Nail care products are a common cause of accidental poisoning in children.¹ Such products accounted for 28 565 exposures reported to regional poison centers in the United States in 1996 with 77% involving children <6 years of age.² Minor effects were noted in 20% of exposures and moderate effects in 2%. There were 12 cases with major effects. Because only a fraction of all exposures are reported to poison centers, the true incidence of nail product poisoning is substantially higher.

Although enamels and polishes are relatively innocuous, the ingestion of enamel and polish removers may result in acetone intoxication³ and the ingestion of artificial nail glue removers (ie, glue solvents) containing acetonitrile and nitroethane may cause cyanide poisoning^4-8 and methemoglobinemia,⁹ respectively. Methemoglobinemia has also been reported after the ingestion of products used in the fabrication of artificial nails that contain n,n-dimethyl-p-toluidine.^10,11

We observed chemical burns of the airway, gastrointestinal tract, and skin in two children and one adult after exposure to three different brands of artificial nail primer. Methacrylic acid was implicated as the offending ingredient. To our knowledge, corrosive injury caused by artificial nail primers has not been previously described. Therefore, we wish to report our experience with such products and alert physicians to their potential toxicity. The products involved were supplied in bottles that had inadequate ingredient and toxicity information on their labels and lacked child-resistant caps. Poison prevention issues are discussed.

	CASE REPORTS

Case 1

A 21-month-old boy unintentionally ingested an estimated 3 to 5 mL of a product containing at least 98% methacrylic acid, with unspecified amounts of isobutyl methacrylate and methyl ester hydroquinone comprising the remaining fraction (No Lift Nails Primer, No Lift Nails, Inc, Costa Mesa, CA). Shortly thereafter, profuse drooling and gagging were noted. He vomited spontaneously and was in obvious distress on arrival . . . [Full Text of this Article]