PAINFUL SCAR FROM HYDROCHLORIC ACID BURN

A 50-year-old male patient, E.A., sought treatment for a highly painful burn scar.
History:
The patient suffered a severe workplace injury due to an exploding piston containing hydrochloric acid, resulting in 70% body surface burns.

• Survival was considered miraculous, as no previous cases had survived burns covering more than 55% of the body.
• He spent 28 days in ICU, experiencing two near-death episodes.
• He felt well for the first three months post-injury, but later developed increasing pain on the right side of his body.

Symptoms two months before visiting the clinic:

• Unbearable, persistent pain along the right side
• Worse during rainy weather, but improved in a very cold, air-conditioned room, causing the patient to spend most of his time indoors
• Thick keloid scar covering the entire body, with the most painful area warmer than surrounding skin
• Pain was so intense that it made life unbearable, but there were no suicidal thoughts
• Required daily injections of pethidine (100 mg) and dihydrocodeine (2 tablets every 4 hours)

Treatment:

• A trial course of infrared (IR) emitters was conducted daily for 36 days.

Results:

• Pain intensity decreased after the first session, though periodic flare-ups still occurred.
• Dihydrocodeine dose was reduced to every 6 hours, then to every 8 hours after 3 weeks.
• After 6 weeks, medication use was limited to once or twice per week, usually on rainy days.
• Pethidine injections were needed less frequently, with only a single dose required on day 44, after which no further injections were necessary for the next three months.
• Keloid scar thickness visibly reduced, and areas on the hands, cheeks, and back became less prominent.
• Dark keloid scars on the hands lightened, and redness on the painful side of the torso decreased.

Conclusion:

• The patient was extremely satisfied with the results and received two additional emitters for home use due to the large affected area.
• No side effects were observed.

This case demonstrated that infrared therapy can effectively reduce pain and keloid thickness, even when other treatments fail.