Systemic toxicity from topically applied salicylic acid.

Topically applied salicylic acid has enjoyed long and extensive usage as an agent to enhance desquamation in various hyperkeratotic skin diseases. In some of these disorders much of the skin surface may be affected, resulting in the potential for significant percutaneous absorption of the drug. We describe a patient who gradually developed evidence of severe salicylate toxicity while being treated with topical salicylic acid. Consequent on a recent letter in the BM71 this report serves as a reminder of a problem which, although recognised,2 may be unfamiliar to the current generation of dermatologists. It also shows strikingly the systemic absorption that may result from compounds applied to the skin.