical kerosene components (aliphatic hydrocarbons with carbon number 9-16 and some aromatic
hydrocarbons) were detected based on the retention times, mass spectra and pattern of the peaks. The causative agent was determined
kerosene. Detailed analysis performed later using the remained collected roof of bulla and blood sample (0.5 ml) utilizing liquid-liquid
extraction confirmed kerosene components in the both samples. No other chemicals causing inflammatory response were detected.
DisclISsion: The.patient may have had been exposed to kerosene while filling a kerosene stove at home about 5 h before first becoming
aware of her skin irritation. Subepidermal bulla, often observed in second-degree bums is a phenomenon separating epidermis from
dermis, indicating that the detached roof of bulla in this case was composed mostly of epidermis. We recently reported that lipophilic
chemicals tend to be trapped in lipophilic stratum corneum in epidermis (Int J Legal Med 118,41-46,2004). This suggests that a skin
biopsy, which removes skin to the subcutaneous fat depth. and causes significant patients pain, is not necessary when petroleum products
are involved. Analysis ofonly 0.0 I g of detached roof of bulla with simple sample preparation is a useful diagnostic method for dermal
exposure to petroleum products both in clinical and forensic fields,
Key words: chemical burns, bulla, GC-MS
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