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Central palatal burns associated with the eating of microwaved pizzas
Burns 25 (1999) 465±466
Central palatal burns associated with the eating of microwaved pizzas O. Nahlieli a,*, E. Eliav a, Y. Shapira a, A.M. Baruchin b,c a
Maxillofacial Unit, Barzilai Medical Centre, 78306 Ashkelon, Israel Plastic Surgery Unit, Barzilai Medical Centre, 78306 Ashkelon, Israel c Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel b
Accepted 14 December 1998
Abstract Burns of the oral mucosa can be caused by heat, cold, radiation, electricity and mechanical or chemical stimuli. Acids, alkalis and salts can cause considerable damage to the oral mucosa, membranes and lips. Most damage is found in the oropharynx, besides the pharynx and tonsils, the alveolar mucosa of the tongue and the masticatory mucosa of the palate or gingiva show localized or diused damage. The clinical appearance depends on the severity of the tissue damage and the destructive properties and mode of application of the causative agent. We present an illustrative case of central palatal burn associated with the eating of microwaved pizzas and discuss similar mechanisms of injury. # 1999 Elsevier Science Ltd and ISBI. All rights reserved. Keywords: Burns; Microwave
1. Introduction Central palatal burns associated with the eating of microwaved pizzas are being seen more frequently. Similar burns were observed after a contact with the heated ®lling of jelly-®lled or cream-®lled pastry. These lesions usually appear as centrally located whitish gray or ulcerated lesions on the middle third of the hard palate. The patient is usually unaware of the cause of the lesion until a careful history is taken. The super®cial necrosis or ulceration results from a combination of the hot heat-holding cheese and the spices that comprise an otherwise desirable feature of this popular food (likewise, the glaze and the jelly in the ®lled pastry).
2. Case report A 40-year-old woman was seen in our outpatient * Corresponding author.
clinic for a painful burn in her palate which she developed few hours after eating a microwaved pizza. On examination a circumscribed reddish-brown blister measuring 2.5 1.5 cm with sloughing white lesion of the mucosa adjacent to it, was noted (Fig. 1). The patient was treated by the application of triamcinolone in Orabase and a bland diet. The burn healed within a week.
3. Discussion Mild thermal burns of the oral tissues arise from the accidental ingestion of hot foods or beverages [1]. These are usually of little consequence, since they are of relatively short duration and involve comparatively small areas. The anterior third of the tongue and the palate are common sites of burns caused by hot food and beverages. The microwave has been associated with an increased frequency of thermal-burns because of its ability to produce a food that is cool on the outside but extremely hot in the interior [1±3]. Perlman [4] presented a case of an adolescent who sustained a
0305-4179/99/$20.00+0.00 # 1999 Elsevier Science Ltd and ISBI. All rights reserved. PII: S 0 3 0 5 - 4 1 7 9 ( 9 8 ) 0 0 1 8 6 - 7
466
O. Nahlieli et al. / Burns 25 (1999) 465±466 Table 1 Microwave heating of ®lled pastry. After Maley [2] Item
Start temp (8C)
Time (s)
Filling (8C)
Pastry (8C)
Jelly-®lled Cream-®lled Roll w/jelly
238 238 238
30 30 30
968 878 1018
908 798 948
to transfer heat. The jelly (or cheese in our case) will transfer heat to the mucosa very rapidly while the pastry portion of the doughnut or pizza (heated to almost the same temperature) does not `feel' as hot. The temperature of the various parts of a jelly ®lled, cream®lled or pizzas can become very high in only a short period of time [4] (Table 1). The potential for burns, in relation to the use of the microwave oven is not strictly equal to that of the conventional stove or oven, however a risk does exist [5]. Dierential heating of food, especially frozen items may result in one area being very hot and another portion remaining cold or frozen. In case of ®lled pastry, the pastry while hot will not transfer heat to the oral tissues at the same rate as the glaze cheese or ®lling thus one is led to believe the item is not hot enough to cause a burn until it is too late. Fig. 1. Central palatal burn associated with the eating of a microwaved pizza. Zone of white epithelial necrosis, blister and erythema of the palate are noted.
burn after heating (in the microwave oven) a frozen jelly-®lled doughnut. The problem is related to the dierential heating which occurs when a frozen product is warmed in the microwave or is associated with the dierences in the ability of various substance and
References [1] Baruchin AM, Lustig PJ, Nahlieli O, Neder A. Burns of the oral mucosa 1991;19:95±6. [2] Maley HP. Burns from microwave ovens. Lancet 1986;1:1147±8. [3] Lynch MA. In: Burket's Oral Medicine, 7th ed. Philadelphia: Lippincott, 1977. p. 69. [4] Perlman A. Hazards of a microwave oven. New Eng J Med 1980;302:970. [5] Godwin Y. Egg on your face. Burns 1998;24:585±6.
Central palatal burns associated with the eating of microwaved pizzas O. Nahlieli a,*, E. Eliav a, Y. Shapira a, A.M. Baruchin b,c a
Maxillofacial Unit, Barzilai Medical Centre, 78306 Ashkelon, Israel Plastic Surgery Unit, Barzilai Medical Centre, 78306 Ashkelon, Israel c Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel b
Accepted 14 December 1998
Abstract Burns of the oral mucosa can be caused by heat, cold, radiation, electricity and mechanical or chemical stimuli. Acids, alkalis and salts can cause considerable damage to the oral mucosa, membranes and lips. Most damage is found in the oropharynx, besides the pharynx and tonsils, the alveolar mucosa of the tongue and the masticatory mucosa of the palate or gingiva show localized or diused damage. The clinical appearance depends on the severity of the tissue damage and the destructive properties and mode of application of the causative agent. We present an illustrative case of central palatal burn associated with the eating of microwaved pizzas and discuss similar mechanisms of injury. # 1999 Elsevier Science Ltd and ISBI. All rights reserved. Keywords: Burns; Microwave
1. Introduction Central palatal burns associated with the eating of microwaved pizzas are being seen more frequently. Similar burns were observed after a contact with the heated ®lling of jelly-®lled or cream-®lled pastry. These lesions usually appear as centrally located whitish gray or ulcerated lesions on the middle third of the hard palate. The patient is usually unaware of the cause of the lesion until a careful history is taken. The super®cial necrosis or ulceration results from a combination of the hot heat-holding cheese and the spices that comprise an otherwise desirable feature of this popular food (likewise, the glaze and the jelly in the ®lled pastry).
2. Case report A 40-year-old woman was seen in our outpatient * Corresponding author.
clinic for a painful burn in her palate which she developed few hours after eating a microwaved pizza. On examination a circumscribed reddish-brown blister measuring 2.5 1.5 cm with sloughing white lesion of the mucosa adjacent to it, was noted (Fig. 1). The patient was treated by the application of triamcinolone in Orabase and a bland diet. The burn healed within a week.
3. Discussion Mild thermal burns of the oral tissues arise from the accidental ingestion of hot foods or beverages [1]. These are usually of little consequence, since they are of relatively short duration and involve comparatively small areas. The anterior third of the tongue and the palate are common sites of burns caused by hot food and beverages. The microwave has been associated with an increased frequency of thermal-burns because of its ability to produce a food that is cool on the outside but extremely hot in the interior [1±3]. Perlman [4] presented a case of an adolescent who sustained a
0305-4179/99/$20.00+0.00 # 1999 Elsevier Science Ltd and ISBI. All rights reserved. PII: S 0 3 0 5 - 4 1 7 9 ( 9 8 ) 0 0 1 8 6 - 7
466
O. Nahlieli et al. / Burns 25 (1999) 465±466 Table 1 Microwave heating of ®lled pastry. After Maley [2] Item
Start temp (8C)
Time (s)
Filling (8C)
Pastry (8C)
Jelly-®lled Cream-®lled Roll w/jelly
238 238 238
30 30 30
968 878 1018
908 798 948
to transfer heat. The jelly (or cheese in our case) will transfer heat to the mucosa very rapidly while the pastry portion of the doughnut or pizza (heated to almost the same temperature) does not `feel' as hot. The temperature of the various parts of a jelly ®lled, cream®lled or pizzas can become very high in only a short period of time [4] (Table 1). The potential for burns, in relation to the use of the microwave oven is not strictly equal to that of the conventional stove or oven, however a risk does exist [5]. Dierential heating of food, especially frozen items may result in one area being very hot and another portion remaining cold or frozen. In case of ®lled pastry, the pastry while hot will not transfer heat to the oral tissues at the same rate as the glaze cheese or ®lling thus one is led to believe the item is not hot enough to cause a burn until it is too late. Fig. 1. Central palatal burn associated with the eating of a microwaved pizza. Zone of white epithelial necrosis, blister and erythema of the palate are noted.
burn after heating (in the microwave oven) a frozen jelly-®lled doughnut. The problem is related to the dierential heating which occurs when a frozen product is warmed in the microwave or is associated with the dierences in the ability of various substance and
References [1] Baruchin AM, Lustig PJ, Nahlieli O, Neder A. Burns of the oral mucosa 1991;19:95±6. [2] Maley HP. Burns from microwave ovens. Lancet 1986;1:1147±8. [3] Lynch MA. In: Burket's Oral Medicine, 7th ed. Philadelphia: Lippincott, 1977. p. 69. [4] Perlman A. Hazards of a microwave oven. New Eng J Med 1980;302:970. [5] Godwin Y. Egg on your face. Burns 1998;24:585±6.