A recent TikTok “body cleanse” challenge encourages viewers to ingest a cleaning substance that can result in a characteristic “boiled lobster” rash (see image). What is that substance?
Sodium borate, boric acid, or Borax ingestion can lead to development of an intense generalized erythroderma with extensive desquamation. Other effects of boric acid toxicity include blue-green vomitus and diarrhea, nonspecific gastrointestinal symptoms, and in severe toxicity, seizures, cardiovascular collapse, and renal failure.
Litowitz TL, Klein-Schwartz W, Oderda GM, Schmitz BF. Clinical manifestations of toxicity in a series of 784 boric acid ingestions. Am J Emerg Med 1988; 6:209–213. Image: Derrick Lung & Cathleen Clancy (2009) “Boiled lobster” rash of acute boric acid toxicity, Clinical Toxicology, 47:5, 432, DOI: 10.1080/15563650902948859
Contributed by: Catherine Dong, MD