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Is the Sweat Test Safe? Some Instances of Burns Received during Pilocarpine Iontophoresis

After iontophoresis, it was noticed that a child had a circular 'punched out' mark of about 2 mm diameter penetrating the skin to full thickness. A stitch was inserted to close up the wound and minimal scarring was visible at follow-up. The likely cause of the mark was explained to the parents who consulted a solicitor. The hospital received two letters enquiring about the accident, but there was no subsequent action and no compensation was requested. The child had eczema but not where the electrodes were placed (instructions state that iontophoresis must not be performed at the site of any skin lesion). Investigation showed that the most likely cause of this bum was contact between the metal electrode and the skin, probably due to it slipping from the calico sleeve when the child struggled. The remedy was to replace the electrodes with button type enclosed in sleeves with a 'button hole' opening away from the skin and to loop the wire from the electrodes under a crepe bandage to give some slack.