A very interesting traditional method in the treatment of skin lesions: aqua regia and related complications

Abstract

Background: Aqua regia, a highly corrosive mixture of concentrated nitric acid and hydrochloric acid, is used to dissolve various metals such as gold and platinum that are not soluble in other types of acids. For the first time in the literature, we report the adverse effects that were observed following the utilization of this strong acid solution in the treatment of various skin lesions.

Methods: Between 2010 and 2013, 43 patients (55.8 % female) with a mean age of 40.2 years, were admitted to our hospital for scars, wounds or malign lesions related to the use of aqua regia on skin lesions. Sixteen patients reported to use aqua regia for treating wounds and 27 of them used it for their scars.

Results: Out of 43 patients, 9 patients developed necrosis, 12 had hypertrophic scars, 15 had scars and 7 had non-healing wounds resembling malignant lesions. The non-healing wounds were located in the facial region in five patients, in the cervical region in one and on the finger-tip in another. Histopathological examination of these non-healing wounds revealed basal and squamous cell carcinoma. The patients were admitted to the plastic surgery department approximately 6-24 months after aqua regia application with complaints of growing lesions. Secondary healing in the lesions with scar development in 55 % of the patients is an acceptable result. However, 27 % of the patients with hypertrophic scars and 16 % of the patients with malignant lesions required intervention.

Conclusion: This present study showed that non-medical alternative treatments have major risks. Aqua regia application might have resulted in the development or rapid progression of malignant tumours in seven patients. In the literature, it has been reported that a number of physical traumas may cause skin cancer. Based on this information, the possibility of such an effect of aqua regia cannot be excluded.

Keywords: Aqua regia; Chemical burns; Non-medical treatments.

Fig. 1

Nasal basal cell carcinoma. a The lesion had been growing rapidly for the last 6 months, b intraoperative appearance: Tumour was infiltrated the nasal mucosa. c The defect was reconstructed with nasolabial flap. d Histopathological examination of the lesion (Hematoxylin-EosinX10)

Fig. 2

Fingertip squamous cell carcinoma. a Appearance of the lesion. b Surgical amputation was performed for bone invasion. c Histopathological examination of the lesion (Hematoxylin-EosinX10)

Fig. 3

Nasal basal cell carcinoma. a The lesion had been growing rapidly after application of aqua regia for 2 years. b Histopathological examination of the lesion (Hematoxylin-EosinX4)