This 30 day old baby girl was admitted to Pinderfields hospital with periumbilical ulceration and pigmentation. Clinically it was felt to be consistent with chemical burns. On further enquiries it was found that she had been treated with silver nitrate for umbilical granuloma by her GP.

There have been case reports documenting burns following silver nitrate application.¹ Studies by Kesaree et al have shown that salt crystals are very safe and cause 100% resolution of umbilical granuloma.² Until further studies are done to look for a safe alternative for silver nitrate, it would be wise to use a cautious approach while using silver nitrate.³