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Potassium permanganate solution has antiseptic properties and is useful in managing infected eczema, particularly in children. Formerly dispensed as crystals, it is now more conveniently available as soluble tablets. Patients must be warned that potassium permanganate causes temporary brown staining to the skin and nails and can permanently stain clothing and ceramic basins or baths. Patients also need to be aware that incompletely dissolved crystals and tablets are irritants. This 18 month old boy had an infective exacerbation of his severe atopic eczema and was prescribed potassium permanganate as an antiseptic in the bath. One tablet is dissolved per 3.4 litres (6 pints) of water giving a 1 in 10/000 dilution. Unfortunately he sat on a non-dissolved tablet, resulting in this 1 cm diameter caustic burn to his right buttock. All paediatricians who prescribe potassium permanganate soaks should be aware of the risks and warn parents to make sure that the tablets/crystals are completely dissolved before use.
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