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An 11-month-old boy presented with purplish discoloration of the feet. The infant had had a runny nose and cough for 2 days. Before the child had been put to bed the night before, the father had applied chopped garlic bulbs to the infant’s feet and had wrapped them with bandages at the suggestion of the child’s grandmother, in an attempt to get rid of the runny nose and cough. The next morning, the infant’s feet were found to be purplish.
A diagnosis of garlic burns was made. The patient was treated conservatively. The parents were advised not to use topical garlic on the child in the future. The wound healed nicely in 2 weeks.
Garlic (Allium sativum) is thought to have been used as early 3000 BC for a multitude of disorders, and a local application of it is a traditional remedy for local pain.1 Garlic is still used as a folk medical therapy or an herbal remedy for a variety of illnesses. Unfortunately, fresh garlic can be a potent irritant under occlusive conditions.2 This is especially true in crushed form. One of many possible adverse reactions is allergic contact dermatitis, which usually is an epidermal reaction. Diallyl disulfide, allyl propyl disulfide, and allicin are the principal allergens.
Diallyl disulfide is capable of inducing acantholysis in vitro and possibly in vivo. The compound also can cause superficial burns to the skin, as it did with the infant in our case. At times it can cause second-degree burns with the presence of bullae.2 Young children are especially susceptible, because the skin is delicate and does not have enough keratinous material in the outer layer of the epidermis to protect against this agent. Comparatively, infants may require 6 to 8 hours of exposure to induce a chemical burn, whereas a longer duration is required in adults.3 Other adverse reactions of topical application of garlic include gastrointestinal discomfort, sweating, dizziness, allergic reactions, bleeding, and menstrual irregularities.
1. Al-Qattan MM. Garlic burns: case reports with an emphasis on associated and underlying pathology. Burns. 2008;35(2):300-302.
2. Rafaat M, Leung AK. Garlic burns. Pediatr Dermatol. 2000;17(6):475-476.
3. Friedman T, Shalom A, Westreich M. Self-inflicted garlic burns: our experience and literature review. Int J Dermatol. 2006;45(10):1161-1163.