2017-18 HSC Section 3 Green Book

HAIR RELAXERS: A BENIGN CAUSTIC INGESTION?

FIG. 3. Physical and endoscopic findings in chil- dren who ingested hair relaxer. (Esophageal and gastric injury is defined as greater than Grade 1 mucosal injury.)

Literature Review of Hair-Relaxer Ingestions

there were no clinically relevant esophageal mucosal in- juries among the 147 of 211 patients who underwent upper GI endoscopy, and no adverse clinical outcomes were reported. In one published case report, Rauch iden- tified a patient with a non-circumferential, second-degree esophageal burn. Resolution of symptoms occurred after

To our knowledge, six cohort studies and two case series evaluating pediatric hair relaxer ingestions have been published to date. When our data were combined with these previously published cohort data (Table 2),

TABLE 2. Cohort studies of hair relaxer ingestion

Author

Study period n

Exam findings

Endoscopic findings

Clinical outcomes

Forsen et al.

1987–1992 15 100% facial; 33% oral cavity burns

No esophageal mucosal injury (n 15) No esophageal mucosal injury (n 9) No esophageal mucosal injury (n 7) 5% with clinically insignificant esophageal burns (n 56) No esophageal mucosal injury (n 7) No clinically significant esophageal injury (n 29)

None at 4 weeks

Stenson et al.

1985–1991

9 67% oral or pharyngeal burns

None at 6–8 weeks

Mrvos et al.

NA

41 12% lip and 7% oral burns

NA

Cox et al.

1989–1995 26 23% lip, 30% oral and 8% pharyngeal burns 8% with clinically insignificant esophageal burns (n 24)

None

Ahsan et al.

1992–1997 59 56% lip and 29% oral burns

NA

Gorman et al.

NA

28 NA

NA

Aronow et al.

1990–2001 33 82% lip, 37% oral, 10% pharyngeal burns

None at 8 weeks

Total

NA 211 Common oropharyngeal burns at presentation No clinically significant esophageal mucosal injury (n 147)

None

NA not available.

J Pediatr Gastroenterol Nutr, Vol. 36, No. 1, January 2003

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